“If you had an orchestra, you wouldn’t want a conductor who’s never played an instrument,” said Dr. Stephen Swensen, former director of leadership and organization development at the Mayo Clinic. “It’s the same with hospitals and physicians. Physician leaders are important — and the most important leader is the one closest to you.”
More broadly, developing physicians as leaders may be good for the medical profession as a whole. A central force behind doctor dissatisfaction is bureaucratic intrusion and loss of professional autonomy. The number of non-physician administrators in the American health care system has skyrocketed in recent decades, and many physicians feel frustrated by policies imposed by those they perceive as disconnected from the realities of clinical care.
Grooming doctors to assume leadership roles could help. Physicians are happier when their bosses are also physicians, and hospitals with physician chief executives seem to perform better than those with non-clinical leaders.
And it’s probably good to start the process early. Medical school admissions have traditionally focused on test scores and GPAs, but assessing leadership skills may be just as, if not more, important for selecting students who will become good doctors. Some residency programs, including my own at Massachusetts General Hospital, have recognized the need to formalize leadership education and have introduced business school-inspired courses on management and emotional intelligence.
Increasingly, medical groups are also creating dedicated pathways for physicians to hone leadership skills and assume graded levels of responsibility over time. For example, Sound Physicians, a company that employs more than 3,000 physicians across the country, has a pipeline for doctors to advance through structured rungs of leadership — emphasizing a different mix of clinical, strategic and business skills at each stage, from individual practitioner to the C-suite. The training includes in-person and online courses, as well as an annual conference, to help doctors develop management and leadership competencies, and learn how to apply these skills within their organizations. Since introducing its leadership development program, the company reports less turnover, higher morale and better growth.
Today, talk of leadership is so pervasive it can sometimes feel empty — the stuff of resume-padding and political advertising. But in medicine, effective leadership has tangible benefits. As our health system continues to struggle to devise ways to improve quality and reduce costs, it’s increasingly clear that a healthy culture can lead to better medical care. For their patients and their colleagues, doctors must be leaders.
Dhruv Khullar, M.D., M.P.P. (@DhruvKhullar) is a physician and assistant professor of medicine and health care policy at Weill Cornell, and director of policy dissemination at the Physicians Foundation Center for Physician Practice and Leadership.