The Pitt as Workplace Feedback Manual

Prestige Television shows us how it's done.

Photo by Natanael Melchor on Unsplash

If you’re newer to my work, I pretty much never write about pop cultural artifacts as texts for business practice, but as a comeback from a post-sabbatical publishing break, it feels right. Meanwhile, I’m working on more typical fare, including some extended thoughts on Economic Contraction coming to you soon.

Credit where credit is due: a client gave me this writing assignment. We’re both watching The Pitt, the Noah Wiley career reboot emergency room drama that has been accurately called “competence porn”. Client said “you need to write about how this show is a masterclass in workplace feedback”¹. Assignment accepted.

The Pitt is set in an overburdened Hospital Emergency Room in Pittsburgh. The show unfolds in real time over a full shift, hour by hour. It’s essentially a workplace drama, however within the stakes of an emergency room shambling along under the weight of the broken American healthcare system and crumbled social safety net. It’s a teaching hospital, and a new crop of students and interns have shown up to work for the first day. Noah Wiley plays Dr Robbie, the daytime attending on duty, aka, the guy in charge.

That this is a teaching hospital is critical: the field of medicine has codified structure for learning and advancing in the field. More experienced doctors routinely step aside and put the tools in the hands of the younger doctors, that’s the whole point.

My lil’ thesis is that the pressure cooker and actual real² urgency of emergency room as workplace removes a bunch of the gunk that can get in the way of effective feedback. If there’s a literal life in your collective hands, you’re going to tell the intern if they’re screwing up.

Spoiler Alert: I write about some specific scenes, though nothing too in depth.

3 things to do, lessons on Feedback Culture from The Pitt:

Give immediate feedback, in the moment

Look, the people in charge don’t even have time to pee! How are they going to remember and circle back to give feedback later? Pick any episode, there are dozens of examples of quick, in the moment feedback given on the spot. No waiting, no processing, or hemming and hawing on exactly how to give the feedback, instead, deliver and move on (because, well, people need medical attention!).

In remote workplaces, this is much harder. We’re often working asynchronously, and it can feel awkward and pokey to reach out to a teammate just to tell them they did something wrong. And so we let things slide until they’ve built up into a little frustration mountain.

Take it from The Pitt: small bits of feedback, continuously. All workplaces need to create structures for feedback to flow, remote workplaces need to be extra intentional on this front.

Make space to debrief the hard stuff

Dr Robbie insists that when the team loses a patient, they take a moment of silence to honor the patient and then debrief the sequence of events and treatment process. As he says, this creates “closure, meaning” for the team, and also an oppportunity to discuss what went well, and any misteps. Again, the man can’t even find time to pee, but is clear that this really matters³.

Another, workplace reality: a couple people roll their eyes during this ritual in an excellent reminder to do the meaningful stuff even if people are sometimes assholes about it.

If someone drops a scalpel on your foot, there should be consequences and being super mad is legit! (But don’t hold a grudge)

First year intern Santos drops a scalpel on attending surgeon Garcia’s foot mid procedure. This doesn’t just really fucking hurt, it also creates all sorts of downstream consequences of stiches, paperwork, and mandatory blood testing that I’m certain are extremely aggravating. Garcia sharply rebukes Santos and kicks her out of the procedure. She’s doesn’t hide that she’s mad, but she’s not directing any particular fusilade at Santos either, she just wants her out of the way.

Look: leaders get to be humans too. Yes, as leaders we should cultivate emotional regulation and the ability to step back instead of reacting— this comes up elsewhere in the show even. This isn’t because managers don’t get to have feelings though: it’s because delivering feedback calmly and kindly ups the chance that feedback will be received.

But we’re not robots. Sometimes people fuck up in ways that cause legit harm, and yelling “fuck!” is the honest, most direct and appropriate form of feedback. Or sometimes there is not legit harm, but your frustration leaks out.

The key though: Santos seemed pretty sure her career was tanked, instead Garcia shows good leadership by quickly circling back to ensure Santos knows she’s moved on and doesn’t hold a grudge. Within an hour, Garcia asks Santos to step in on a procedure.

On the other hand…2 things not to do:

“Shaming, belittling and insulting are [NOT] effective teaching tools”

Enough said.

“You just gave a speech titled, literally, how to bury your feelings”

From the first episode, concerned coworkers question whether Dr. Robbie should even be at work. This shift is the anniversary of his mentor’s death from Covid, and as the season unfolds we infer that Dr. Robbie is suffering from some semblance of unadressed grief and PTSD flashbacks from Covid. He’s at work anyway, all his feelings festering under the surface.

In one scene, Dr Robbie snaps and dresses down Dr Collins in an over-personalized totally inappropriate hissy fit. That it’s alluded they previously dated makes it all the worse. (Armchair diagnosis: because he feels out of control in the face of hospital bureaucracy and his ability to manage in the face of an untenable system, he instead attempts to assert control over a resident, maybe?).

I’ll state the obvious: leaders, we have to take care of ourselves. It’s not optional, because there are real consequences to being too tired, too grief stricken, too ____.

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I jotted down a bunch more examples (including some fantastic examples of receiving feedback well). If you’ve seen the show, would love to know what you’ve noticed: hit reply or let me know in the comments. Any other shows offer a masterclass in workplace culture?

Besides watching television, two favorite resources to learn and practice feedback:

Therese Huston’s Let’s Talk is hands down my favorite book on delivering feedback.

Lara Hogan wrote a helpful little book called Resilient Management and has great free worksheets on feedback equations and setting expectations.

1. If instead, you’re more interested in stunning model of workplace dysfunction, may I suggest The Bear?

2. In a time long ago in a land far away, I worked at a prestigious Midwestern art museum where we used to (sort of) joke “this is not an emergency room people!” Mostly directed at the curators who tended to show up to work cosplaying ER doctors. Which is to say, Emergency Rooms are the benchmark for actual urgency in workplaces, mostly the rest of us are just manufacturing urgent circumstances. While I don’t think treating your non-life-threatening work as ER urgent, I think modeling ER-level feedback is a great idea.

3. In emergency preparedness, this kind of post-action debrief is called a hot wash.