Teamwork and The Bear
Author: Michelle Brooks, MD
Author’s note: this was written after I watched the first season of The Bear.
After the first episode of The Bear, FX’s/Hulu’s breakout TV “comedy” du jour, I wasn’t sure I was going to finish it. I grew up working in restaurants since I was 16, first at Papa John’s Pizza, then at a local sports bar (with elevated Louisiana cuisine, because restaurants in Louisiana do not survive without good food), and finally in a fine dining atmosphere prior to heading to medical school. I still have restaurant-themed nightmares about missing someone’s salad order or breaking a cork in a bottle of wine, and the depictions of restaurant culture in this show were enough to produce some nocturnal agita. The Bear’s story is so delicious that I ultimately devoured every morsel, and it confirmed for me what I already knew: that food service and the medicine aren’t as different as they seem. Success in either field requires individual skills, preparation, and attention to detail paired with competent leadership and guidance. Barriers and delays to success (whether inherent in the system, unplanned, or intentional) abound. Throw in a heaping tablespoon of system and supply chain issues and a dash of unexpected events into the environmental mixing bowl, and you have the recipe for a chaotic, stressful workplace.
Despite the chaos, the mission of both fields is ultimately altruistic, whether it’s to serve a mind-blowing menu or to provide safe, effective, and compassionate healthcare. (Side note: the second season of The Bear delivers this message by introducing a #WomanInMedicine, explicitly making this comparison). Both fields require a high capacity for organizational learning, especially when they fail to deliver excellence. Introducing any change to an organization can place strain on the system, especially if there is not an impetus to learn and grow. In The Bear, the chefs working at The Beef seem fine with churning out a menu with ok Italian sandwiches. The kitchen is (in their view) clean enough, and the sloppy prep work gets the job done. However, the new executive chef brings his own set of ideas (along with his knives and culinary institute training), and an external reviewer assigns them a “C” rating. Suddenly, what seemed to be working is just…not…working. It takes the whole season for most of the chefs to get behind the mission of upping their game. We do the same in healthcare – accepting mediocre. So what will it take to get us to excellence?
Effective Teamwork:
Role Definition: whether in the hierarchy of the French brigade or medicine, role definition allows team members to take ownership and responsibility both for their environment and their tasks.
Perks: delegation of tasks, ownership, autonomy, creativity
Pitfalls: watch out for toxic hierarchies
Adequate Preparation: cutting those onions quickly and accurately might seem like a menial task for a chef, but it’s a huge part of making the meal service run smoothly. Similarly, being able to organize tasks and data allows for effective delivery of healthcare. I really like this article on PRePPING your patients.
Perks: organization, ensure adequate resources, efficiency
Pitfalls: watch out for and coach team members who struggle with time management
Structured Communication: the closed loop communication of “4 sausage 2 mordatella all day” – “yes, chef, 4 sausage 2 mordatella” may seem redundant in the show, but it ensures that important information is not lost. In healthcare, this is especially needed at times of handoff. I’m a huge fan of the I-PASS technique for structured handoffs.
Perks: succinct, transparent, ensures fidelity
Pitfalls: watch out for team members who take shortcuts; limited opportunity for feedback in the moment
Psychological Safety/Conflict Management: one of my favorite scenes involved the sous chef giving the executive chef feedback that she didn’t feel like he listened. Conflict will always be there. Those who learn to fight fair and fail well with a mindset toward learning and growth will ultimately benefit from everyone’s creativity.
Perks: idea generation, feedback, reflection, capability to adapt, authenticity
Pitfalls: watch out for inauthentic listening, early dismissal of concepts
Feedback: whether the dish is tremendous or needs acid to be perfect, it’s important to give both positive and constructive feedback to team members. Leaders need this, too, and silence isn’t always golden – figure out how to elicit the feedback.
Perks: transparency, opportunity for learning, focus on growth
Pitfalls: balance it (like salt or acid in the dish). Too much constructive feedback at once can leave your team member feeling, well, salty.
While the season finale teased a complete overhaul of the restaurant, we often don’t have that option in healthcare. Leading effective teams to transformational change from within the organization is a logical next best step. Teamwork, organizational learning, and tackling barriers are all challenges in healthcare, but #WomenInMedicine are uniquely poised to overcome these challenges and make healthcare better.
Yes, Chef?
Oh and here’s a Jambalaya Pasta recipe. *Pro tip, measure the Cajun seasoning with your heart, not a teaspoon.
About the author: Dr. Brooks is the Deputy Associate Chief of Staff for Education at the South Texas Veterans Health Care System in San Antonio, Texas, and an adjoint Associate Professor at the University of Texas Health Science Center at San Antonio. She is also a Deputy Editor for Digital Media at the Journal of Hospital Medicine. Dr. Brooks is an award-winning clinician-educator with expertise on incorporating handheld technology and social media in medical education for residents and students. She has a background in quality improvement and patient safety and enjoys teaching quality and safety concepts broadly to interprofessional teams.
