Upon entering medical school, few of us recognized the eventual need for leadership skills. As we progressed through training, only some of us may have appreciated we were gradually inheriting leadership demands based on the patient care and treatment hierarchies in place within most clinical disciplines. Nonetheless, few of us received formal leadership education or management training in the early stages of our career education.
Today, only a paucity of medical schools and residency programs provide a modicum exposure to leadership development for physicians … unfortunately!
The healthcare industry continues to face an era of seismic change and disruption, one in which the demand for effective physician leadership is rising more dramatically than ever. The COVID-19 pandemic brought this need into sharp focus as exhausted clinicians, contentious politicians, and a terrified public cried out for leaders with medical training and priorities beyond the financial bottom line.
The demand for physician leadership is not new. Well before the pandemic’s public health crisis, a constellation of forces already placed physicians at center stage. They include shifts from volume-based care delivery to a value-based system; a public health-oriented focus on the management of population wellness and resolving the multitude of social determinants of health; a new preference for person-centered care, coupled with shared decision-making; and development of safe, efficient, high-quality clinical care models in diverse settings, among many others.
Historically, healthcare delivery organizations have benefited from the distinctive perspective of physicians among their leadership. And because of increased constraints on revenue and heightened review by insurers, today’s health system leaders are more often in the position of making critical administrative decisions that ultimately affect clinical care.
Critical Connections and Collaboration
Physician leaders have been described as “interface professionals” who best connect medical care with management decisions. As a bridge between other physicians, non-physician clinicians, and non-clinical administrators, physician leaders can be the catalyst that every successful organization needs, linking the so-called sharp end (the front lines of care) with the blunt end (management, leadership, and governance).
But physicians can’t do it alone, and it’s not done by just doctors listening to other doctors. We must work with inter-professional clinical teams in a complex environment. Nurses, surgical technicians, nurse practitioners, physician assistants, and all other members of the healthcare team who work closely with physicians typically respect the physicians’ point of view and are more likely to buy into organizational changes and process refinements when guided or led by physicians in leadership roles.
Industry thought-leaders emphasize the critical requirement of building great teams and working within them effectively. But they also point out how challenging it can be for physicians to transition from the independent thinking driven into them during medical training to the interdependence of teamwork.
We must necessarily acquire a new set of competencies, including team building and communication skills, business intelligence in finance, marketing, strategy formulation, information technology, law, and other knowledge needed to steer healthcare organizations of all sizes over the bumps and pitfalls of a complex system in flux.
When embracing leadership as a physician, we must all recognize this dichotomy of skills and knowledge compared to our medical training. Doing so is critically important for physicians so that success is more likely in helping, individually and collectively, to create the positive changes sorely needed in healthcare. Physicians are the expected leaders in the industry.
The literature about the benefits of physician leadership is still relatively sparse, and AAPL is committed to increasing its ongoing contributions to the literature through a variety of thought leadership initiatives that will become even more evident in coming months.
The re-release of an updated AAPL white paper on physician leadership, Physician Leadership: More Valuable Than Ever, is one such example. However, a recurring illustration of the beneficial impact of physician leadership is that every year when U.S. News & World Report’s annual “Best Hospitals Honor Roll” is reported, an overwhelming majority of top-ranked hospitals are run by physician CEOs. Others have also recently noted the strong connection between high-quality ratings and physician leadership.
Another illustration is how the relationship between quality and cost creates a critical arena for collaboration among clinical and financial leaders. Effective interaction between the chief medical officer and chief financial officer requires a supporting organizational structure.
CMOs and CFOs speak different languages, have different perspectives, and focus on different goals. Clinical and financial leaders must see and understand the respective pain points of their C-suite colleagues with diverse functions. Clinical and nonclinical leaders must break down silos and establish common ground. Such collaboration is essential to increase value in healthcare and achieve success in the increasingly prevalent value-based models.
Without the combined expertise of clinical and financial leaders, reaching new organizational and population health goals will be challenging, if not impossible. Encouraging clinical acumen and input with regard to operating decisions fosters collaborative work that benefits all aspects of healthcare delivery.
Facilitating Positive Change
Many hospitals and health systems are currently scrambling to recruit talented physician leader candidates from the outside, or they are grooming physician leaders internally through on-site courses, experiential learning opportunities, and certificate or advanced-degree programs with colleges and universities, yet they still have additional work to do in bringing more physicians into leadership.
The AAPL Certified Physician Executive credential has been available for nearly 25 years and is an industry standard that is highly complementary to other higher education programs. Of note, AAPL also partners with five universities and offers seven distinct master’s degree programs with these partners. The AAPL alumni from these programs continue to achieve significant career advancement and are positioned to lead in many top-tier institutions.
In essence, the medical profession is still viewed as a leadership profession and our society considers all physicians to be leaders at some level. Embracing the benefits of strong physician leadership can facilitate positive change in clinical care delivery and within other sectors in our industry.
And so, as physician leaders, we must embrace the complexities of our industry. We must embrace the reality we chose when transitioning to this profession. And we can choose to embrace the opportunities where our individual and collective energies are able to help create the positive transformation needed for our industry. Managing the dichotomy is essential and helping others to recognize and embrace the dichotomy is needed so that more physicians become comfortably engaged with leadership.
Leading and helping create significant positive change is our overall intent as physicians. AAPL focuses on maximizing the potential of physician-led, interprofessional leadership to help create personal and organizational transformation that benefits patient outcomes, improves workforce wellness, and refines the delivery of healthcare internationally.
We must all continue to seek deeper levels of professional and personal development, and to recognize ways we can each generate constructive influence for one another at all levels. As physician leaders, let us become more engaged, stay engaged, and help others to become engaged. Exploring and creating the opportunities for broader levels of positive transformation in healthcare is within our reach — individually and collectively.
Note: Portions of this article appeared as an op-ed piece in Modern Healthcare (10-3-2022)
Reference
Angood, P.B. Physician Leadership: More Valuable Than Ever — A White Paper from the American Association for Physician Leadership