How to Operate In-House Physician Leadership Programs

In-house leadership coaches make determined and sustained efforts to help physicians change behaviors that can derail their careers.

Physician leaders can benefit from in-house staff development programs.

"Internal physician coaching has been a real success for us," Keith Olson, MS, director of physician consulting services at Ann & Robert H. Lurie Children's Hospital of Chicago, said during a presentation this week at the MGMA annual conference in Boston.

Olson said in-house physician leader training has several advantages over consultants or sending physicians to leadership programs, including a higher degree of effectiveness in changing people's behavior.

"Other organizations send physicians to an executive program—two weeks at Harvard, Stanford, or Kellogg in Chicago. What I hear from physicians who come back from these programs is, 'It was a great experience, and I met some great people.' Then three weeks later not one behavior has been changed. Those programs also are very expensive," he said.

In-house leadership coaches can make a determined and sustained effort to help physicians change behaviors—such as constantly interrupting their peers—that can derail their careers, Olson said.

"The difference is that instead of going to a program and getting information, we're talking for weeks on end about the behaviors they pull out of structured materials and want to get better at. I keep these behaviors in front of them."

Measuring success
 

Lurie Children's Hospital currently has 45 doctors enrolled in the organization's physician leadership program. Participants are meeting with Olson every two weeks, monthly, or quarterly.

After his presentation at the MGMA conference, Olson told HealthLeaders that there are four primary measures of success for an in-house physician leadership program:

1. Since participation in executive coaching should be elective—and physicians have a low tolerance for anything that wastes time—high demand and continued participation in ongoing coaching is an indicator that participants view a program as worthy.
    
2. In a successful program, peer referrals should be a major source of participants.
    
3. Annual feedback should be gathered from participants asking about the effectiveness of the program and getting input about what will make the program more effective.
    
4. The ultimate indicator of success is that growth and development are seen in the participants by their leaders and peers.

Growth has been a key measure of success for the leadership program at Lurie Children's Hospital, he told HealthLeaders. "It's exploded in growth, and that is one indicator of success because it's elective."

Competencies and learnings
 

During his presentation at the MGMA conference, Olson shared core competencies for leadership coaches and the lessons that have been learned from the leadership program at Lurie Children's Hospital.

There are a pair of essential leadership coaching competencies, he said.

"One is the coaching skills, the trust-building skills, and the listening skills—these are skills that help change people's behavior. As one of my clients said to me, 'Keith, you are politely blunt.' To get people to change their behavior, you have to be able to be politely blunt."

The other core competency is physician-centric. "The other bucket is understanding a physician's world," Olson said.

"Surgeries run long, clinics run long, and grant proposals are due. A physician's world is a chaotic place. We keep trying to cram a traditional approach to leadership development on the physician's world, and it fails."

He said Lurie Children's Hospital has learned several lessons from operating an in-house physician leadership program:

• Leadership programs should be perceived as an investment in key talent, not a place where people who are behaving badly are sent.
   
• Leadership coaches must adapt to the physician's world such as being flexible to odd work hours. Coaches should not get upset when meetings are cancelled or rescheduled.
   
• Leadership coaches should encourage physician leaders to develop tools and techniques to have a sustainable path in their lives. The drive that got physicians through residency, fellowship, and the early phase of their careers is not only unsustainable but also a potentially toxic influence on leadership abilities.
   
• Having an internal leadership coach creates the ability to have ad hoc sessions in a timely manner. Internal coaches tend to be readily available when a leadership program participant needs to talk with someone about pressing issues such as a stressful conversation involving negative feedback.