An excerpt from All Physicians Lead: Redefining Physician Leadership for Better Patient Outcomes.
I Googled the term “physician leadership” and got 183,000,000 hits in 0.45 seconds. There are seemingly endless courses and programs devoted to developing physician leadership, and there’s no shortage of attention to the topic.
Almost uniformly, however, the books and courses approach the topic from a similar angle. Physician leadership is often viewed as something that occurs when physicians reach a point in their career where they are ready to lead a department or join the C-suite of an organization. While physician leadership is seen (rightly) as a vital force in health care, the prevailing view is that only mid- to late-career doctors who graduate to positions such as clinic chief or CMO are considered leaders.
Now, look up the term “leadership” without the “physician” qualifier. Definitions vary, but they consistently involve an attempt to influence behavior to achieve a desired outcome. With that in mind, here’s a definition:
Leadership is influencing behavior to achieve desired results.
Can we agree on this definition? If so, then it’s easy to see that leadership isn’t something physicians aspire to or work toward as a “someday” career goal. Leadership is something physicians do every day. We influence thought and behavior to achieve desired results.
Whether we are persuading a patient to stop smoking, urging a lab to return speedy results, convincing an insurance company to cover a procedure, or guiding a surgical team in the OR, physicians lead.
People look to physicians as leaders. They expect us to make decisions, inspire teams, influence patients’ behaviors, present complex concepts in relatable ways, rally families around medical decisions, communicate honestly and empathetically, and be exemplars of professional conduct.
The accepted connotation of “physician leader” is limiting, referring to doctors in named positions of authority. We should change the conversation, stop viewing physician leadership only through the lens of organizational structures, and recognize that all physicians are leaders now. Physicians influence behavior to achieve desired results every day. And those results couldn’t be more vital: the improved health of our patients.
All physicians lead—not just department chairs, chief medical officers, and hospital CEOs.
The minute you put on that long white coat
If you are a physician, then from the moment you put on the long white coat on your first day, you are influencing behavior to achieve desired results.
You lead patients
Almost every encounter with a patient is a leadership event. Physicians sit down with patients to develop treatment plans that require a change in their life. The desired result may be to lose weight, start a new medication, or change an unhealthy habit—essentially, trying to influence them to do something they weren’t doing before.
Dwight Eisenhower once said, “Leadership is the art of getting someone else to do something you want done because he wants to do it.” Influencing patients successfully requires skills that are fundamental to leaders in all disciplines.
You lead health care teams.
Physicians lead treatment teams, whether it’s a single assistant, the hospital team assigned to your patients, or a whole clinic staff. The “desired results” can change daily. You might be facing a logjam in the clinic where patients aren’t moving through as quickly as they should, and you’re behind schedule. This is a leadership event. You can vent your frustrations on everyone by shouting, “Come on, people, we need to get things moving!” Or you can use higher-level leadership skills—pull the team together and say, “OK, we’re running behind, and patients are getting frustrated. Let’s hear everyone’s suggestions on how we can fix this.” Either way, you’re influencing team members to achieve a desired result. Sound familiar?
Such leadership situations for physicians—and the choices you make in handling them—present themselves many times per day.
You lead patients’ family members.
You also lead patients’ families. The desired result might not be to spur a specific action but rather to bring the family to a higher level of understanding. You want them to know what treatments you’re planning for their family member and why. You want them to know that you care and will do your very best.
My experience in pediatric neurosurgery reminds me every day how important this skill can be. You might be asking parents to put their child at risk via surgery, so you want them to be clear on why you are doing it. You want to listen to all their concerns and mirror those concerns back to them. You want to demonstrate that you care about their child and the family. You want them to become as comfortable with this decision as they possibly can be. This is certainly a leadership event of a high order. It requires fielding difficult questions, giving clear answers, reading people’s emotions, listening empathetically, and presenting intricate treatment options with clarity and wisdom.
You lead medical students, residents, and fellows.
Part of our responsibility as physicians is to train other physicians. The desired result is that they become good doctors. This presents a complex leadership challenge. First, we should be aware that we are teaching leadership skills in addition to clinical skills. Even if we don’t recognize we are leading, our leadership behaviors are observed and evaluated by the next generation of doctors. It stands to reason that we should reflect on this and recognize we are setting an example for physician leadership—good or bad—every day. We should have a firm grasp of the leadership skills we are trying to teach. Additionally, beyond observing residents’ technical skills and clinical judgment, we have an opportunity to pay attention to how they’re interacting with other team members, patients, and families, and coach them on how to do that better. This includes rewarding and complimenting them when they do well as leaders. Finally, we should model the behaviors we’re teaching and coaching—all within a highly stressful environment.
Are you convinced yet that leadership is integral to the everyday life of a physician?
Leon Moores is a neurosurgeon and author of All Physicians Lead: Redefining Physician Leadership for Better Patient Outcomes.
