BETTER BOSS Wolfgang Stehr, MD, MBA, talks with a more trusting staff at UCSF Benioff Children's Hospital in Oakland, Calif.

Surgical professionals who advance from the OR to the corner office typically learn about the business of surgery on the fly. That happened to me as I progressed from staff surgeon to medical director of perioperative services and division chief at my hospital. Real-world experience taught me a lot about case costing and running staff meetings, but here are a few ways I look at my profession differently now that I've added an MBA to my MD.

1Clear communication
Business school didn't teach me how to make better PowerPoint slides. It instilled in me the universal principles of communication: thinking about what message you want to convey, and how to tell the truth efficiently and clearly without blaming, judging or finger-pointing. That's done by turning the focus on yourself, by learning about what makes you tick before you can communicate better with others. It also involves listening to understand instead of preparing to reply while someone is speaking to you. Listen carefully to every member of your team, so you can clue into what they need in order to do a better job.

Learning about the universal principles of communication has improved the way I communicate in the OR when things don't go as expected. For example, when a needed instrument is missing, aggressive questions such as Didn't you read my preference card? or Can't you do your job? have been replaced with Is there a reason why the instrument is missing, and What can we do to ensure it doesn't happen again? The surgical team is held accountable, but the blame and shame reaction is gone. We thrive by working together as a team to solve problems.

I'll also spend a couple minutes with the staff before surgery begins, especially when members I've never worked with are in the room, to go over the key parts of the case, my preferred way of performing the procedure and the equipment I'll need. Surgeons often walk into the OR with a sense of entitlement, and don't try to connect with the surgical team. Taking a moment to create a collaborative environment beyond the surgical safety time out has an added impact on patient safety and ensures that the entire surgical team has a positive experience.

2Develop trust-based relationships
At business school, I took part in a workshop designed to improve trust-based communication. When I returned to work, I helped design similar training for the perioperative team. We had participants share what they most wanted their colleagues to know about them, what holds them back, their biggest career dreams and what they wanted to be remembered for at the hospital. It was amazing to see how impactful the exercise was, even for a small group. New and deep bonds were formed over the 2-day workshop between co-workers who had been working together for 20 years. The next time one of them had a problem, instead of firing off an angry email, they'd pick up the phone and ask how the other person was doing before calmly discussing the issue.

During the workshop, a recovery room nurse and an anesthesiologist got to know each other and developed a trust-based relationship. A week later, the nurse felt something wasn't quite right with a patient in recovery, and said she felt more comfortable picking up the phone to call the anesthesiologist. The anesthesiologist said he didn't hesitate to assess the patient instead of demanding the nurse "just follow his orders."

3Deep dives into data
I thought I knew a lot about the business side of surgery, but my MBA made me realize I never truly understood the details of top-line growth, bottom-line growth, profit margin, contribution margin — all of the concepts financially oriented professionals use every day. My graduate degree gave me the background needed to make more informed and second-level-thinking decisions.

I'm using that baseline knowledge to create more financial transparency in the OR, so we can make decisions about supplies and equipment based on hard data instead of emotions. For example, we used to stock surgical staplers that cost $10,000 per box and that expired every 6 months. Some surgeons balked at limiting the stock on the shelves, even though the staplers are used for very few specific cases that can be scheduled well in advance. We've shifted to ordering the devices on an as-needed basis and have saved thousands of dollars. Grad school trained me to think much more about those factors and to identify creative cost-saving solutions.

4Improved productivity
I'm more aware of managing my time wisely, because I juggled my career and schooling for more than a year. Better time management has taught me the importance of delegating some of my responsibilities, instead of trying to take on everything myself. Those trust-building workshops? I asked the hospital's new perioperative staff educator to handle putting the program together and she did a tremendous job. In the past, I would have been the one writing countless e-mails and placing phone calls to organize the event. Delegating work requires trust, and trust can be built intentionally. Thanks to my MBA, I'm evolving from individual contributor to force multiplier and supportive leader by empowering the people around me. OSM