Reframing Contemporary Physician Leadership: We Started as Heroes
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The practice of medicine, today, requires transformational skills. Healthcare challenges are no longer adequately addressed by the traditional paternalistic physician role. Healthcare must be physician-led, but patient-centered. Effective leadership must be collaborative rather than authoritarian, proactive rather than reactive.
Most physicians work in environments where current cultural paradigms, such as physician as hero, lead to burnout.
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Physicians have not been adequately trained in many of the skills necessary for leadership competence and therefore lose agency with respect to important decisions.
The pace of technological change impacts physician work in ways traditional workflows cannot accommodate.
This book is a broad analysis into the history, limitations, and possibilities of the healthcare delivery system. Reframing Contemporary Physician Leadership: We Started as Heroes readies physicians for making the necessary changes to transform a system of accelerating cultural and technical changes. Dr. Grace Terrell jumpstarts the conversation about how physicians need to prepare to lead in this complex adaptive system.
You’ll learn about the transformation that helps physicians strengthen their ability to lead. You’ll take a historical journey through the medical profession and the transitions that brought it to where it is today. You’ll gain insight necessary to think through the implications of leadership and current health policy considerations.
Dr. Terrell profiles 11 physician leaders through real-life vignettes to provide concrete examples of physician leaders (and their successes) in the current delivery system. These inspiring vignettes will give the reader a deeper understanding of the historical sources of our current situation and the trajectory of the future state of the healthcare delivery system.
About the author
Grace E. Terrell, MD, MMM, CPE, FACP, FACPE, is a national thought leader in healthcare innovation and delivery system reform, and a serial entrepreneur in population health outcomes driven through patient care model design, clinical and information integration, and value-based payment models. She is also a practicing general internist.
She has served as CEO of Eventus WholeHealth, LLC, a company focused on providing holistic care to medically vulnerable adults. She is the former CEO of Cornerstone Health Care, one of the first medical groups to make the “move to value” by lowering the cost of care and improving its quality for the sickest, most vulnerable patients; the founding CEO of CHESS, a population health management company; and the former CEO of Envision Genomics, a company focused on the integration of precision medicine technology into population health frameworks for patients with rare and undiagnosed diseases.
Terrell has served as vice chair of the U.S. DHHS’ Physician-Focused Payment Model Technical Advisory Committee, the chair of the board of the AMGA, is a founding member of the Oliver Wyman Health Innovation Center, and the co-author of Value-Based Care and Payment Models.
She currently is executive in residence at Duke University School of Medicine’s Master in Management of Clinical Informatics Program and a senior advisor for Oliver Wyman management consulting firm.
Contents
- Preface: Physician Identities and Leadership Roles
- PART I: CONDITION RED: SITUATION TODAY
- Chapter 1: Where We Stand
- The Impact of the Boomer Generation
- America’s Medical Profession
- The Physician’s Compact
- Riding the Waves of Change
- Chapter 2: Powershift and Teambuilding
- Force One: The New Physician-Patient Relationship
- Force Two: Health Information Technology
- Force Three: From Cottage Industry to Corporate Medicine
- Force Four: Healthcare Macroeconomics
- Healthcare Is Now a Team Sport
- Chapter 3: Varieties of Leadership Experience
- Three Theories of Leadership
- Good Physician Leadership Requires an Understanding of Governance
- Effective Healthcare Organizations Require Collaborative Clinical Leadership
- Quantitative Skills Are Crucial Assets for Physician Leaders
- Chapter 4: Barriers to Healthy Change
- Structural Barriers
- Psychosocial Barriers
- Other Impediments to Progress
- Chapter 5: We Started as Heroes
- The Heroic Model of Contemporary Training
- The Heroic Academic Journey
- The Ecosystem for Training Heroes
- New Paradigm for Learning
- Spectrum of Motivations
- An Inflection Point
- PART II: THE FUTURE IS OURS TO MAKE
- Chapter 6: The Pace of Change Accelerates
- Strengthening Communication
- The Perils and Promise of Precision Medicine
- Implications of Social Technology for the Therapeutic Relationship
- Improving Quality and Safety
- Reflection Points
- Chapter 7: Professionalism Is Redemption
- Competing Clusters and the Physician Leader
- Professional Existentialism
- Professionalism in Industry Relations
- Redemption
- Chapter 8: Physician Generation Next
- Today
- The Ongoing Physician Leadership Journey
- Let’s Get Ready
- PART III: LEADERSHIP PROFILES IN ACTION
- Chapter 9: Real Physicians, Real Leaders
- Situational Leadership
- Servant Leadership
- Transformational Leadership
- Nostalgic Leadership (Traditional)
- Entrepreneurial Leadership (Innovation)
- Academic Leadership (Teaching)
- Lifestyle Leadership (Physician Wellness)
- Empirical Leadership (Research)
- Activist Leadership (Policy)
- Tactical Leadership
- Strategic Leadership
- Conclusion
- References
