As physicians, we have surrendered much of our leadership role to nonmedical professionals — and we no longer can ignore that. No matter where we are in our career journey, we can do something about it.
The practice of medicine and the business of health care certainly have changed a great deal in the past few decades. Some of us might perceive many of these changes as being recent, but they have been in the undercurrent for decades — rapid scientific advances, population changes, increasing patient expectations, increasing specialization, interprofessional collaboration to provide health care, the need for increased numbers of physicians and other health care providers, the expanding role of government and increasing regulation, and rising costs.
While these factors might have grown in magnitude and impact, all of these “changes” we see today were described in 1965 (Cooper JAD, The Coggeshall Report. Acad Med 1965;40(7):700-702).
One change not identified back then seems to have emerged insidiously, and it is profoundly affecting physicians, our individual patients and the entire health care delivery system. Over the past few decades, while the number of physicians continues to grow slowly, the number of managers of medical care has grown much faster, with the majority of growth among nonphysician managers and leaders.
Every day in our practices, physicians who provide the care experience the adverse consequences of not being sufficiently engaged in managing and leading the care. In our dedication to take care of patients, as a profession, we unwittingly ceded much of our traditional leadership role to business managers, administrators, legislators and other nonphysicians who lack tangible experience taking care of patients.
Medical education and training traditionally have focused on providing education and advancing knowledge in the environment of providing outstanding clinical care. While we must not lose sight of those goals, neither can we ignore the leadership gap that has developed. In the past, physician leaders emerged more often by chance than by design. However, the need is too important and our health care systems have become too complex to leave this to chance.
Can leadership be taught? Can leadership abilities be developed? Absolutely! We must pay attention to developing leadership and leadership skills among younger physicians, who will become the physician leaders of tomorrow. However, current needs and demands can’t wait for us to grow a generation of physicians who have developed leadership skills beginning in medical school. Nor does each of us need to wait until we are in a senior leadership position at a hospital or in a professional society, or serving in a legislature or elected to office.
As individual physicians, where, then, should we lead? Each of us needs to lead where we stand, by making a difference in the roles we have. Strive to develop even better leadership skills, and, perhaps more important, to nurture your interests to get more involved to make a difference, not as a self-serving noble, but as a noble servant.
Four manuscripts in the May-June 2018 Physician Leadership Journal exemplify opportunities to fill the leadership gap — active participation of medical students in leadership development, promoting leadership development of residents through meeting residency accreditation needs, mentoring early career physicians, and interventions that empower practicing physicians leading to reduced burnout. There are lessons each of us can incorporate to lead where we stand.
If we can effect this change as a profession, all of the other changes in health care will be better managed for our patients and for society.
Hal B. Jenson, MD, MBA, CPE, is a member of the Physician Leadership Journal editorial board. He is the founding dean, corporate president and CEO of the Homer Stryker M.D. School of Medicine at Western Michigan University.