A search for leadership books on Amazon offers over 86,000 results, and there are as many definitions of leadership as there are people who write about it. However, most experts would agree that leadership occurs in groups striving to achieve a common goal or set of goals. A leader must have followers, and must influence those followers to act in the interest of a common purpose.
Throughout human history, we’ve formed groups because our survival depended upon it, and we’ve chosen leaders who exhibited strength, stamina and confidence because they prevented chaos within the tribe and kept us safe from danger. While the threats to modern society are different, we still maintain the group mentality to survive.
Organizational change is one such threat, and we look to our leaders to guide us through that change. We look to our leaders for safety and protection in our jobs.
The health care industry is an ever-changing landscape and, now more than ever, physicians are its leaders. One recent change, which many have perceived as a threat, is the Affordable Care Act (ACA). Most are familiar with affordable health care for uninsured Americans as one of the key pieces of this legislation, but there are also mandated hospital- and physician-driven programs focused on quality, clinical outcomes and patient satisfaction. A complex, ambiguous legislation, the ACA has been a catalyst for physicians to step up as leaders. The ACA legislation affects all health care organizations and nearly all stakeholders, and compliance requires both teamwork and strong leadership. As the drivers of patient care, physicians are, in many ways, best suited to lead the changes needed to meet the new requirements.
This means physicians must develop the specific leadership skills that enable them to inspire followers, especially in the face of change. To embrace change means to look beyond “the way we’ve always done things.” Instead, leaders must facilitate relationships that encourage confidence and build competence; they must value and encourage learning and process improvement while recognizing contributions in meaningful and creative ways. These skills are often the difference between success and failure in the face of change — and they’re what set great leaders apart.
A physician’s clinical training, while perfectly tailored to the practice of medicine, does not transfer well to leadership. Independence is rewarded and ingrained in physicians, as residency and fellowship programs encourage competition from the start. They are taught to be autonomous, and must often detach from emotion to provide the best care for the patient. Physicians tend to be deficit-based thinkers, always looking to identify their patients’ problems. Conversely, leadership occurs in groups, requires influence and connection rather than detachment, and involves common goals as opposed to individual standards. Effective leaders look for solutions, not problems. These critical differences illustrate why it is crucial that physicians learn the art of leadership.
Successful leadership development requires commitments from both physicians and their organizations. Physicians must be proactive in their own learning, and organizations must offer leadership development in ways that meet physician needs. Leadership development programs addressing the unique needs, perceptions and skills of each individual have far greater chance of buy-in, commitment and long-term success. Engaging with someone outside the organization, who has the experience to design and implement a leadership development program, may lead to fresh ideas and can often engender more trust among participants. The two most common ways to develop physician leaders are classroom-style learning and one-on-one coaching.
A classroom-style program has the benefit of addressing many physicians at one time, and provides the participants peer support as they develop their leadership styles. These programs use assigned reading material and case studies to teach leadership concepts and give the physician opportunities for individual as well as group learning. However, it is important to keep these classes small, as large group lecture environments tend to hinder the experience by making it difficult to meet individual physicians’ needs.
One-on-one coaching provides a confidential environment in which to address each physician’s unique needs. One-on-one programs are customized to directly target weak areas, or development opportunities. This environment requires more independent study, but also allows for deeper discussion than the group setting. Validated, personal assessment tools and 360-degree evaluations help participants understand their own leadership styles, as well as the way others may perceive them.
Both programs have their strengths and benefits, and implementing both allows for variety in the learning process. Physicians can support each other and discuss the challenges clinical training brings to their leadership development process.
If an organization is new to physician leadership development, it’s best to start small, with just one or two physicians, or a small group of department chairs. Then, make adjustments to the program as necessary before implementing on a larger scale. Success measures are vitally important to the effectiveness of the overall program. Those investing time and resources in leadership development need to be able to measure the results, preferably quantitatively. Three such measures are patient satisfaction scores, physician productivity and turnover rates.
This new world of health care requires a new type of leader, one who has a vision, who inspires others to follow that vision. Health care has needed physician leaders since long before the Affordable Care Act, but these changes drive the discussion about physician leadership development more today than any other time.
Jill M. Lewis, MBA, MSOLE is the owner of Austin-based Mosaic Leadership Consulting, and an adjunct professor at St. Edward’s University. Jill is a former executive with Urology Austin, National Surgery Network and healthcare consultant with the Coker Group. firstname.lastname@example.org
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