Category Archives: Leadership

Leadership Development

One of the things that I am most proud of about the North Shore–LIJ Health System is our institutional commitment to leadership training. There are lots of examples, but the best I know of are the “high potentials program” for administrators and the “leadership development program” for physicians. Both accept a fraction of nominated individuals, and provide a variety of support services, classroom training and mentorship to participants. Not surprisingly, the programs get rave reviews and the graduates are sprinkled in leadership roles throughout the organization.

I was recently asked to address a group of about 50 participants from both programs as part of a series called “executive forums,” in which a senior executive tells his “personal leadership story” and does a Q&A with the attendees. Sounds good except – because of some crossed lines of communication – I didn’t realize that was the expectation until I had little or no time to prepare. As it turned out, I am glad I didn’t have more time.
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A Global Force for Good

A few years ago, the United States Navy launched a new recruiting and marketing campaign using the slogan: “America’s Navy – a global force for good.” The line was apparently a flop, and the Navy threw it overboard for “protecting America the world over,” but I liked it. I thought it captured a deep truth about the Navy, which is that it is undoubtedly a “global force” and that the force exists for a good purpose, but I guess most people thought that it made the Navy sound too much like a bunch of social workers.

I was reminded of the phrase, and of an experience I had while serving in the Navy Medical Corps, when I read a recent article in the Annals of Internal Medicine.  A Navy physician retold the story of a mission he was on to a remote village in Honduras. He and his team were flown into small villages, where they would “see dozens of patients each day and dispense an assortment of symptomatic medications” and where “the most practical health benefit that we provided villagers consisted of hundreds of tooth extractions.” He further noted that “although advertised as humanitarian missions, these exercises provided US military personnel with experience working with military and civil authorities from host nations.”

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More on Physician Autonomy

Last week, inspired by the Independence Day holiday, I wrote about the important distinction between independence and autonomy. I made the case that professional autonomy is not about each doctor doing as he pleases, but about physicians as a group taking responsibility for shaping medical practice.

I was pleasantly surprised over the holiday weekend when I came across a recent paper in Health Affairs that illustrates how effective physician leadership (autonomy) can reduce unnecessary practice variation (independence) and improve clinical care. The paper also reinforced some of my earlier thoughts about the central role that physicians must play in redesigning systems of care. Continue reading More on Physician Autonomy

Independence and Autonomy

With the approach of the 4th of July, I have had “independence” on my mind. In my professional role, I always have “autonomy” on my mind, since it is often at the top of the list of things that doctors care deeply about, and I have been kicking around how the two relate to one another.

Webster’s (OK, the on-line Merriam-Webster dictionary) defines “independence” as “freedom from outside control or support” and offers up “self-sufficiency” and “self-reliance” as synonyms. “Autonomy” is defined as “the quality or state of being self-governing” and suggests “self-determination” among the synonyms.

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Planning for the future

I have a pretty well-rehearsed answer for anyone who asks me what my role is all about. For those unfamiliar with the North Shore-LIJ Health System, I rattle off a few key statistics (16 hospitals, $7 billion in revenue, 48,000 employees) and then give a brief description of our clinical service lines, the ambulatory services division, which provides operational and back-office support to our physician practices, and the medical group, which integrates clinical services. Continue reading Planning for the future

Physician Compact

There is a lot of stuff written in the business literature about “corporate statements” and the role they can play in guiding strategic decisions. When done right, I think these foundational documents can be quite effective. Does anyone doubt that Walmart really does focus its efforts every day on its stated mission of “saving people money so they can live better”?  Continue reading Physician Compact

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. Continue reading Physician Leadership