In today’s healthcare environment, nearly half of all new physicians are salaried employees of a hospital or healthcare system. Now, more than ever, physician leadership is of paramount importance. With increasing pressure to increase care quality and simultaneously lower healthcare delivery cost, it is essential that physicians and administrators work together. Physicians must continue to grow into executive roles and lead both healthcare systems as well as manage other doctors and clinical staff.
By the very nature of the practice of medicine, all physicians are leaders. Doctors direct clinical care on the wards, in the ER, in the operating room and in the office. However, physicians must begin to embrace roles where they are directing activities in a boardroom as well. Current medical education certainly falls short in formal leadership training and needs critical improvements immediately. In 2010, Harvard Business Review addressed this very issue. Surgeon Atul Gawande is quoted as saying “most medicine is delivered by teams of people…yet we don’t train physicians how to lead teams or be team members. This [training] should begin in medical school”. Medical schools must begin to formalize leadership training and help to create more graduates who are not only skilled as physicians but are also skilled as physician executives.
In order to train emerging physician leaders, we must identify those characteristics that are most important to develop. Much has been written about leadership in business. I believe effective physician leaders have many skills and traits in common with executives that manage Fortune 500 companies. I believe we should focus on identifying and cultivating these characteristics in medical school and residency in order to produce the physician leaders of the future. Although my list is not all inclusive, I have chosen to highlight 4 points I feel are most important to leadership in medicine.
1. Integrity, Trust and Respect: In order to be effective at motivating and inspiring others, a physician leader must be respected by his or her peers.
2. Skillful Communication and Effective Conflict Management: Team members composed of physicians are traditionally used to being in charge and their voices heard. An effective physician leader is able to listen to others and assimilate ideas quickly. In order to maintain trust and respect of team members, the physician leader must be able to quickly resolve conflict among physicians, among administrators and among staff. The challenge is to resolve the conflict in a way that is equitable to all, in the best interest of the team at large and does not alienate team members with dissenting opinions.
3. Clear and Compelling Vision: The effective leader must understand the goals of the team and work to develop a path to success. The physician leader must see the “Big Picture” and be able to clearly communicate the goals and strategies to the team. In order to guide the team to the ultimate goal the leader must see a world without boundaries. Sometimes problems are best solved by thinking outside the norm and utilizing novel strategies to solve big problems.
4. Judgement and Accountability: A leader must be able to make decisions and live with the consequences of the choices that are made. Effective leaders accept personal responsibility for their actions and the actions of the team that works at their direction. This behavior helps to build a leader’s reputation of having integrity, trust and respect. Team members rally around leaders who do not “throw them under the bus”.
Medicine is in transition. Physicians must lead the way in order for the highest quality healthcare to be effectively delivered going forward. Physicians in training must learn to lead. We must prioritize the training of physician executives. Medical schools must develop formalized training in team building and students must learn to be both effective team members as well as team leaders. The great physician leader will make GOOD healthcare systems GREAT. As physicians, the fate of the US healthcare system is squarely in our hands. WE can choose to sit back and watch things develop around us or we can begin to LEAD the way today.