As a physician leader, Sam Cullison, MD, CPE, led a team that worked with AAPL’s Lx Solutions to create a hybrid learning program. In this Q&A, he talks about his own journey and advice for others.
The physician leadership journey isn’t often a straight line, and it most assuredly wasn’t for Sam Cullison, MD, CPE, vice president for graduate medical education at Methodist Health System in Dallas, Texas.
Four years ago, Cullison joined Methodist and was charged with spearheading its physician leadership education. As a veteran leader, clinician and educator, he had earned certificates and taken leadership-based classes in the past. So he had to be persuaded to join the Methodist program as a student himself. Now, at 69, he is a newly minted CPE.
As a physician leader at Methodist, he led a team that worked with Lx Solutions to create a hybrid learning program, beginning in 2014, and has guided three distinct cohorts so far, comprising 62 physicians. Participants in the two-year program take CPE core courses and electives onsite and online.
Lx Solutions is a comprehensive consulting service, an affiliate of the American Association for Physician Leadership. Its team of industry experts helps health care organizations address underperforming processes and redirect efforts toward quality health care.
Cullison spoke with AAPL's Dian Ginsberg about the program at Methodist, his own journey and advice to other physicians.
Q Tell us a little about your background, and how you started in physician leadership. What drives you?
A Super good question. I think my journey goes back pretty far, in that I got involved in the Student American Medical Association when I was a medical student in the mid-’70s. I found myself eventually being a national officer with that organization. It started when I called to complain. I became aware as a second-year medical student that there was a rural health placement project for medical students that was available around the United States by this organization, the Student American Medical Association. It wasn’t offered in the state that I was going to medical school. It was a good lesson to learn. Because you learn that if you complain about something, the next thing you know, you may be running it. So in the second year of medical school, I ran a small health project placing students in rural doctors’ offices. So, one thing led to another, involvement in this medical student national organization, then involvement in a national resident organization, and, ultimately, officer-ships in my state medical specialty organization and the medical society for the state.
Though my journey began with complaining about something, quite honestly, it’s not why it continued. As trite and trivial as it may sound, it’s a desire and commitment to make the world a better place than what I found. So that’s really it in a nutshell. That’s a fairly direct quote from my capstone presentation. What drives me is what has always driven me: Making the world a better place.
Q How did you find out about the CPE, and what did you find appealing about the program?
A I really wasn’t interested in a CPE degree, to be quite frank. Having had a 37-year professional career in the Seattle and western Washington area, four years ago I took a job here in Dallas, Texas, which was to oversee graduate medical education across our eight medical residencies and fellowships here at Methodist. I found that kept me very busy as we worked to improve our programs and do some expansion.
After I’d been here about a year, my boss — the best boss I’ve ever had in my whole life — came to me and, with the departure of a medical executive here, she asked me to create a physician leadership training program for the health system. We formed a committee of physician and nonphysician leaders at Methodist and determined a selection grid that we would use as we analyzed the available sources for such a program. That grid included that it had physician-centric characteristics, that it would provide business and leadership training, that it would have a recognized degree or product, that it would be afford-able and that it could be provided onsite. … We looked at local schools, providing some mid-level and master’s-level programs, and also some national organizations. It was our group’s decision that ACPE/AAPL product would best meet our needs. That has continued to be the case.
Our first cohort group was 23 doctors, and they have now finished their two-year fellowship. Our cohort two is in its final, second year, and cohort three is roughly one year in, just beginning the journey.
Given that I saw myself toward the latter chapter of my professional career, I intended to be an administrator, but not be a student. I was also, at the time that I started this, president of a fairly large national organization, and that was keeping me busy, too. I didn’t think it was a good fit.
My boss encouraged me to be a student in the program as well. While she didn’t compel me, by any means, I ended up agreeing that I would do that. It turned out to be a brilliant move on several levels.
It has helped me be a better administrator of the program. Just because, as a simultaneous student, any bumps in the road or roadblocks that I could have been unaware of as a student, I became immediately aware of them and was better able to administrate it because I was a customer as well as an administrator. The other part, which has been incredible, is the mixture of the educational programs has really been superb. The faculty are just world-class, amazing teachers. … Because we ended up “right-sizing” our fellowship group … big enough to have diversity of opinion and thoughts and contributions, but small enough to have an intimate character to them … my involvement … has allowed me to be the beneficiary of these very meaningful, close working relationships with most of the physician leaders at our entire health system, and has compressed what might have taken 20 or 25 years of relationships to establish, I’ve done it in three or four years. Most of us physicians are learning and educational junkies anyway, so it’s super-duper fun. … It’s been a great journey. I’ve been very lucky.
QWhen you created the program with lx solutions, what were you hoping your colleagues would get from it?
A We wanted to provide a broader educational experience around leadership, health policy and the business of medicine for our physician leaders. We had a lot of experienced leaders, but we didn’t have a lot of educated leaders. Now, we’ve got both.
Cohort one, which was our smallest class … they were all super-experienced senior leaders, but had had no opportunities for training in the area. Cohort two is a mixture of mostly young leaders without a lot of experience but new leadership roles, also untrained, and people viewed at the system level as having great potential as leaders, but not necessarily serving in leadership roles yet. Cohort three is people with potential and no training, and little experience as well. That has been a fascinating cultural happening to observe. … Even now that I’ve finished a CPE, I’m still involved in the classes … and go in and out. It’s been fascinating to see the dynamic, how it’s different for super-experienced leaders … as compared to inexperienced potential leaders with no training. All of them seem to gobble up the education with a voracious appetite. We’ve had twice as many people apply [as can be accommodated] every time we’ve opened up a new class.
Q The diversity of the group is impressive, and they all look eager to be there.
A They are classic adult learners. … They apply. We have a selection committee, which is made up of physician and nonphysician leaders. We try our best to accept those with the greatest potential for adding value to Methodist. … These are very engaged learners. … Our completion rate for cohort one was 96 percent. … This has been a huge home run for us. It absolutely, positively changed the culture here at Methodist.
Q What about the program pleased and surprised you most?
A What pleased me the most has been the ability to impact the organization by providing this education to our physician leaders. … The unexpected impact was this opportunity to get to know all these doctors across all our campuses. It’s been personal and professional. I think I can do a better job for Methodist because of the relation-ships I’ve been blessed to create with the other doctors.
Q Tell us a little more about your personal journey through the CPE program, and how you in-tend to apply that in your current role.
A Quite a number of our classes have been very meaningful. Classes about working with physician performance. I find myself giving feedback and help people function better as physicians and leaders, and the education has been really helpful. I found the finance course to be really helpful to me as well. … I may actually now do the master’s. I’m really thinking seriously about that.
I have quite a number of different duties here; the one I like the most is this [association] fellowship. … One of the things that drives me is making the world a better place. And I have felt like this fellowship program is really helping us at Methodist be a better, more functional, effective, thoughtful organization. The opportunity to be part of that, given what’s important to me and my core values, is just a huge thing, and I feel very blessed.
QWhat would you advise someone considering a physician leadership program?
A If you’re thinking about it, and it is something that otherwise provides meaning to you in your professional life already, pursuing formal training is a way to take it to the whole next level.
Q Anything else you’d like to share with us?
A I’m personally proud to have had the opportunity to participate in this program. I’m also incredibly proud of Methodist for both the financial and other commitments to our program. It’s been wildly successful. We’ve already decided we’re continuing the program for the indefinite future. There may be a time when we stop doing this, but I don’t know when that’s going to be. … We’re continuing on our journey.