The Burden of Clinical X-ray Vision

2019 has been a year of reflection.  I woke up this morning thinking about x-ray vision.  It's not exactly what you might think. A little over a year ago, as the CEO of a organization that oversaw a nearly billion dollar nursing home operation, I chose to walk away.  The main reason was that I had clinical x-ray vision.

One can only imagine what it would be like to have x-ray vision.  While at first it would seem cool, there's a significant burden that comes along with being able to see what no one else can.  There's the rub.  If you have x-ray vision, you can see behind walls, you can see behind the curtain, you know answers to things that others can only surmise.  There are different levels of business acumen that apply to this concept.  Some people have financial acumen that allows them to look at numbers and see answers that others can't see.  I have always had an uncanny knack of being able to look at a profit & loss statement and see underlying trends and problems that took others hours of analysis to see.  Some people have operational acumen that gives them the ability to look at workflow and know how things will turn out operationally.  The best managers combine these two skills to create financially effective operations.  It also helps to be a good leader under these circumstances, because, if you have x-ray financial and operational vision, you must be able to translate that acumen to others.

Some leaders will help other see what they can see.  Other leaders just tell others what they can see.  Both methods work, but can have a widely varying impact on morale.  In some ways, it's the difference between a benevolent and malevolent dictators.

I strongly believe that many leaders in healthcare industry are glad not to have clinical expertise and clinical x-ray vision.  This provides them with plausible deniability.  On the other hand, not all physicians have good clinical instincts, and not all physician leaders are able to translate financial and operational decisions to their clinical impact.

I was in a position where I knew the potential clinical impact of operational and financial decisions.  I shared my knowledge with the powers that be, and they chose not to respect my insight.  Ethics demanded that I leave.  At the end of the day, clinical x-ray vision is not a burden, it's a gift.  And I'm fortunate to have that gift.  I'll always be ready and willing to use it!