The Four Dimensions of Physician Leadership in the New World – Part 1

Developing personal leadership skills


The following is the first of a four part blog on the challenges of physician leadership in the next 5-10 years.

First of all, should all physicians be leaders?  Or put another way… does being a physician make one a leader?

By nature, all physicians have to assume some form of leadership role as part of the routine practice of medicine.  Even the full time clinician, from the perspective of the patient, is the “leader” in that patient’s medical treatment and management.  Even a solo practicing physician is the “leader” in the management of a successful office.  All physicians can benefit from leadership skills.

As our health care market matures, there will be a greater need than ever before for physician insight,  content expert, and leadership at all levels in the health care system.  How do physicians appropriately “step up to the plate”?   Leadership skills of any sort are rarely taught in medical school. As a result, physicians have in my opinion, not done nearly enough in the area of leadership, leaving the vast majority of medical policies and decisions to non physicians.

The classic paradigm of “captain of the ship” must now yield to the more practical role of “invaluable member of the health care team”.  How does the physician rise to meet this challenge?  I offer four dimensions of physician leadership for the new world.  Each dimension has an individual question for the physician.  During my interactive  seminar on The Four Dimensions of Physician Leadership in the New World, a Self Assessment, we discuss strategies and practices to improve the leadership skills of the physician in all four areas:

1.  Developing and enhancing personal leadership skills

2.  Becoming a more effective member of the health care team

3.  Championing the culture of quality and patient safety…

4.  Becoming a better ambassador for the patient and the community


Let’s now address the first:

1. Developing and enhancing personal leadership skills

The practice of medicine has become an increasingly “conflict”- rich environment.  Yet the physician tends to have little training in the areas of conflict management and resolution,  negotiating skills, problem solving and customer service orientation.  All too often the physician learned in medical school and residency “my way or the highway”….. and came to find out that many times patients choose the latter.  Fortunately, many of these skills are easy to teach.  At a minimum, the physician must recognize the need to master these skills and encourage other physicians to do the same.

Social skills of any kind were never stressed throughout medical education.  During times of inordinately high stress such as internship and all-night call, the physician was often left with too few coping skills, except for those of pure survival.  Too often the physician said, “I write the orders, you follow them !”.  That’s how we learned from our superiors and that’s how we saw the practice of medicine.

The physician historically has not learned leadership skills, and was in a social/ structural position in the health care hierarchy so that it never really mattered.  We are in a different world today.  Conflict management and problem solving are core skills that physicians need to master….. maybe almost as important as clinical skills.

There are several approaches to improving conflict management and problem solving that the physician can easily learn and ultimately master.  These involve first recognizing the situation, and then learning through relatively simple steps, how to better respond and resolve the issues.  Role playing can be of big assistance here.  I have found that the great majority of physicians respond very well to these techniques and can rapidly incorporate them into their daily patient and administrative schedules.

But these skills must be taught and must be practices.  They may not at all come naturally.  The physician will need to work on these just as much as he/she needed to work on memorizing anatomy and pharmacology.

These skills become increasingly important for the physician administrator.  The physician executive has another layer of skill sets to develop.  At a minimum, the physician executive will now have a boss.  A medical practice can be run somewhat autonomously, but the corporate setting is quite different, and sometimes shocking for the incoming physician.

Different skill sets are required for the physician manager than are needed for a clinician.  Typically, the “top” clinician is considered for these positions, and the physician may now find him/herself in very untested waters during very stressful times.  Simply put, the best clinician may NOT have the skill sets for the best physician manager or physician executive.  This can be a very difficult transition for new CMOs.  Relationships with the medical staff can change significantly.  Physicians have typically learned deal with fellow physicians through peer consensus…. and the problem is, simple consensus may not be the right course of action…The single biggest challenge of the physician executive is to make decisions that might NOT be popular with the medical staff, but yet are the right course of action for the health care system and community.   The physician executive must represent the best interests of the entire system, not just the physicians.  I have found that in my CMO mentoring program, this is one of the biggest issues that I face.

The physician executive may be in a situation to have to counsel or even discipline a fellow peer.  This can be very stressful for the physician executive if the proper skill sets of problem solving and consensus are not mastered.

So the first question the physician I must ask the prospective physician leader is:  How can you better develop your own leadership skills in these areas?

I challenge the physician to be honest, introspective and assess what specific skills most need to be developed.

Personal leadership skills are necessary for the successful physician leader… but they are not sufficient.  This is just the first dimension.  Stay tuned for my next blog.

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