What does it mean to be a health care leader?

american society of anesthesiologistsA guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

Clearly, physicians are the leaders of the health care team.  We were educated and trained for that role.

But on the business and political sides of health care, maybe not so much.

One reason is that the word “leadership” has a lot of different meanings.   A leader in one area is not automatically a leader in another area.  Requisite skill sets vary greatly for various situations.

In determining what is best for a patient, we rely on a certitude that has been instilled in us since long before medical school.  But when it comes to dealing with the massive changes we are now facing in health care delivery brought upon us by payers and the ACA including population health management, quality metrics, and patient satisfaction, we are suddenly on uncertain ground.

The dollars and cents and the nuts and bolts of health care have shifted dramatically.  It seems as if it’s no longer sufficient to be an excellent clinician and the leader of the health care team.  Now we also have to be financial wizards, efficiency experts, technology experts, business people, and entrepreneurs, but not just for ourselves, but for our practices.

Being a leader in these settings requires not only the accumulation of a vast amount of new and ever-changing knowledge, but the development of new interpersonal skills that get our voices heard without being domineering, and thus, shut out of the conversation.  The new paradigm in health care delivery demands a new way of being.  It’s all about teamwork, and there are a lot of captains, but we all need to be collaborative, cooperative, and constructive.  This isn’t going to be easy.

One of the biggest hurdles to overcome will be to step outside of our comfortable routines and commit the time and energy it takes to become a leader in the new health care delivery system.

The parameters of this column obviously do not permit a wholesale review of a step-by-step process required to become a leader.  And, to be honest, a defined step-by-step process for becoming a leader doesn’t exist.  But there are hundreds of articles, books, and conferences on “leadership” available on the Internet.  You may want to start there.  Read a lot.  Take a class or two.  Then get out of your comfort zone and raise your hand, step up, and take on a leadership position.  Developing leadership skills is kind of like in surgical residency, “See one, do one, teach one.”

Quotations can be inspirational as well as educational.  Here are a few that resonated with me and reinforce the message I want to get across about physician leadership in this new era.

Maybe summing things up most succinctly is a quote from President John F. Kennedy, “Leadership and learning are indispensable to each other.”  Simply being placed or stepping into a leadership position is not enough.  It takes a lot of self-education to stay current and, of course, that takes extra time out of a day when you’re already up to your eyeballs in patient care and paperwork.  But it’s essential.

Being a leader requires a positive mindset.  It requires you to be encouraging of others and about the future.  As Napoleon Bonaparte noted, “A leader is a dealer in hope.”  Those in the trenches who never look up at the sky seldom see the bright side.  Remain optimistic.  People will always need health care, it’s just going to be delivered and paid for differently.  Fight for how you think it should be done.

Once you do take on a leadership role, you likely will see a different, maybe hidden, side of yourself that you didn’t even know existed.  It can become addictive.  In many people, the more they have, the more they want.  Or as Zig Ziglar positively put it, “When you catch a glimpse of your potential, that’s when passion is born.”  When you step outside of yourself and see that you can make things happen, it reinforces the desire to do more.

When you see that you can make a difference for yourself and others as a leader, you begin a snowball effect with those around you.  As President John Quincy Adams observed, “If your actions inspire others to dream more, learn more, do more and become more, you are a leader.”  You become the catalyst for a domino effect that builds in many directions.

And what lesson on leadership would be complete without a quote from Winston Churchill?  He pointed out that, “Success is not final, failure is not fatal: it is the courage to continue that counts.”  We have experienced so much change lately that takes the wind out of our sails, guts the joy of medicine, and sucks the life out of us.  But we don’t have a lot of options other than to get involved and stay involved and make our voices heard.

We need to be leaders with the courage to continue.

James D. Grant is president, Michigan State Medical Society and treasurer, American Society of Anesthesiologists.

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