What distinguishes a physician leader from other doctors? The AMA puts the number of physicians in the United States at roughly 940,000, which includes both active and inactive doctors in virtually all practice settings and represents many top-notch clinicians, researchers, and residents. But how many of them can be considered leaders?
I posed the first question to Richard Schwartz, MD, a professor of surgery at the University of Kentucky College of Medicine who has researched and written about physician leadership development. His answer, in short: A physician leader is someone who is able to deliberately put on a different hat—clinical or managerial—depending on the task at hand.
It sounds simple enough, and the hat analogy certainly isn't new to discussions of leadership. But for hospital administrators and executives, putting on a different hat typically means shifting their focus to a specific area of management—patient safety, finance, or human resources, for example.
For physicians, it isn't so easy. The skills that make physicians excellent clinicians are in many cases "diametrically opposed" to the qualities needed in a manger or organizational leader, Schwartz says. Physicians are trained to interact one-on-one; leaders must deal with multiple constituencies at once. Physicians, particularly surgeons, are accustomed to making life-or-death decisions on the spot; leaders incorporate feedback and work on long-term projects. Physicians are trained to think of the patient first; leaders must consider all stakeholders. To throw another analogy into the mix: Physicians play solo sports, like tennis; leaders play team sports, like soccer.
So for a physician to step out of an operating room and into a board room requires not just a shift in focus, but an entirely new skill set. Successful physician leaders are aware of the distinct skills needed in each situation and are able to switch hats at will. They are able to put a foot in both worlds, and that's precisely what makes them such an asset. "The goal of the physician leader is educate the administrative hierarchy about clinical issues and physicians about administrative issues," Schwartz says. No one else has the perspective and skills to pull off both of those tasks.
Where many physicians go wrong is assuming that the quick thinking that makes them successful in the emergency room will translate at an organizational meeting. And where many organizations go wrong is in promoting physicians to leadership positions based on their clinical expertise. Just because a cardiologist is the rock star by every clinical measure doesn't mean he or she has what it takes to be a department head.
In fact, sometimes the physicians with the most influence in an organization don't hold traditional leadership positions. These "opinion leaders" are able to bridge the administrative-clinical gap without official titles.
So is physician leadership development simply a matter of identifying physicians who already have hat-switching abilities? That's part of it, but physician leadership can also be developed. "A lot of the popular literature would say leaders are born, not made. But there's no data to support that, whether you're talking about running GM or a healthcare system," Schwartz says. "You can groom yourself to be a good leader if you put in the time and the effort."
It's just a matter of learning a few new tricks.
Elyas Bakhtiari is a managing editor with HealthLeaders Media. He can be reached at ebakhtiari@healthleadersmedia.com.Note: You can sign up to receive HealthLeaders Media PhysicianLeaders, a free weekly e-newsletter that features the top physician business headlines of the week from leading news sources.
The CDC speculates that 1.7 million patients get hospital infections each year, and some suspect that it is actually several times that number. By screening patients for infections, however, hospitals can identify MRSA positive patients, isolate them, use separate equipment and insist on gowns and gloves when treating them, experts say. Despite this evidence, only 30% of hospitals in the U.S. are screening for MRSA.
Everyone has one: The co-worker who is always complaining about their workload, their boss, and, well, everything. They're often just a bit too snappy with customers and will roll their eyes behind the boss' back when they're reprimanded.
Everyone has one—even hospitals.
These "special" people can severely inhibit an organization's efforts to create a quality healthcare experience for patients, said Gerald B. Hickson, MD, director of the Center for Patient & Professional Advocacy and associate dean for clinical affairs at Vanderbilt University Medical Center in Nashville. Hickson presented VUMC's policy of no tolerance for unprofessional behavior Wednesday afternoon during Leadership Day at the annual congress of the National Patient Safety Foundation.
VUMC has had a culture of no tolerance for unprofessional behavior for the last 10 years, Hickson said. This culture includes a rule that everyone—from the physician who brings in the most revenue to the custodians cleaning patient rooms—has the responsibility of giving patients a quality experience. That means that every employee must not only watch his or her own behavior—but confront fellow employees who may be out of line.
"People need to be trained to recognize when a pattern of unprofessional behavior exists and address it," Hickson said.
Hickson emphasized that although this program has been in place for a decade, it is constantly changing as the organization's leaders learn more about their employees and the organization. Addressing cultural issues that inhibit quality care is, he said, "a marathon, not a sprint."
NPSF is not the first conference to address workplace culture. In fact, most conferences targeting hospital executives offer sessions that offer ways that leaders can get nurses and doctors to work together, inspire change, and encourage communication. From the outside, all of this culture talk may seem like it's taken from a page in Michael Scott's management manual, (If you don't watch "The Office," you should.) but hospital executives tell me that bringing the different cultures of their organization together to work for quality patient care is one of the hardest parts of their job. They're hungry for any piece of advice that might make this part of their job easier.
There will be many pieces of advice shared here at NPSF this week and I'll continue reporting on the ideas exchanged here in Nashville. Check back in and send me any questions, comments, or suggestions you might have.
Maureen Larkin is quality editor with HealthLeaders magazine. She can be reached at mlarkin@healthleadersmedia.com.
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The Ohio-based Hospital Measures Advisory Council has agreed to recommend reporting a list of hospital data, including rates of staph and C. diff infections. The panel has to make its recommendations to the director of the Ohio Department of Health, which will be followed by public hearings and approval of the final rules. The Hospital Measures Advisory Council was created by state law and charged with recommending public reporting of various measurements of hospitals.
Although the Texas Legislature have approved a bill to create a state Infection Reporting System, lawmakers failed to provide any money for it. As a result, Texas hospitals are still not required to keep statistics or report them to the state. The system, which was supposed to launch June 1, would collect data on surgical-site infections, certain bloodstream infections and respiratory infections. The information would eventually be made public on the Internet, but officials estimate that they need $1 million to get the system going. Although a committee is talking about the kinds of data hospitals should collect and how they should report it, the program's fate remains unknown.
Heparin manufactured in China and linked to dozens of deaths in the United States is now safe because of tighter testing and controls, according to U.S. Health and Human Services secretary Mike Leavitt. The FDA has linked 81 deaths and hundreds of allergic reactions to a contaminant found in China-made shipments of the blood thinner.