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Physician Leadership: Myths & Facts


It should be obvious to all that the politicians and pundits driving the healthcare debate in this country have a surplus of sound bites and a deficit of solutions. Many cannot even accurately define the fundamental problem: COST.

The United States cannot sustain double-digit healthcare inflation, and an 18% of GNP healthcare system. Our companies cannot compete in the global market with 15-20% of their overhead going to healthcare. Medicare spending, already funded through its trust fund, without thoughtful intervention will bankrupt our country in the near future.

The solution to our dilemma is to define and sustain VALUE in healthcare. This will be very difficult.

It will require a close examination of every process in which we now engage and asking the crucial questions:

- Is the process necessary?
- Is it efficient?
- Are the right people involved in the process?
- What are the proper metrics for measuring the results?

It will require a paradigm shift for our physicians in:

- The way physicians practice
- The way in which they are reimbursed
- The way they interact with other healthcare providers

This creation of value in healthcare will not arise from the sound bites of pundits or through the mandates of politicians. It will be created by the thoughtful integration of our dysfunctional fractured healthcare delivery system. This integration will require effective physician leadership. The creation of effective physician leadership will require us to re-examine some of the myths that are currently handicapping our perspectives.

Myth 1: You can’t heard cats
FACT: Lions hunt in prides

A CMO of a large healthcare system once said the following to me. “Fred, We don’t have a problem with leadership, we have GREAT leaders. We have a problem with “followership””. The myth here is that physicians cannot be led. The fact is that most physicians in leadership positions today are ineffective because no one has bothered teaching them effective leadership skills. These skills include self and social awareness, appreciative listening, team building, and dealing with disruption. Effective physician leaders empower their physician colleagues to make the transformation from the weak position of isolated individuals to the collective power of groups.

Myth 2: Great physicians make great leaders
FACT: Clinical or scientific skills are different than leadership skills

Too many of our physician leaders today are chosen on the assumption that their superb diagnostic, surgical or research skills will automatically translate into superb leadership skills. In fact, many of the skills that make for excellence in the clinical or scientific arena actually interfere with the collaborative skills required in leadership.

Myth 3: Leaders are born not made
FACT: Leadership is a skill set that, when taught correctly, can be learned

While certain personality traits make leadership skill acquisition easier for some and harder for others, the overwhelming majority of physicians can learn to be effective physician leaders.

Myth 4: IQ trumps EQ
FACT: With IQ’s over 100, EQ trumps IQ every time

High IQ is a given in any physician leadership position. What separates effective physician leaders from their ineffective colleagues is high EQ, or high emotional intelligence. EQ skills include the ability to listen and empathize. They include the ability to separate what may be an appropriate message delivered in an inappropriate fashion.
Those with high EQ are able to challenge others in ways that optimize their performance without evoking resistance.

Myth 5: Leadership = Management
FACT: Leaders are responsible for different tasks than managers and require a different skill set.

This myth in particular has been harmful to leadership development. Much has been invested in adding MBA, MHA, MMM, etc. to the MD title. While helpful to physician leaders, the skills learned in acquiring these titles are primarily management not leadership skills. It is not therefore surprising to find a cadre of frustrated physician leaders who find that their new titles do not translate into effectiveness.

Myth 6: Physician leadership training can easily be incorporated into the organization’s general training program
FACT: Physicians in leadership roles face unique cultural and organizational challenges that require specific skill acquisition followed by intensive coaching and mentoring.

Imagine a quarterback going into a huddle with 10 other quarterbacks. This is what physician leaders have to do. They need to influence highly competitive, strongly opinionated and fiercely autonomous individuals to perform as a seamlessly integrated highly functioning team. The skills needed for the task can only be acquired through objective assessment, tailored training, and practical interactive education. New skill practice requires intensive support with group and one on one coaching.
Physician leaders are desperately needed to define value in healthcare. If we don’t define value, we invite others to do it for us. An investment now in training our leaders to be optimally effective will reap long term benefits to them, the organizations they serve, and most importantly, to our patients.