Reflecting on Graduation Season

By Justin Kreuter • June 12, 2017

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It’s graduation season. I’ve noticed stores lined with “books for the new grad” as well as various wisdom-imparting graduation speeches being shared on social media. Although I have listened to a few of these speeches, during my workouts, I have been listening to Extreme Ownership: How U.S. Navy Seals Lead and Win, by Jocko Willink and Leif Babin. With their Navy Seal war and business stories fresh in my mind, I went to our Medical Laboratory Scientist (MLS) graduation.

These complementary topics, new graduates, and leadership lessons set me up for an impactful graduation experience.

Reflecting on my effectiveness as a medical director, I was asking myself: How do I take ownership? How effective am I at strategic planning?

Ultimately, am I an effective or ineffective leader? With my thoughts running laps in my mind, new graduate Kate McKeown’s question tripped me up. “Why do we have to learn this?” Ms. McKeown began her greeting on behalf of her graduating MLS class with this question. Why do we have to learn this?

My line of self-questioning had been focused on my leadership role as a medical director, whereas Ms. McKeown’s question pulled me to consider the impact that my leadership behaviors are or are not having in my laboratory. What does my team understand? Willink and Babin talk extensively about the importance of teamwork, keeping plans simple, prioritizing issues, and empowering junior members of the team. None of these happen if the team doesn’t understand. Any team needs to be able to answer, "Why do we have to?" Ms. McKeown answered on behalf of her graduating class, “We have to learn this because these tests are critical for patient care. This information is needed each day.”

Michael Silber, M.B., Ch.B., Dean of the Mayo Clinic School of Health Sciences, spoke next from his experience as a neurologist. He echoed Ms. McKeown’s points about laboratory medicine as a critical component of state-of-the-art medicine. He elaborated on the awesome responsibility shouldered by laboratorians.

He said, “I accept your results as the results.”

Laboratory medicine is a complex aspect of medicine that requires specialists. We are trusted to be experts in the tests that we run and apply that expertise throughout our work. According to Willink and Babin, this sometimes means that we need to use influence, experience, knowledge, communication, and professionalism to make senior leadership aware of the situation. This lesson is certainly in my mind every time I call a physician to discuss orders for inappropriate blood products or coagulation testing.

Bobbi Pritt, M.D., Medical Director of the Medical Laboratory Science Program, spoke third. She emphasized communication. Despite the stereotype, we are not alone in some "dark basement" of laboratories. We have medical laboratory scientist colleagues, collaborative laboratory directors, and available physicians for discussion of clinical concerns. I received similar advice when I came on staff at Mayo Clinic, and it has paid off in spades! Listening to Extreme Ownership, I’m thinking about taking collaboration one step further. When is the last time that I debriefed with my staff? I would like to start proactively asking my team about lessons learned.

Sue Lehman, Program Director of the Medical Laboratory Science Program, anchored the speeches on this graduation day.

She spoke passionately, reminding the new graduates that, “offering no result is better than providing inaccurate results.”

This quote highlights laboratory medicine as the first and last line of defense for patient safety. Think implications of pre-analytic, analytic, and post-analytic error. The lesson here from Willink and Babin is situational awareness. Continually check what is coming in, how things are running, and question the plan against emerging information to ensure it still fits the situation. A recent post-analytic error brings this lesson home for me. Do you know how your results are being used in patient care? How do you maintain situational awareness in your laboratory and practice?

I always make it a point to attend our Medical Laboratory Scientist graduation; however, this year was particularly impactful. Excellent speakers (especially Ms. McKeown) and concurrent reading made for a great combination. Please share your comments below or on social media via the hashtag #CanISeeMeNow or mention me @KreuterMD.

Justin Kreuter

Justin Kreuter, M.D., is a clinical pathologist at Mayo Clinic in Rochester, Minnesota. His practice consists of both general and subspecialty aspects of clinical pathology. At Federal Medical Center-Rochester, Dr. Kreuter runs the general laboratory that supports a local in-patient population and does a large amount of reference work. At Mayo Clinic, Dr. Kreuter's time is split between the transfusion medicine service and transplant laboratory. In addition to clinical activities, his academic interests include several aspects of medical education, including teaching clinical judgment, frameworks for feedback, and reflection in medical practice.