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How Do You Know You're Ethical? 

by Francine R. Gaillour, MD, MBA, FACPE

Recent news accounts of how Enron and Health South executives viewed their participation in---or distance from---shady deals led to me ponder:  what kind of guidelines to most people apply to their behavior to know whether they are "in bounds" or "out of bounds?"  

What I find interesting in the case of many corporate scandals of late, is that the leaders in the spot light were either oblivious to corporate guidelines about ethical standards, or were aware of the breach of ethics, but met with no resistance.  It made me wonder what kind of conversations took place, REALLY, in the board rooms. 

We hear of memo's to the CEO after the fact, but what kind of EARLY conversations could have avoided the corporate debacles that cost people their livelihoods?  As a clinician or healthcare leader, what can YOU do to initiate a dialogue that will help your organization stay within the boundaries of ethical conduct, as you would define it?

Ask Yourself Four Questions

Here are four questions, adapted from Seattle Times columnist, Dale Turner, to ask when you are confronted with issues regarding personal or business behavior:

  1. If everyone did what I am doing, what kind of world would it be?  This is the test of universality.  Do only that which can be done by all. This can also be viewed in terms of sportsmanship:  One who plays fair wants no special concessions for himself that are not valid for all.

  2. Where is this likely to lead if I persist in this pattern of thought and conduct?  If we choose a particular road, we determine our destination.  Where will this path ultimately lead?

  3. Would I be willing for my conduct to be known by all?  Would I be comfortable in reading about my behavior in the local paper, or the Wall Street Journal, or viewing myself being questioned on national television?

  4. What would the person whom I admire most think of what I am doing? Would that person approve or disapprove? Ask yourself: "What would ______ do in this situation?

Clear the Junk

Separate from asking these four questions, it is worthwhile to spend time in quiet reflection---whether you call this prayer or meditation---to clear your mind of the "junk" and rationalizations that stand in the way of knowing with conviction what the right path truly is.  

Open Your Eyes

If you care about whether healthcare business is or remains ethical, I invite you to take the first step in improving the situation: Open your eyes. 

Look around you right now.  What do you see in your practice, in your organization, in your city and region?  What conduct and behavior are you ok with?  What do you feel good about? What are you truly proud of?  

Conversely, what conduct do you feel embarrassed about, or do you wish would not be taking place? Notice not only in your own practice or organization, but also your colleagues' practice or other organizations? What kinds of conduct is not in passing muster with the four questions above?

As you open your eyes and take notice, avoid self-censorship like "who am I to be critical or pass judgment." Just go through the 4 questions above and answer each honestly regarding the behavior or conduct you are evaluating.

The next step then in keeping healthcare ethical will be addressed in a future article:  How to initiate a dialogue about ethics so that colleagues participate.

Francine R. Gaillour, MD, MBA, FACPE is an executive coach and business consultant.  She is president of The Gaillour Group and director  of Creative Strategies in Physician Leadership.  Dr. Gaillour is a professional speaker on healthcare leadership, technology and cultural change.  

She can be reached at (888) 562-7289 or francine@physicianleadership.com


"The Mystery of Callings"

Dear Daring Doctors,

I invite you to read a wonderful speech delivered at the American College of Physician Executives Spring conference by Dr. Aldre Delbecq, titled "The Mystery of Callings."  A longtime instructor in Change and Innovation for the ACPE, Dr. Delbecq shares his professional journey and how his most rewarding work has been the result of following a calling, or responding to the unexpected invitation to contribute.  He provides some great insight for all of us on how to look at career development.  Here is  short excerpt and encourage you read the full text: 

"Careers unfold in wonderful and unanticipated ways allowing our gifts to be well used. But there is a condition: the flow is smooth only when we focus on service to others and forget ambition."  

Click here to read the full text


Francine R. Gaillour, MD, MBA, FACPE
15600 NE 8th Street, Suite B1-173
Bellevue, WA  98008
(206) 686-4205

Francine R. Gaillour, MD   2006 Ki Health, Inc.