One of the things I felt I was great at as a director was figuring out what was best for the organization overall from my department. In other words, though I wanted accuracy, if I had to weigh perfection against bringing in consistently high dollars I went for the consistency. In my opinion, it was worth writing off one bad account that was causing nothing but grief as long as I maximized every other area.

That also worked with procedures that impacted employees. I would discuss something with the supervisors, then we'd get the employees together to roll it out and get their thoughts on it. There would almost always be at least one employee who saw things a different way, but if it wasn't an overly compelling reason not to do something they we went ahead and did it. Lucky for me those decisions never failed us, probably because we got as much input from everyone as we could.

Having said that, though, there are times when one has to listen to the lone voice, or at least consider it, because they might bring a unique perspective to the situation. For instance, I was at a big meeting at another hospital many years ago when the subject of emergency room admissions came up. One of the people representing the department stated that during the admissions process they never asked anyone what their race was. Instead, they'd look at the person and make the determination what it was and put that down on the form.

I just couldn't have that, and I openly objected. I stated that there's no way a person can tell by looking at someone else what that person decides they are. Many people can't tell the difference between a Native American and a Hispanic person. I've had Middle Eastern friends tell me that they'll have people start speaking Spanish to them, then get mad when they don't know the language until they tell them where they're from. After about 20 minutes they understood my point of view, and then we discussed how the subject should be broached, since it was a statistic the state required at the time.

There's also those lone voices that might think of something that no one else has, or is at least willing to state the case. I remember a meeting where we'd come up with a tracking system for one process we hoped would help us be more efficient. The supervisors loved it, and most of the employees loved it. But one employee finally said that it wouldn't work because there were two extra processes that would have to be done first before getting there. No one had thought to test that out first, so we went to see if she was correct and she was. When I asked the other folks why they hadn't said anything, because a few more knew it wouldn't work, they said we seemed so enthusiastic about it that they figured they'd just give it a try.

Sometimes those single voices of dissension are right on the money. It can be difficult trying to figure out when they are and when they're off track. The best thing anyone can do is to listen to everybody, no matter how strange the idea might seem, then use your best judgment to make the proper decision.