Physician Leadership

I had the privilege recently of teaching a course on “physician leadership” as part of the North Shore –LIJ “Physicians High Potentials” program. For those of you who are not familiar with the program, it provides training and coaching for physicians in the health system to enable them to take on formal leadership roles, and covers topics as diverse as how one’s own personality affects communication with others and health care financing.

At the start of the session (which I taught with Dr. Vicki LoPachin), I tried to give a brief overview of why physician leadership is so important, and why I believe it is an extension of the more traditional “healer” role of physician. My argument, which drew heavily from the work of Richard Bohmer, went something like this:

Physicians have always felt a keen professional obligation to improve the health of their patients. In the current parlance, we have always tried to improve patients’ outcomes. For most of recorded history – indeed until recent decades, physicians practiced mostly as independent craftsmen (and yes, they were almost always men) with a general ignorance of causes of disease and limited therapeutic options. Patient outcomes, to the extent that they could be improved, depended on what we knew and what we did to and for patients.

Today, it is clear that our patients’ outcomes depend on much more than our independent action. They depend on systems of care that weave together the contributions of many from clerical staff to nurses, from technicians to specialist colleagues, as well the use of advanced and often potentially dangerous technology and drugs in complex institutional settings.

For physicians to retain their rightful place as patient advocates and health promoters… as professionals devoted to improving our patients’ outcomes, we must assert our leadership in the design and control of these new complex systems of care. In other words, I believe that physician leadership in health care organizations is the contemporary expression of our most ancient and honorable tradition.

What do you think?

5 thoughts on “Physician Leadership

  1. The health care delivery system as we know it must (and is) changing. As physicians, we have a unique perspective and interest in shaping the process and end result. But we did not go to school to learn how to do this Developing practical solutions to our Nation’s health care delivery crisis, and having the leadership skills to implement the solutions will require physicians to learn new skills and move beyond the traditional roles physicians have filled. We will need to develop and guide teams of health care workers to collaborate.

    This was most clearly illustrated to me in a presentation by Clayton Christensen, author of The innovator’s prescription: a disruptive solution for health care (Professor of Business Administration at the Harvard Business School). Christensen compares the upcoming changes in health care delivery to disruptive changes seen previously by industries such as the computer industry. Just as mainframe computers were brushed aside by the desktop computer industry, we need to develop more efficient, more responsive delivery models to care for disease processes that are well understood. This will redistribute resources to better meet the needs or the market: our patients.

    No single group is in a better position than physicians to understand the complexity of medical care, the rapidly evolving science of medicine and to guide our Nation out of the health care delivery crisis. But leadership is a skill we will need to learn. I applaud the author, Dr. Ira Nash, for leading the way.

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