Undercover Boss: Arnold Relman MD – March 11 Chat

20PROF2-articleLargeBlog post by Lisa Fields

This summer a ninety year old gentleman fell down a flight of stairs and broke his neck. Right after his accident he was transported via taxi to the emergency department where the doctors and nurses worked tirelessly to save his life. It must have not taken long for the care team to learn that this was clearly a very informed patient as he shared, “I need to be intubated.”

This very critically injured patient turned out to be Arnold Relman, M.D, former editor of the @NEJM 1977-1991 and a senior physician of medicine, social medicine and emeritus at @harvardmed. You can read his story here.

Leaders gain powerful perspective when they choose to make the decision to come out of their office and walk, talk and really engage with those who work within their organization. Many, if not all, of our healthcare leaders within our community make a conscious effort to do this on a regular basis. CEO Leslee Thompson has written about her work in this area and what she has shared has led to solid results.

As a consultant, I often show a clip from the television show Undercover Boss to help illustrate the results that come when we make a distinct effort to view our work culture in a new and transparent way. While I keep making the “pitch” for senior leaders to take this bold step to be an undercover boss. I’ve never had anyone take this challenge. Although there are a variety of legitimate reasons why this might be challenging, I still hold that the results would clearly result in a new and valuable insight.

I believe in clearly an unfortunate way, Arnold Relman, MD became in a sense an undercover boss when he became a patient within both Massachusetts General Hospital and Spaulding Hospital. His narrative was transparent regarding both the care he received and the lessons he learned from healthcare leaders. As Gia Sison MD and Amy Berman RN have clearly demonstrated in previous #HCLDR tweetchats, when a healthcare leader becomes a patient many lessons are learned and our perspective is forever changed.

20JPPROF1-popupDr. Relman like in all Undercover Bosses episodes, experienced first hand what was working and what clearly was not within these institutions. Dr. Relman shared very specific feedback regarding his experience with Massachusetts General Hospital and Spaulding Rehabilitation Hospital. His frank assessment of both the hospitals and healthcare leaders once again reminds us that in today’s world all patients and caregivers have more platforms to share their experience. While HCAHPS is certainly an important tool to measure patients’ perspective regarding hospital care Facebook, Twitter, Blogs, Youtube, etc. also give us patient and caregiver information in real time.

Brian Stelter from the New York Times shared a terrific tweet today from Randi Zuckerberg, formerly marking at Facebook as she presented during the #SXSW Producers Session:

I hope the leadership within these two medical institutions will ensure that those who provided excellent patient care are recognized for their efforts. Too often only the bad news is shared and we forget to highlight and recognize those who provided excellent care. This piece also gives an opportunity for learning and growth.

Cleary healthcare has experienced tremendous change since Dr. Relman began his medical career. His assessment regarding the role technology has played for today’s physician was revealing:

Doctors now spend more time with their computers than at the bedside.

We’ve heard this unfortunate truth before but having it come first hand from such an experienced and respected medical leader was difficult.

One powerful lesson he learned was how important the role of good nursing care is for patients. Dr. Relman shared:

I had never before understood how much good nursing care contributes to patients’ safety and comfort, especially when they are very sick or disabled. This is a lesson all physicians and hospital administrators should learn. When nursing is not optimal, patient care is never good.

I’m looking forward to this Tuesday chat as we explore Dr. Relman’s work. I’m especially looking forward to our last question as we close this Tuesday: “What’s one thing you’ve learned tonight that you can take to your place of influence to help a patient tomorrow?”


  • T1: As Healthcare Leaders what do you consider the most important lesson Dr. Relman shared with us from his article?
  • T2: How might Healthcare Leaders take the lead to ensure we understand and appreciate the value of our Interdisciplinary peers.
  • T3: What do you think the benefits would be if our senor leaders took the challenge to be an undercover boss?
  • Closing Thought: What’s one thing you’ve learned tonight that you can take to your place of influence to help a patient tomorrow?


Arnold Relman “On Breaking One’s Neck, 2014” The New York Review of Books, New York, NY, (February 6, 2014). http://www.nybooks.com/articles/archives/2014/feb/06/on-breaking-ones-neck/, accessed on March 11. 2014

Harvard Catalyst Profiles
Arnold Seymour Relman, M.D. Professor of Medicine, Emeritus
Harvard Catalyst The Harvard Clinical and Translational Science Center,
Boston, Mass http://connects.catalyst.harvard.edu/Profiles/display/Person/78290 accessed on March 9, 2014.

Arnold Relman, “In Dire Health, 2012” The American Prospect, Washington, DC
(January 13, 2012). http://prospect.org/article/dire-health accessed on March 9, 2014.

Lawrence K. Altman, M.D., “A Patient’s Eye-View of Nurses. 2014” The New York Times, NY (February 10, 2014). http://well.blogs.nytimes.com/2014/02/10/a-patients-eye-view-of-nurses/?_php=true&_type=blogs&_r=0 accessed on March 9, 2014.

Abigail Zuger, MD, “A Drumbeat on Profit Takers, 2012.” The New York Times, NY.
(March 19, 2012). http://www.nytimes.com/2012/03/20/science/a-drumbeat-on-profit-takers.html?pagewanted=all accessed on March 9,2014.

Thomas Lin and Tony Cenicola Video “Profiles in Science” The New York Times, NY.
(March 19,2012) http://www.nytimes.com/2012/03/20/science/a-drumbeat-on-profit-takers.html?pagewanted=all accessed on March 9, 2014.

Chelsea Conaboy, “Dr. Arnold Relman on becoming a patient, 2014” Boston.com Boston, Ma (January 30, 2014) http://www.boston.com/lifestyle/health/blogs/white-coat-notes/2014/01/28/arnold-relman-becoming-the-patient/qNOh2uJDpLYkqyibGbRT2L/blog.html accessed on March 9, 2014.

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