Medical schools don't adequately prepare physicians for roles in management and leadership, but mentorships can help, says a surgeon leader.
A generation ago, few would have thought that a surgical department chair might need help to develop her or his leadership style.
"Chairs used to be all knowing, omnipresent," says Todd K. Rosengart, MD, FACS, professor and DeBakey-Bard Chair of Surgery at Baylor College of Medicine and the professor of heart and vascular disease at Texas Heart Institute. "Who would have the audacity to teach a chair anything?"
This was back in "the old days of the great surgical icons," Rosengart says, when the leaders of departments were the best and most talented clinically, invented new procedures, and worked the cutting edge.
Leadership has been evolving since then.
"The old model of the surgeon being defined by the role in operating room has changed quite a bit," Rosengart says. "In the modern era, of healthcare that is not what counts anymore."
It's changed—and continues to change—so much, in fact, that the Society of Surgical Chairs, an organization comprised of chairs of departments of surgery and surgical specialty departments of medical schools, academic medical centers, and teaching hospitals, two years ago began hosting mentorship panel sessions at its annual meetings. There's a recognition that with change comes a need for guidance, communication, and cooperation.
A paper published recently in JAMA Surgery "summarizes the key points raised at the Society of Surgical Chairs mentorship panel sessions held at the 2014 and 2015 annual meetings of the society."
"One thing that we all learned from each other is that almost universally, we all face similar problems," lead author Rosengart says. "It's fascinating in these sessions to see how much head nodding's going on."
Although the paper and sessions are about surgery in particular, Rosengart says the lessons learned are useful across disciplines.
"The management issues are certainly applicable across the board," he says.
The paper highlighted three points that the group developed to support effective leadership and patient care:
- Collaboration and cooperativity: Working with other chairs and institutional leadership
- Humanism and mentorship: To ensure faculty growth and development
- Operational efficiency: Using institutional goals to advance the department
Rosengart says that many of these learnings were intuitive. They reflect that academic medicine has changed tremendously from an authoritarian, hierarchical structure to one that's more collaborative, interactive, and respectful.
One hot topic was how to best work with Millennials. The intergenerational clashing views on work and expectations reflects the evolving attitudes around healthcare leadership.
"One part of our conversation that's mentioned in the article was how to deal with Millennials," Rosengart says.
The paper describes the juxtaposition of Millennials' [born between 1977 and 1996] work expectations—their desire for healthy "work-life balance, early and frequent promotion and reward, and rationales for meaningful work commitments"—with the older generations' style of "respect for authority, unfaltering total commitment to the job, and expectant patience for recognition and advancement."
He says the "knee-jerk" reaction to Millennials is that they're impossible and difficult.
Through discussions, however, "very quickly it became clear that the Millennials were just looking for good feedback, good definition of goals and objectives and good incentives… That in many ways was intuitive."
How could anyone argue against those things, he asks.
Lack of Management Training
The mentorship panels and JAMA paper raise another point: That medical schools don't prepare physicians for roles in management and leadership.
"It's interesting how, by and large, very few of us ever received any training in medical school or early in our careers [about] what has now become a very complex discourse of personnel development or management," Rosengart says.
As a result, many of his colleagues have taken management courses, or even earned their MBAs.
"Clearly there's probably a role and a need for management training," in medical school and residency training, he says.
The Society of Surgical Chairs is in the midst of launching a year-long mentorship program that matches junior chairs with senior chairs.
Members have expressed great interest. "We've never had such a robust response," Rosengart says.
Alexandra Wilson Pecci is an editor for HealthLeaders.