Is it possible to create an outstanding organizational culture in what is often a hellhole of anguished patients, staff dissatisfaction, and high physician turnover? Emergency Medicine, with its high stress, high stakes, and ever-diminishing autonomy, has been a burnout zone for decades. Except—for almost thirty years there’s been an Emergency Medicine oasis in the Twin Cities. (Maybe it’s the wrong latitude for an “oasis” metaphor—perhaps an idyllic ice-fishing camp?) Anyway, Emergency Care Consultants (ECC) has consistently achieved excellent patient care, superb hospital relationships, high engagement, innovation, growth and nearly non-existent physician turnover.
What’s the deal?
Dr. Christopher Obetz, CEO, gets specific about what’s worked in ECC. Key organizing principles are physician ownership, physician decision-making, extensive participation in hospital and health system roles, support for splendid work lives, and of course, patient care at the center of everything.
ECC Values:

1. Provide outstanding emergency care—and make sure decisions don’t harm or detract from patient care. “It helps all of us keep our eyes on what’s most important, which is patient care. And that’s inarguable.”
2. Focus on hospital and health system relationships. “We hope to be irreplaceable.”
3. Focus on “us”—by minimizing overwork (no “crispy” doctors), and assuring plenty of family time, good pay, support for the physicians’ passions and aspirations, and flexible work hours, a.k.a. Shift Nirvana. Excuse me, what’s that you say? Shift Nirvana? Why?? See Value #1.
In This Episode:
[2:10] First things first: physician leadership
[11:46] Orienting EM physicians to their new ownership and problem-solving capacity
[34:33] Shift Nirvana means: “Our payroll specialists hate me because it’s like putting together a piece jigsaw puzzle instead of a 100 piece jigsaw puzzle.”
[28:53] How taking excellent care of the physician career translates to excellent care of the patient
[29:42] Dr. Obetz’ personal philosophy on what constitutes excellent patient care has changed since he was a young whippersnapper
[30:39] Symbiotic hospital relationships; ECC’s reputation as problem solvers
[38:12] An inverse correlation between expertise and certainty
[41:54] Pain in triplicate: COVID, the George Floyd murder, and an unexpected hospital closure
Key Takeaways:
Physician leadership and exquisite attention to career translates to all kinds of good stuff, especially excellent patient care
The Emergency Department as the nerve center of the hospital
A symbiotic “partnership” relationship with hospital leadership: a key to growth
Shift Nirvana must be dynamic as physicians’ careers and home lives change
A triad of pain in 2020: coronavirus, the George Floyd murder, a hospital closure
Meet Christopher Obetz, MD:
Dr. Christopher Obetz, an emergency medicine physician, is the President and CEO of Emergency Care Consultants (ECC) in Minneapolis, Minnesota. ECC is a “physician-owned, independent, and democratic” organization responsible for both outstanding emergency care and outstanding emergency medicine careers in ten hospitals in the Twin Cities area. Dr. Obetz has been leading ECC for the last decade, a period marked by significant organizational growth.
The organization is known for its consistent high quality care and service, excellent business outcomes and sustained high satisfaction among physicians and staff. Innovation is fueled by ECC’s high physician involvement model and purposeful collaboration with all stakeholders. One such innovation is the comprehensive scribe program implemented early in the era of electronic medical records.
(known as Topher by family, friends and colleagues)
Resources:
Emergency Care Consultants: https://www.eccemergency.com/
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