5 Lessons From the ER That Will Save Your Company During a Crisis

This MD’s tips can help restore order and save your business during difficult times.


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Extolling the virtues of the humble routine may seem antithetical to the risk-taking entrepreneurs pride themselves on. But according to Dr. Angel Iscovich — Dr. I to his fans — our proclivity for the predictable is not just comfort food for the brain; it’s the foundation that might just save us in crisis moments.

Without a doubt, we humans are creatures of habit. We’re hard-wired to opt for safety and tend to create an established, daily routine at every life stage. This is what Dr. I, my co-author of The Art & Science of Routine, calls a “time bubble.” A time bubble is a mental barrier between the world and the individual, comprised of the activities we choose to occupy our days.

Dr. I contends that routine is a pathway to high performance. Whether it’s hitting the treadmill every day at 6:20 a.m. or clearing our desk once per quarter, it’s his belief we perform best when our lives possess consistency and structure. Likewise, repetition, the sister of routine, allows us to do everything from perfecting our elevator speech to keeping our cool in high-pressure situations.

Dr. I also knows quite a lot about maintaining balance in the midst of upheaval. The former emergency physician served as CEO of EmCare West, a multimillion-dollar emergency medical care organization for years. It turns out the business world isn’t so different from the ER. A certain level of structure and commitment can also keep companies from the brink –- whether this be hemorrhaging when stocks plunge or facing down bankruptcy. As smart business professionals, we really can prepare for the chaotic and unexpected (and no, that’s not an oxymoron).

Here are five insights I learned from Dr. I, the routine expert, to ensure your company thrives in times of uncertainty and crisis:

1. Insist on decorum and mutual respect.

In a study published by Clear Review, 40 percent of employees say they don’t feel appreciated. Civility, not to mention, kindness, may be cultural norms threatened in the social media era, yet according to Dr. I, such etiquette observances are critical in times of crisis. “We must focus on the mission and respect every one of the team members’ input at all times,” he says. “Yes, we may encounter momentary catastrophes, but our shared values and our mission are not momentary.”

Makes sense, right? When everyone is working toward the same goal, there’s a cohesive team mentality instead of rogue individualism. It’s interesting to note that when the brain is in the grips of fight or flight, we slip into survival mode and become super egocentric, incapable of compassion or empathy. Yet, according to Dr. I, you can calm everyone in the room and increase team spirit by speaking to the group instead of singling out individuals, keeping the bigger picture in mind instead of getting lost in detail.

Dr. I points to Starbucks CEO Kevin Johnson for proving the importance of civility during a 2018 incident that unleashed a viral media storm. At the time, two African American men were arrested at a Philadelphia Starbucks because the manager said they didn’t purchase beverages. When news of this event broke, it unleashed a torrent of public anger at the men’s mistreatment.

Acting quickly and decisively, Johnson employed Starbucks’ shared values of responsibility and accountability. Recognizing the need for mutual respect, he issued a public apology and created seminars to standardize practices for equitable treatment. “Approximately 8,000 of the employees had a complete day off to do a training on what was called the new third space policy,” Dr. I adds.

Side note: As of this writing, Starbucks’ stock has soared in the last three months and reached an all-time high close on July 26, 2019. Evidently, the company is doing something right under Johnson’s helm.

Related: 15 Ways to Lead With Effective Communication

2. Enforce a distinct and recognized chain of command.

“One voice must rise above the chatter to quickly deliver a targeted message in times of insanity,” says Dr. I. According to him, order is not a democracy when things go to hell. Having one uncontested leader is imperative, and if that leader is you, you must own it.

“One of the greatest errors is just to delegate to other executives,” he adds. “Problems exacerbate when leaders don’t say, ‘Hey, I’m in charge here. The buck stops with me.’” Dr. I acknowledges such authoritarianism may be unwelcome in less challenging times. Yet, it’s key to instilling stability when an individual — or organization — is under attack. Speaking of attack, a team may create more chaos with loud, impassioned opinions when only one (measured) voice should suffice.

To further underscore this point, Dr. I found copious studies in his book proving noise can overwhelm our physiology. Heightened stimulus may be great for a playoff game but can be fatal during a company crash, as it translates as stress in the body. “What I talk about is how the fight or flight response increases your adrenaline, your epinephrine, and doesn’t necessarily let you focus on the task at hand.”

Bottom line: keep your team focused on what needs to be done, mandate all voices, be restrained and predesignate a speaking hierarchy. This preemptive routine will ensure tasks are executed immediately and no time is lost on needless debate.  

3. Remain calm and mindful.

“We can prevent hysteria by focusing on the breath,” says Dr. I. “Stress increases blood pressure, leading to shorter breath lengths. These send panic signals to the body. It’s a vicious cycle that can spiral out quickly, putting us in survival mode and cutting off the prefrontal cortex, making good decisions impossible.”

Similar to the way cardiovascular exercise improves one’s ability to handle physiological stress, organizations can strengthen their “calm” muscles to keep the hive mind centered when danger threatens. Just as mindful, diaphragmatic (belly) breathing can be our best ally in crisis, so, too, can a self-prescribed response yank us back from flying off the handle.

Focusing on regular responsibilities and developing a crisis time bubble can also be beneficial to getting groups to the point where following coping mechanisms feels second nature. Why does this matter so much? When things get hectic, Dr. I says people tend to abandon what they’re doing and focus on the fire.

However, it’s best to stick with what you know. Following protocol allows the collective “brain” in the room to relax into familiarity, lowering blood pressure and reducing tension. To further mitigate stress’s deleterious impact, it’s helpful to identify stress points.

Knowledge is power, so it’s also helpful to pay attention when stress begins mounting, to take a moment away. “Excuse yourself,” advises Dr. I. “Gain some objectivity so you can address your colleagues in a calm fashion. This is particularly needed if you’re a leader, as it allows you to lead in a nonoverly emotional manner.”

Related: 50 Rules for Being a Great Leader

4. Don’t sweat the small stuff in times of crisis — or it might kill your company.

Dr. I recommends getting clear on the essence of an emergency. “Nothing else matters when you’re in the eye of the storm,” he says. “Nothing.”

So, how did his high-stress trauma unit deal with emergencies, keep their cool and their humanity? By committing to the concept of triage: handle the most urgent concerns, the core problem first.

As evidence of this, when leading one of his own companies, Dr. I experienced a bleeding of profits that led to a poor third quarter. Not too long after, it became evident his organization was heading to the danger zone. “To fight the crisis, we developed an operating procedure — a new routine. We established a war room and went to the heart of the situation, which in this case, was collections. You really have to focus on the core, the vital signs of a company, to keep it healthy when the inevitable calamity strikes.”

Along these lines, Dr. I recommends not wasting time considering down-the-road possibilities when your company is plummeting. After all, the red ant on the street may sting, but the bus you don’t see will kill you. Don’t get distracted by minor things.

5. Develop standard-ordering procedure (SOP) to keep the wolf from the door.

Fear comes from uncertainty. Yet as any good entrepreneur knows, you feel the fear and do it anyway. Still, there are ways to mitigate the unknown, including making a cultural choice to learn from and incorporate each crisis into an ongoing, company-wide standard operating procedure (SOP). “When we draw from precedent, we have a context to work from. By establishing routine, future events don’t feel so overwhelming,” says Dr. I.

Dr. I points to Marriott’s 2018 cyber breach, the second largest in history, as a teachable moment. “Marriott was proactive. They created a website providing credit monitoring and a call center to address consumer concerns. This digital trail is essentially a living SOP, a precedent that can be culled from in times of future crises.”

Further to this point, generating a set of best practices for facing a crisis, as well as hosting debriefs after the worst is over, can better arm organizations with coping strategies for uncertainty.

Routine as crisis panacea

Clearly, Dr. I recommends practicing routines and building time bubbles to stave off the exigencies of uncertainty. Even so, he allows for a degree of spontaneity to face the unknown. “Routine is important. However, even the best models don’t always work well and don’t fit all situations. If you’re trying to apply the same analysis, statistical or otherwise, to every danger, you are bound to find cracks in your paradigm. It’s best to have a solid game plan but also to prepare for multiple solutions and outcomes.”

Undoubtedly, structure is necessary when the world seems to fall apart. It helps us stay grounded and in control. Yet every crisis is different. The best we can ever do is to prepare now, to give ourselves — and our people — a protocol to best respond to life’s curve balls.


News Article Courtesy Of Michael Ashley »