What Can Physicians and Their Teams Learn from Bill Belichick’s “Do Your Job” Approach?

As we are deep in the middle of the season, it’s time for a football-themed blog.  As a Pittsburgh Steelers fan, it pains me but I’m going to say nice things about Bill Belichick of the New England Patriots – perhaps the greatest NFL coach of all time.

Belichick is noted for his no-nonsense “do your job” approach to coaching.  Many people don’t realize that “do your job” is not a stand-alone, simplistic coaching philosophy.  It’s the final instruction and reminder after a lot of work teaching, developing talent, creating a culture of trust and team cognition, and where the team comes before the individual.

See our previous blog on the concept of “team”:  A High-Performance Culture Based on Teams – NOT Programs! Eight Steps

Team Dynamics and Organizational Performance

I had to explain this recently to a physician.  His organization was struggling with performance issues in the OR.  Group communication was not ideal.  Staff retention and engagement were low.  The physicians and nurses were not on the same page and there was growing animosity.  Physician engagement scores were down.  There had been critical patient safety issues and too many communication and safety-related process errors.

We were asked to analyze the situation and recommend interventions to get things pointed in the right direction.  First, we helped the group to identify specific operational and process issues. With the right guidance, structure, and expertise, operational/process issues lend themselves to solutions that are not all that complex. 

The real challenge are the “cultural/group” issue that prevent the effective deployment of those solutions.  Process solutions and communication tools don’t work if the people deploying them don’t have the requisite communication and team skills. 

Process solutions and communication tools don’t work if the people deploying them don’t have the requisite communication and team skills. 

These groups tell the story of a deteriorating culture that lacks open communication, trust and psychological safety.  Often there is a negative social climate where the group fails to learn from mistakes, in spite of adopting communication tools.  A punitive, power-driven climate hinders care and makes it hard for people to feel valued or appreciate the value of their work.

We undertake a frank discussion and it becomes clear that they don’t understand what it takes to build an effective team. Generally, the group has NEVER had a discussion about how you turn a group of individuals into a team.  Other industries get this concept.  Successful football coaches get it. 

All would be great if everyone would just "do their job!"

Invariably someone in the room expresses skepticism about all of this “team stuff” and states that if everyone would just “do their job”things would be fine (sometimes they even quote Coach Belichick!).

What this person doesn’t understand:

Healthcare has unique team challenges:

• Team members have different training and points of view

• Teams are often forming/reforming – sometimes the “team” is different for every case!

• These people are working in a complex, high pressure environment.

• There is often a lack of role clarity.

• Healthcare organizations have historically been built not on integration but on silos.

• There is a culture not of psychological safety, but of the “need to be right.”

• We rarely do any training on fundamental communication techniques.

Meanwhile, what we know is that the best teams are built on:

• Dependability

• Structure and role clarity

• Shared understanding of the meaning and impact of the work, and

• Psychological safety

Team members need to know they are making valuable contributions, that they share a clear sense of purpose, and that their teammates have their back and will do their job.  The physician who constantly scolds anyone who makes a mistake and does nothing to develop them, or just complains that people should “do their job” -simply doesn’t understand the psychology of teams or his or her important role in BUILDING an effective team that will help him/her and the patient.

"Do your job" is not that simple...

Bill Belichick demands that his players “do their job” after teaching techniques so that players can excel, after establishing a clear plan and expectations.   Individual players have developed a deep trust of their coaches and teammates. 

Watch a Patriots defense and you’ll see that they’ve created “team cognition” at a high level.  Everyone knows how the teammate next to them will respond to any situation.  They are thinking with one brain.  It allows them to react quickly and effectively and to learn from mistakes.

None of this happens by accident and it, certainly, doesn’t start with the admonishment to “do your job.” If organizations care about performance, and appreciate the value of teams, team performance can be improved with a structured, deliberate approach.

None of this happens by accident and it, certainly, doesn’t start with the admonishment to “do your job.”

At J3P, this means identifying the process issues and ensuring there is a structure in place to resolve them. Then we attack the cultural/group issues, by breaking them down, and deploying targeted group and individual developmental strategies to resolve the specific operational challenges.

Want a basketball-focused discussion about team concepts?  See our blog applying some of Phil Jackson’s coaching philosophies to leading in healthcare.