Why we need physician champions to reform health

One advantage of being a surgeon and an MBA is the opportunity to observe different ways of approaching and responding to challenges.  My surgical training and 25 years of practice in academic and community hospitals have helped me become more comfortable with making major decisions despite the lack of perfect information.  Although I find that it takes longer to bounce back from nights on call, I relish the excitement of stating a preoperative diagnosis before making the skin incision, knowing that I will learn the patient’s diagnosis soon after opening the abdomen.

As we await the Supreme Court decision, I believe that physicians’ comfort with moving forward despite uncertainty prepares them well to lead their organizations into uncertain times.  However, we need to overcome the following hurdles:

  • We have received little formal training in communication skills, win-win negotiation, or conflict management during medical school, residency, and fellowship training; because we are trained to think like scientists, we are often perceived as abrasive; moreover, when we feel time pressures, we are unlikely to discuss matters with fellow healthcare professionals, forgetting that problems that we do not talk about become situations that our colleagues may act out;  for example, patient care can suffer when nurses do not call physicians for fear of being chewed out.
  • The leadership styles with which we have greatest familiarity during training are command and control and pacesetting (leadership by example);  unfortunately, these styles are the least optimal for building a safe environment for reflection and learning, causing us to be perceived as poor team players; we have little exposure to more visionary, democratic, and affiliative models that move people toward accomplishing shared goals, obtaining buy-in, and connecting with fellow healthcare professionals.
  • However, during training, most of us experience the benefits of mentoring and coaching, which improves performance by building on clinical knowledge

Physician champions are outstanding clinicians who have earned the respect of their peers by caring for patients in a consistent and reliable fashion, delivering great clinical outcomes.  They are the people we turn to when we need medical care.  They are also seasoned professionals who can leverage their knowledge and experience to improve care for their community.  Possible roles for physician champions include:

  • Presenting and discussing clinical data with fellow physicians
  • Minimizing physician-hospital battles
  • Creating a safe environment for learning
  • Helping to build transparency and trust

Imagine the progress you can make at your organization by leveraging the power of physician champions while you await increased clarity on the national direction for healthcare reform, for example, by reducing readmissions, improving processes of care, and decreasing variation and waste.  Regardless of the outcome of the Supreme Court decision, providers will face increasing pressure to provide more coordinated, cost-effective care because our present non-system is unsustainable and because it is the right thing to do for patients and families, who come to us in times of need.

Kenneth H. Cohn is a surgeon and CEO, Healthcare Collaboration.

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