Using What You Already Know to Make the Transition From the Clinical Field to Healthcare Compliance

(This article was contributed to Corporate Compliance Insights by Tina Williamson, the Director of Corporate Compliance for Mississippi Children’s Home Services. Ms. Williamson can be contacted by email at tina.williamson@mchscares.org.)

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Cushy office? Check.

Bankers’ hours and no holidays and weekends (mostly)? Check.

A job that not only allows you to review a company’s policies, but actually do something about the ones that stink to high heaven? Check.

Yep, you’ve finally landed that dream job in corporate compliance. And while years and years of study, tuition bills that defy belief, and some serious candle-burning may have landed you the job, those things did not prep you for this role; nor did any MBA-level class on “Effective Management Strategies”, or any high-dollar management self-help seminar that focuses on the “Top Ten Qualities You Need to Adopt”, or books written by gurus who also happen to be the CEOs of the corporations our federal government is currently bailing out of bankruptcy.

Nope.

Most of your effectiveness as a compliance professional can be directly tied to the all those years of clinical experience you gained while working as a medical professional. However, you can’t reap the benefits of this experience until you learn how to channel your clinical experience in relevant ways into your new career in corporate compliance.

Making the transition from the clinical field to corporate compliance is not an easy one. Nevertheless, a compliance professional with a clinical background will find that the skills gained over the years “in the trenches” will serve them well, not only in gaining “street cred” with employees but also in developing a corporate compliance program that is easy to understand and effective.

I was once in your shoes. And my initial weeks of transition from the clinical field to corporate compliance wasn’t pretty, to say the least. However, once I understood and embraced the fact that my clinical years had prepped me with little “treasures in heaven” (quoting my first year of law school Torts’ Professor, Lee Hetherington) when it came to being an effective compliance director, my transition became a whole lot easier to bear.

Looking back, I can identify eight areas that really stand out as areas that helped boost me from compliance newbie to compliance extraordinaire (well, not really, but I’m working on it).

Feel free to take notes.

Time management skills

There is nothing that hones time management skills like showing up at 6:30 a.m. to find out that two therapists had called in during peak RSV and flu season, there was an influx of patients with pulmonary problems admitted to the hospital during the previous shift, and the few therapists left to hold down the fort were juggling therapy loads and mandatory training sessions during their eight hour shifts.

As a clinician, patients come first and everything else that can be fit in comes next. As a compliance director, I understand that if I’m going to make training mandatory for employees, I’d also better make it short, sweet, and to the point. Providing handouts for further reading is a must, and making my office available for follow-up to the harried clinician who was probably only half-listening to my presentation is a great way to clear up any questions that will pop up further on down the road.

Crisis management

Nothing screams panic mode like two simultaneous codes at opposite ends of the hospital. As a clinical supervisor, you pray that you can either clone yourself, or that two other supervisors will suddenly appear next to you—one to run the shift, the other to run the code that you’re not currently working. Since that would only happen in Never-Never Land, to prepare for the inevitable I’ve learned to ALWAYS stop and take stock of what is truly a crisis and attend to the most pressing needs first, and to surround myself with staff that either were as qualified as I am, or who actually have more experience.

As a clinician, you fondly refer to this as triage.

Use those same skills in order to rank compliance issues by importance. Tackle the big ones now. Work on the little ones as you go.

Keep that team mentality

I’ve heard of the Management Cap strategy: that you can only effectively manage those who have less experience than you do. As clinicians, we know that this is a load of bull thought up by people who are so insecure about their own abilities that they won’t hire someone who might steal their job. In a hospital, everyone on the medical team has something to contribute, and you work together to fix the issue. And if the team hits an issue they can’t figure out, they call in a person with expertise in that field to help them out.

As a compliance professional, keep this team mentality. You will want to be surrounded by people who know as much or more than you do about the issues at hand. They will keep you out of trouble, and can step in and help out when you’re swamped. I make it a practice to hire employees who have something to offer the company that I can’t. I don’t want an office full of mini-me’s running around. It would be rather redundant, and inefficient.

As a new person to the field of compliance, you will find that it’s all about having confidence in your ability to lead, and to tap into the resources of those that you supervise, as well as the resources in the various departments that will be affected by the decision in front of you. By doing so, you’re not showing weakness, you’re showing innovation and fostering a great relationship with your colleagues.

Don’t shy away from working odd hours

With a few exceptions, all new grads of clinical programs don’t have much choice about shift choice when they land that first job. My first job out of RT school was on the graveyard shift. As they told me when they hired me: Everyone paid their dues, and now it’s your turn. My nights turned into days, days into nights. Family and friends stopped going to the movies with me because I couldn’t stay conscious past the first few minutes of the film.

Yet I endured for two reasons: first of all, I had no choice. Second, patients don’t keep bankers’ hours. 24-7 means, well, 24-7. And it really, really aggravated me to have to hang around after a 12-hour shift to attend meetings for my department or required employee training sessions that were set according to the Director’s or the trainer’s day job schedule.

As a Director, while my normal office hours are 8-5 Monday through Friday, I still am prepared to go to that shift meeting at 11 pm or 6 am if there is a Compliance issue that needs to be addressed or a training session to be held . I would NEVER ask a staff member who just finished a 12-hour night shift to “hang around” until 9 am or, god forbid 11 am, for a routine meeting.

As a compliance professional, you need to accommodate employees’ schedules. All of them. Its common courtesy. And good business practice.

Focus on the issue, not the emotion

Oh, there were days that I wanted to vault across patients’ beds and pummel the sarcastic coworker rounding with me. Or respond to his/her pathetic attempt at humor with a remark that dropped me to their level. And, yes, I did stoop from time to time (to the remark, not the pummeling). With my Spanish heritage, before I became a health professional, I tended to go from calm to full-out fire-breather in six seconds. Ten years as an RT taught me to step back, let things go, and fight the battles worth fighting.

As a new compliance professional, you’re going to find that some people are just going to be difficult. They thrive on it. Sometimes they’re going to behave like third graders. Your job is to make sure that you don’t drop to the same level when you’re dealing with them. Someone in the room has to be the professional, and by getting personal it’s extremely easy to lose focus of the issue that needs to be addressed and get side-tracked by the petty stuff.

As the compliance professional, it’s your job to be the “impartial” party that keeps your company on the straight and narrow track. Employees, and unfortunately, other management staff, will try to use emotion to distract you from the real issue. When this happens, remember that you have the upper hand: in the hospital, you have been in situations that are truly life and death situations. This compliance stuff pales in comparison.

Seeing things from “the trenches”

I’ve been there. I’ve worked in hospitals that had policies and procedures that defied reasoning, not to mention every state and federal law in existence. Some were old policies that had been written back in the Stone Age. Others were written by MBA’s who, before they became hospital administrators, had such glamorous and relevant jobs on their resumes as “ice cream scooper at Baskin-Robbins” or “paper copier at Sikes law office.”

I still shudder with horror as I remember a former RT boss who lamented that he’d just received a call from the new CEO, who wanted to know “exactly what is this ventilator that you need for your department and what does it do?” (Disclaimer: before I get hate mail from CEO’s who don’t have direct clinical knowledge—understand that I’m probably not talking about you. Mind you, there are some really great CEO’s out there who have never held a clinical position. But they also oriented themselves to the hospital and patient service. They didn’t hide out in their offices and avoid getting dirty by getting to know their hospitals.)

Anyway, back to this point, I started my glorious career track as a secretary in an RT department, worked as a psych tech on night shift my first year of RT school, then as a CRT my second year in RT school, and as an RRT until I finished law school (you get the picture). If it can be done by an RRT, I’ve done it. And, I’ve been able to observe the other allied health disciplines on an intimate level by the virtue of the fact that RT’s are EVERYWHERE in the medical field.

How does this translate into effective skills in your new career? Because your years as a clinician gave you an incredible cross-education in the medical field, and a great understanding on how the different disciplines work together to achieve the common goal of patient care. Clinicians really do get an education by sheer virtue of the mobility of their patient care. If, like me, you took advantage of your time in the hospital to study the other disciplines and to learn their shop talk and the issues that they deal with on a daily basis, then USE it.

Use that experience to identify a policy that makes absolutely no sense in the real world or with current laws and regulations, and retire it into oblivion where it belongs. Be aware that sometimes policies look wonderful on paper, but in practice are totally useless and time-wasting. There are ways to be in compliance and provide excellent patient care. Never change a policy until you’ve asked the people who have to adhere to the policy what they think would work best for them, before just jumping in and making suggested revisions that only comply with the regulations, but are almost impossible to put into practice.

You will fail in at least one task your first year

Nothing taught me humility, and my limitations, like intubating a patient. I don’t know about you, but performing my first intubation in front of an audience of ER docs, RT students, nursing staff, and fellow RT’s in a code was the ultimate pressure moment for me. I thought my heart was going to stop. My hands were sweaty, I couldn’t hear anything for the sound of my pulse pounding in my ears, and to top it off, I couldn’t, for the life of me, visualize the vocal cords (an important first step in intubating any patient). After two attempts, I was ready to scream. Then the light bulb in the laryngoscope died, and I really started to fret. At that point, I realized that I needed to hand off this one to the more experienced RT on the code team. Did I want to? No. However, two minutes after I handed over the task, the patient was intubated and stabilized, I endured a little good-natured ribbing from the staff, and the world did not end because I wasn’t able to get the tube in.

As a new compliance professional, you’re going to get into situations where you have no idea what you’re doing, or you’re going to make a serious mistake that will keep you awake several nights, beating yourself silly. Trust me. So what do you do when that happens?

Realize that sometimes you’re going to fail, and you’re going to have to ask for a little help in your career. Hand it off to someone else so you can regroup and get your head clear.

As a clinician, you know that you may not always get the tube, or IV, or needle in each and every time. It doesn’t make you a lesser person when you have to ask for help in a project or when you fail. It just makes you human.

And when you do make a mistake, make sure that you have a plan to fix your mess BEFORE you confess to your CEO the error. And don’t delay in owning the mistake. Your honestly will pay off in spades later, as your effectiveness as a compliance professional hinges largely on your reputation, as well as your knowledge, in the field.

You can survive an audit

Oh man, did I dread those weeks in the hospital when JCAHO or OSHA was coming to visit. I always tried to figure out when they were going to be on-site, and then I put in my vacation requests for that entire time period. I was denied, of course, as my director saw right through me. And I am so very glad he did.

Now that I’m the person that an auditor targets when it’s review time, I am extremely grateful that my medical director made us all work together on those projects. The wealth of information that I picked up from hospital audit preparations are invaluable in my present position. And after years of being forced to do the same in your clinical work and throughout the hospital, you can most likely say that you could almost conduct an on-sight JCAHO inspection with your eyes closed.

Right?

So don’t panic when the agencies notify you they’re dropping by for a little look around. Just relax and realize that you’ve most likely already had a great grounding in audit prep in your clinical work. Build on this knowledge, and run with it.

I could go on and on about how to make the transition from the clinical to corporate compliance, but I won’t.

Instead, I will end here by giving you this bit of advice: you will have days as a corporate compliance professional that will make you wonder why you ever left the clinical field in the first place. You will feel like the skills you are learning will never have a marketable value outside of this field. You will have days that you are bored, that you are frustrated, and that you feel like you have no clue as to what you are doing.

Trust me on this one. You need to enjoy these days, and pay attention to all that is going on around you. Absorb everything. Volunteer for those extra projects that no one else wants, no matter how mundane or aggravating they seem to appear. One day you will find that that extra observation and work will pay off. And not only you, but your coworkers, hospital, employees, and the patients under their care will be better off because you started this path with clinical skills and that you learned how to integrate those skills into your new career as a compliance professional.

I guarantee it.

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Tina Williamson is the Director of Corporate Compliance for Mississippi Children’s Home Services. She earned her degrees in Psychology and Biblical Studies from Belhaven College, and her Doctor of Jurisprudence from Mississippi College School of Law. A former Registered Respiratory Therapist, Williamson has more than 16 years of experience in the health care, legal, and international criminal case management fields.

Tags: clinical experience, compliance training, Healthcare Compliance, Tina Williamson