Physician Leaders at the Table

by Dr. Chuck Stoner
Stoner & Associates Consulting

As we carve our future healthcare strategies, the involvement of physician leaders has never been more important.

Our healthcare organizations are immersed in the disrupting waters of unprecedented change. Like any transformational change that challenges established models and practices, the path forward is laden with uncertainties. Yet, most experts agree that as we carve our future healthcare strategies, the involvement of and reliance on physician leaders has never been more important. In short, physician leaders must “be at the table.”

A Unique Mix and Mindset
There are at three reasons why physician leaders are central to our healthcare discussions. First, they possess expertise and credibility that allows them to be mediators who encourage other administrators to more fully understand clinical needs and perspectives, while helping their clinical peers recognize and appreciate underlying business needs and necessities.

Second, as noted by Harvard Professor Richard Bohmer, “physician leaders help assure that patient well-being will not become a subservient concern in the face of politically charged issues of cost containment and revised delivery models.” Third, there is growing evidence that when doctors are actively engaged in enhancing organizational performance, better clinical and financial results are likely to occur.

Physician leadership involves a unique mix. In most cases, physician leaders work in two differing domains: the clinical domain and the administrative domain. While these domains overlap and influence one another, each has its own roles and expectations, with differing notions of acceptable (and unacceptable) behaviors and views of how to go about accomplishing needed outcomes. Each domain carries, to some extent, a different mindset.

Let me clarify this distinction a bit by drawing from recent research. We know that physicians are highly educated and intelligent. In most cases, through inclination and training, they are quick studies who are comfortable being in control. Generally, they drive themselves to high levels of personal performance, and given the consequences of their work, they eschew mistakes.

As clinicians, these factors are part and parcel of success. Yet these same factors can manifest in less functional ways in administrative and leadership roles. For example, the pace of frequent meetings and often slow administrative progress can strain their action-oriented tendencies. Physician leaders may become impatient with others, inflexible when they feel they are right, and frustrated by those whose work ethic is less than expected.

Building Leadership Competencies
Looking more deeply, moving from clinician to physician leader involves at least four important transitions, each carrying new demands and complexities. The first is the transition from doer to leader. Physicians strongly value independence and autonomy in driving action for high-quality clinical outcomes. As leaders, these characteristics may need to be tempered as one focuses on the nuances of working with and through others to get results.

The second transition involves a shift from relying on technical and clinical skills to a stronger dependence on interpersonal skills. Skills in deep listening, reflective questioning, conflict resolution, negotiation, team building, motivation and navigating politicized contexts all reach new heights of importance.

The third transition involves the move from a narrow (clinically-driven) focus to a more strategic focus. Here, the ability to examine issues and problems broadly with a system-wide perspective (imbued with financial realities) becomes critical.

The fourth transition involves the shift from being a change recipient or reactor to becoming a change leader. Here, an active role in creating future direction and helping execute needed transformation is stressed.

Increasingly, progressive healthcare organizations are recognizing and implementing broad programs for enhancing the business and leadership competencies of their physician leaders. Although these programs are broad, three critical themes (prompted from physician assessments) prevail. These include:

  1. Building stronger awareness, understanding and use of financial data and measures;
  2. Developing broader strategic awareness so an eye on the big picture is enhanced; and
  3. Encouraging stronger interpersonal awareness, specifically the development of emotional and relational skills.

These organizations are keenly aware of a new reality: that the selection and development of high-potential physician leaders is essential for organizational growth and success. iBi

Dr. Chuck Stoner is professor emeritus, Bradley University and president of Stoner & Associates Consulting. His latest book is Inspired Physician Leadership: Creating Influence and Impact, published by the American Association for Physician Leadership.

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