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Experience in the Corporate World
October 5, 2005
Early one morning, while I was contemplating on shifting from clinical towards more administrative work, a patient from the Republic of Botswana (located in Southern Africa) came to the clinic dehydrated. He had cold clammy skin and was trembling. He has not eaten for two days. When asked why, he replied, “No appetite.” The senior medical officer asked me, “Do you still know how to insert an intravenous line?” I replied, “I do.” But the last time I did one was five years ago and that was at A-Up of the then University Hospital.
The patient was Black. It was difficult to see a vein in his hands and arms and he did not want a needle inserted into his skin. But I had to do my job. I established an intravenous line and started him on 500 cc of D5LR as fast drip with one liter of the same fluid to follow to run for eight hours. I endorsed the patient to the next physician on duty. I had to report for office work at eight in the morning.
At the office, I work on my laptop, check emails (and perhaps visit www.wvsumedaa.com for recent posts), and then spend the next eight hours in an air-conditioned room doing paperwork and talking to people. At five in the afternoon, off I go. It seems so simple but life in the corporate world is not at all simple. It takes a lot of patience, initiative, responsibility and a lot more.
My first experience in the corporate world was in a medical transcription company. I would begin the day assigning jobs to 25 transcriptionists (which later became 50, then 75, then 100…). After assigning jobs, all I will hear all over the workplace are the sounds of the keyboard and the foot pedal.
“The pedal is utilized to play the voice files using one’s foot so that both hands can concentrate on the keyboard. This is much like the same principle in driving a car. While the foot works on the gas and brake, the hands concentrate on the steering wheel.”
I was a doctor-on-call in the said company. When a transcriptionist is done with a file, he/she calls on me to edit the work. Editing entails lots of patience. A transcriptionist would type “excretory wheeze” instead of expiratory wheeze, “vowel sounds” instead of bowel sounds, and “cabbage” instead of CABG. This could give you a big headache especially when you are talking about 100 people under you.
When I applied for the managerial position of the company, I was asked during the interview if I know anything about management. I replied, “I have read the book Jesus, CEO: Using Ancient Wisdom for Visionary Leadership.” The interviewer was not impressed. It took me a lot of effort to convince him I was worth hiring. I was hired anyway. While the book I mentioned was not able to help me during the interview, it helped me a lot at work. Jesus is the best leader of all time. His leadership technique was based on the strengths of self-mastery, action and relationships. After all, he was able to effectively organize a group of twelve.
Now going back to having 100 people under your supervision, there is no way you can edit all their work. You should realize this while you still have few people under you. So the best way to act in this situation is to be pro-active and not reactive. That is how effective management works. When I started handling 25 medical transcriptionists, I already trained editors from them. So when the group grew to 100, the original 25 were already trained editors handling three transcriptionists each. And all I had to do was to make sure that at the end of the day all files are uploaded via FTP site so everybody can go home.
Presently, I am connected with a multinational healthcare company for a clinical trial project. The same leadership and management skills apply in this situation. And communication skills play a very important role because I meet people from around the globe. Once, a doctor from the Republic of Croatia (situated between Central Europe and the Mediterranean) came. He was a consultant of the company. It is quite difficult to start a conversation with a professional who is very well known in his field and who you have just met. So I just asked him, “Do you know Toni Kukoc who played for the Chicago Bulls?” He replied, “Yes, we live in the same neighborhood.” And our conversation went on smoothly. The key in starting a conversation is establishing a common ground.
Recently, two French doctors (one male and one female), who are the medical directors of our office in Paris, came here to see how we conduct clinical trials. I brought them to the hospitals where we do the trials. At one government hospital, we passed by a third degree burn patient. The female doctor asked, “Are you not superstitious here?” I replied, “Sometimes, why?” She answered, “That patient was in ward 13.”
I told them most Filipinos are Catholics. So are the French according to them. But they were surprised to see that Holy Mass was celebrated in the middle of a mall during one Sunday. They attended anyway.
I brought them to the radiology department of one hospital. I showed the x-ray of one of the cervical cancer study patients who underwent brachytherapy. “The radiation oncologist was able to insert 10 vaginal packs in this patient,” I told them, “after the procedure, he was able to remove 11 vaginal packs!” The female doctor remarked, “You’re funny!”
“Brachytherapy is a type of radiotherapy for cancer where the radioactive source is placed in the tumor itself giving a high radiation dose to the tumor while reducing the radiation exposure to the surrounding normal tissues. In cervical cancer, vaginal packs are used to protect the bladder and rectum.”
While it was not hard talking to the two French guests, I found it difficult deciding where to take them to eat. We had buffet breakfast at one of the hotels. The guy just ate bread and butter. The lady had oatmeal, which she called “baby food.” So the next day, I brought them to a restaurant that has French toast in the menu. The guy enjoyed his toast. The lady still ordered “baby food.”
I ordered a fresh fruit platter for them. “What’s that?” the lady asked pointing at one of the fruits. “That’s papaya,” I replied. “How about that?” she further asked. “That’s melon,” I answered, “they are good laxatives. Would you want another plate?” She replied, “You’re really funny!”
It is advisable to know a little of the cultural background of the people you meet especially in a multinational company. One time I was talking to our Thai clinical research associate who visited the country and it was only then that I found out that 95% of them are Buddhists. Knowing a background of the person you are meeting can help achieve an effective conversation.
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The author with two doctors from France.
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Presentation skills also play a significant role in the corporate world especially in meetings, trainings and lectures. Microsoft Powerpoint will be a very useful tool. I usually start a presentation with a slide that would attract the attention of the audience right away. When I gave a lecture on chronic renal failure, the first slide showed an image of Alonzo Mourning of the Miami Heat who underwent a kidney transplant. My presentation on cervical cancer revealed a picture of Brooke Shields who endured a secret battle with the disease in the mid-90s. And when the topic was breast cancer, I just began by saying, “This is the normal breast,” and I showed a picture of one. Now that you have the attention of your audience, it is very easy to proceed with your presentation.
While you concentrate on leadership, management, communication and presentation skills in the corporate world, it is very hard to completely forget about clinical skills, which are called for from time to time. After all, that is what doctors are trained for. And although I concentrate nowadays on just the documentation of patient data, I still have to do clinical correlation.
We give chemotherapy to cancer patients in our clinical trial project. Documentation of patient demographics, schedules of chemotherapy and doses of drugs is easy. Clinical correlation of the effects of the drugs and laboratory data is a different story.
“Chemotherapeutic drugs cause myelosuppression. So, laboratory data of post-chemotherapy patients would show anemia, neutropenia and thrombocytopenia. And the nadir (lowest point) is expected on Day 10-14.”
One of our European consultants asked me, “Why do you have to take the laboratory tests on Day 10-14 when you already know it will show anemia, neutropenia and thrombocytopenia?”
I replied, “We have a high incidence of both community and hospital acquired infections here in the Philippines. So when the ANC (Actual Neutrophil Count) of the patient goes below 500, we just have to administer G-CSF (Granulocyte–Colony Stimulating Factor) and give oral prophylactic antibiotics.”
I review several laboratory results of post-chemotherapy patients. I go over the levels of hemoglobin, neutrophils and platelets just in passing because they will be low anyway. I concentrate more if there are monocytes because these will indicate that the bone marrow is responding and the patient is recovering. That is clinical correlation.
In this modern age of technology, the trend at work is multi-tasking so you just have to learn all the skills you can. While you need leadership, management, communication, and presentation skills in order to survive in the corporate world, you will still be able to apply these skills in whatever situation in life you may be. And the clinical skills you have developed in time are still very useful from time to time. After all, life (and work) is all about survival of the fittest. And the fittest are the multi-skilled.
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Views expressed on this column and any other by-lined articles on this site are the authors' own and do not necessarily reflect the views of the organization or its members.
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