Excerpt from Lessons Learned: Stories from Women in Medical Management

By Deborah Shlian, MD
May 4, 2021

The questions so often asked by women physicians aspiring to management is, “How can I enter the field” and “How can I move up the ladder?” The fact that doors to leadership in organized medicine have swung open is only half the battle.

Women have to be willing to walk through those doors. The women in the book, Lessons Learned: Stories from Women in Medical Management are a diverse group. Some are nearer to the beginning of their management careers, others are midway and a few are close to or have already retired. Some are married, some are not, some have children, and some have none. Some are surgeons by training, others are primary care doctors. While each of the women physicians presented in the preceding pages is unique, working as physician managers in virtually every type of healthcare organization in the US, their stories share some common themes. I’ve put together several helpful tips from their experiences.

Know Yourself
Before considering a transition from clinical medicine to management, do a thorough self-assessment. Clarify who you are and who you want to become as a person and as a leader. Examine your values and goals. Determine your strengths and weaknesses as well as what brings you the most satisfaction.

Effective leaders are lifelong learners
President John F. Kennedy once said, “Leadership and Learning are indispensable to each other,” suggesting that an effective leader should always be open to new information and perspectives. This is particularly true for the healthcare system, which is constantly changing.

Look for ways to polish your skills, and use those skills as building blocks to move ahead. The physician manager today must have an understanding of the details of the business of healthcare, including finance, accounting, strategic planning, information systems, organizational behavior, human resources, and relevant legal issues. Although there is an increasing trend toward formal education, one way or another, if you aspire to management, you will need these skills.

And even if you have a formal degree, you will need to integrate your reading and study with experience. So take every opportunity to obtain practical experience within the organization. The medical world is full of committees, task forces, etc. that can offer exposure to administration, working with people and systems and problem solving. The Related Reading Section that follows contains recommendations by the contributors to this book.

Know your organization
To borrow a medical analogy, organizations, like organisms, are organic and have specific structures and functions. The structure of a medical organization would cover such issues as the type of legal entity, the mode of governance, financing, etc. On the other hand, the overall way a specific organization functions is affected by what is often called its “cultural climate.” For example, how do professional and nonprofessional staff interact; what is the extent of bureaucracy and hierarchy; how much operational responsibility is given to physician managers? Understanding both these aspects of your organization is critical to moving ahead.

Get to know people both inside and outside your organization who you can tap for information and support. Young people involved in team activities tend to develop this critical skill earlier than those focused on more individual, competitive endeavors. If you are not already a member, consider joining the American Association for Physician Leadership. AAPL’s stated mission is to help ensure that physicians continually grow as individuals and become successful healthcare leaders. Hopefully as more women seek leadership roles, they will see the association as a great resource for attaining their goals.

Take the initiative
Don’t expect handouts. In the corporate world, upper management promotes people who find and seize opportunities. Actively seek projects to take on. If you see something that needs changing, develop a plan and present it to senior management. Whenever possible, take on projects that give you visibility within the organization.

Be a risk taker
Be willing to grab opportunities where and when you find them. Whenever you read profiles of people who have had high-level management positions in and out of medicine, you find that they generally got where they are by taking on new assignments. For women, having supportive spouses and families is critical.

Creativity helps, too. For example, if you want to participate on a committee and accommodate family needs, suggest doing some of the work through conference calls (including video) and e-mail.

Reassess goals as you go
Goals developed when you first begin your medical career will likely need adjustment as your personal life circumstances as well as the business/healthcare environment changes. Some people suggest reassessing goals at least every 5 years. The time increment is less important than having the discipline to do it.

Learn to negotiate
If you’re not convinced of the importance of honing negotiating skills, consider that you negotiate every day, whether you’re resolving conflicts between you and your spouse or children, working out vacation schedules with other physicians or staff, or discussing treatment plans with patients and their families. In terms of moving up the management ladder, men historically have been better at asking for things they need in order to be more productive to get ahead. Refining your negotiating skills and learning to achieve win-win solutions will maximize your leverage as a manager.

Select the right subordinates
If you’re in middle management, the personnel you select will determine how well suited you are for a senior position, because senior managers are generally judged not by how well they do, but rather by how well their staffs do. Senior managers must have a clear vision of the future of their organization. They need to be leaders for change.

Find a mentor and/or role model
This is not always easy, but it can make all the difference in becoming a successful manager. Find someone you’d like to emulate and ask directly for his or her help. More often than not, that individual will be delighted to share their wisdom. As you move up in management roles, become a mentor yourself.

Most people today agree that the healthcare delivery system in the US requires fundamental change. I am among those who believe that physician executives articulate in the language of healthcare policy and business are in a unique position to lead the needed reforms. I also believe that women should be among those leaders. Women now make up half or more of medical school classes and have moved into clinical areas traditionally off limits to women. The challenge for the future is for women physicians to also move into top management roles. I hope some of you will be among those women.

Excerpted from Lessons Learned: Stories from Women in Medical Management





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