August 5, 2026 Salus Health Care Forum

Jeremy

Yes, I think it fits into co-regulation. That’s what made me think about this. Yeah, I really appreciate that, Jack, because I think as you’re pointing out, delegation is one of the more challenging lifelong skills. Anyone who wants to consider themselves in a master class has learned it’s very, very challenging because it requires actually really knowing that other person pretty well, as you’re pointing out. You need to know their strengths and weaknesses. And then there’s a discomfort that happens in that delegation, which can feel like abandonment, even if it’s not intended to be that way. Or it can feel like micromanagement. If that’s the most common thing I see is leaders who micromanage because of anxiety that they’re not going to do it right.

And so they don’t actually ever fully delegate to anybody, anything. And it reminds me of running codes.  If you’re running the code and trying to put the central line in and intubate the person and jolt them, you’re doing all the stuff. You’re doing a terrible job of leading the code.

And so I often use the metaphor for our chief residents of like, you’re now running the residency executive functions of all the residents. And that means you’re not going to do everything. You have to learn how to help other people take things over. I agree with you, Jack. I often find that people are thrilled to have stuff asked of them if they get the right support.

Jack

Your code example, I wrote something else down. And when I became an attending, and as I started working through, I whistle during stressful hospital cores, traumas, and I will whistle in the ER as a way to self and co-regulate the whole team. And I’ve only been challenged once on it. A nurse was like, how can you be so calm? Because I’m trying to provide calm to the group. So I have taken up this sort of this routine of when I walk into the ER in a trauma, I will be whistling something to help bring the tone down, for I’m not going to intubate this person. I want the person who’s intubating them to not be like, oh my God. I want them to be a little calm.

Bill B

Mark, I think that relates to what you were talking about last time about introducing music into the room and not just for the patient. I think you were saying eventually it’s for everyone in the room. This comes back to the notion of the ideational train. What does it mean that you suddenly have music rather than fears hoping on the train?

Mark

That makes sense. But it was always patient focused and the patient’s choice. And over time, I got a sense of what everybody worked best with. But that was a process that was engaged for many years.