Medical leadership is becoming more important, perhaps because it's becoming more common.
The American College of Physician Executives reports that more than five percent of hospital CEOs are now physicians, with that number growing rapidly under the value-based system.
Medical schools at Duke University, the University of Wisconsin and the University of Kentucky are now including medical leadership training, offering courses such as accounting, marketing and management training to go along with clinical coursework. Medical leadership is important because physicians relate best to other physicians, and those who can learn the administrative side can help the healthcare system overcome one of its more persistent challenges – bridging the gap that can often exist between administration and clinicians.
Many physicians are also natural problem solvers, so moving into executive roles and attempting to improve the delivery of healthcare is something many find appealing. But moving from caregiver to leader isn't always easy. And please note I use the term "leader" and not "manager." Those are two very different terms. A leader has the ability to affect change in a positive manner. A leader inspires those around him or her to impart a willingness to improve. A leader has goals, drive and commitment and the skill set to achieve them. A manager oversees the day-to-day operations of an organization. Yes, good managers are important, but we desperately need good leaders.
As the chief medical officer of a company with more than 9,000 affiliated physicians, I find leadership development to be one of my most important responsibilities. Each year, I strive to turn hundreds of physicians into leaders through education, training and mentoring. I've learned a lot about what works and what doesn't with regard to leadership development. There is certainly no "one-size-fits-all" when you're dealing with people, but I've learned there are certain traits to look for when it comes to leadership.
Generally speaking, there are three main types of leadership styles:
- Directive - also known as autocratic
- Participative - sometimes referred to as inclusive
- Delegative – also known as laissez faire
There are plenty of subcategories and more specific styles, but most can be generally classified within these three. There is no right or wrong kind of leadership style and in fact, the Harvard Business Review found that many of the best leaders employ combinations to fit given situations and particular staffs. But no matter the type of style an individual employs, I've found the following qualities inherent, and always present, in a good leader.
1. Listening
Study after study has shown that participative leadership is most productive on its own. That's because it allows leaders to seek out the opinions of the team while still retaining the ultimate decision-making authority. The team feels heard, appreciated and engaged while learning to respect the leader who shows them respect in return. Employees who are actively involved in projects and decisions have greater job satisfaction, higher commitment to the organization and greater respect for the administration. The participative style also allows for more voices, meaning the best ideas are heard and implemented. This improves productivity and output.
Many studies report that good communication skills are critical for good leaders. But communication is a two-way street, and very often communication has less to do with talking and more to do with listening. Listening isn't something that comes naturally to a lot of physicians. So when I meet a doctor who is a good listener, who really understands and processes what others say, I know he or she has the potential to be an excellent leader. As the Greek philosopher Epictetus once said, "We have two ears and one mouth so that we can listen twice as much as we speak."
2. Vision
It's so important to have vision when you work in the healthcare industry. There are so many challenges and setbacks, even day-to-day, that it's easy to get mired in the minutiae and lose focus. A good leader is able to manage the current challenges and the daily grind while still being able to step back and focus on the big picture – the logic of where we're going and where we should be in five or six years. You can't take anyone into the future successfully if you're unprepared for what that future may hold. Successful leaders can juggle the here and now and create a mission and goals for overall improvement.
A lot of medical leaders who work at Lean facilities have regular Lean meetings to talk about what went right and what went wrong since the previous meeting, and how to improve going forward. They look at the current metrics and make reasonable goals for what the metrics can and should be a month, six months a year from that point. If we can make and meet those types of goals for a hospital department, then we can do that for multiple departments, for hospitals, for hospital systems and so forth. One of "The Seven Habits of Highly Successful People," according to author Stephen Covey, is beginning with the end in mind. If you are a leader who can see what's ultimately best for your patients, your staff, your hospital, and work backwards from there to where you are now, then you are likely to steer everyone in the right direction.
3. Integrity
Most healthcare organizations have a Chief Medical Officer, or CMO. It's a job that has many different connotations, duties and roles. But one common thread for all CMOs, and for all healthcare leaders, is integrity. A physician first and foremost is someone who sets out to help people. So a physician leader, no matter the job title, sets a moral tone for the rest of the staff. People who go into medicine do so for altruistic reasons, but after being in the healthcare industry for a while, it's easy to lose sight of the reasons that led you there in the first place. A good medical leader remembers why they're there and holds tightly to the moral compass that initially called them to become healers.
4. Empathy
While empathy is considered a basic human quality, it's often missing from the workplace. In a healthcare setting, we often empathize greatly with patients but neglect to extend the same consideration to our coworkers, who may need it just as much. Empathy often works like respect – it can be contagious. Empathy begets empathy the way respect creates respect. Good leaders resist the urge to roll their eyes, tap their feet or think they don't have time to listen to complaints or others' feelings. They really listen and put themselves in their colleagues' place. They give the benefit of the doubt. In the process, they forge strong relationships and keep valuable connections to their employees.
5. Optimism
As clinicians, we sometimes encounter patients on their worst days. But as healers, it's our job to help them through it. Doing so requires a certain amount of bright-siding. We've all seen the placebo effect and the impact of a positive mental outlook and the effects of mental toughness as caregivers cheerlead patients through their treatment. As healthcare leaders, we need to direct that optimism towards other physicians, practitioners and staff. The medical industry, as is often reported, is replete with depression, substance abuse and divorce, so it's critical to impart positivity to your staff. Physicians aren't making the money they used to. Medicare issues are becoming more complicated. Healthcare challenges are growing. Caregiver roles are changing. Politics and payers have taken center stage. All these changes – the ones we know are coming, the ones that are in progress and the ones that are unknown – are daunting and disconcerting. The leaders that can stand and face them with cheer and excitement and view these changes as opportunities to improve will inspire those around them.
Beware the Authoritarian
Along with the positives, I want to issue a caveat. Of the leadership styles mentioned, the autocratic, or directive style, has repeatedly been shown to be the least successful and the least productive.
It's not that autocrats are necessarily bossy people; sometimes they're simply new and eager to impart change and set the world on fire. Sometimes they think they will be able to quickly command respect, but respect usually needs to be earned and, of course, earning anything worthwhile takes time.
Whether they are new leaders or experienced administrators in new roles, leaders who go in prepared to listen and communicate, express clear vision, maintain integrity, express empathy and sustain their optimism are poised for success. They are our best hope to solve some of our greatest healthcare challenges.
Citations
Angood, P. M. (2014). The Value of Physician Leadership. Retrieved from www.ACPE.org.
Covey, S. (1989). The 7 Habits of Highly Effective People. New York City: Simon & Schuster.
Dubrin, A. (2012). Leadership: Research Findings, Practice and Skills. Mason, Ohio: Cengage Learning.
Lee, T. H. (2010). Turning Doctors into Leaders. Harvard Business Review.
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