Physicians are CEOs of their medical floors

The ability to lead is not something that comes naturally to everyone. There are some people out there who are wired to lead right from when they are very young — but these are few and far between. Most of us have to train ourselves, and acquire the necessary leadership skills based on our own learning curve and experiences. The fact is that we are all leaders in one way or another. Whether at home or in our communities, we all find ourselves in positions every day where we are taking charge. In our daily jobs, no matter what our assigned position, there are always little ways to take ownership and lead in our departments if we want to.

Typically in any organization, the head honcho is the CEO. The buck stops with him or her. Throughout my career, I’ve met dozens of CEOs, and have also got many close friends and family who have reached the pinnacles of their career. My honest opinion, especially in healthcare, is that the brilliant CEOs are few and far between. I’ve been fortunate enough to work with some of them, who are truly inspiring and possess those magical leadership skills. Others, to be frank, have been less than inspiring, and you wonder with their general demeanor and communication skills, how on earth they reached such a position!

As for physicians, we have a very unique job indeed in terms of leadership, because we have less of a “hierarchy of physicians” when it comes to clinical care. The attending physician is always the clinical leader. When any doctor steps out onto the floors, whether we realize it or not, all manner of professionals — nurses, physical therapists, students, and even the housekeeping staff — will look to us as leaders. We, therefore, must act, and communicate, like one. Surprisingly though, unlike many other professions which are more savvy with teaching some of these skills, doctors do not receive anywhere enough coaching on this topic. We need to be ready the minute we graduate from residency, but sadly are not.

Let me stop right there, because I want to stress that being a leader is a journey I’m still on as well, and learning new things every day. Leadership didn’t just come naturally to me since I was young, but I’ve strived to develop my skills over the years. I can truly say that I always keep in mind that as a physician, I am an assumed leader in the hospital or clinic. If I am on a floor of acute medical patients, I actually see myself as the CEO of that floor, and especially — of my patients. This may sound over the top, but it’s how I approach my job and take seriously the responsibilities of being the physician in charge. The buck stops with me, and I make that clear. Patients, families, nurses, whoever — can ask for me if there are any issues whatsoever. I am the captain of the ship. And I believe that no matter what specialty or department a physician is in, this is something that should be encouraged. Every doctor can, and should, “grab the leadership.” This doesn’t mean being arrogant or have grandiose ideas — quite the opposite! It just means acting like a leader at all times if you are a doctor. Moreover, it will also make you much happier with your work.

Little needs to be said about what’s happened in healthcare and to the physician practice environment over the last 20 years. Many believe our profession has completely sold out to corporate medicine (I will leave every reader to make their own judgment on that). By thinking and acting like a leader in your area, no matter how small, you are actually doing a great deal for the profession, each and every day.

A few years ago, I remembered sitting in a large physician departmental meeting. A couple of colleagues complained that when the CEO or other “suits” came up to the medical floor, they just ignored the physicians and walked straight past them. The physicians felt “offended and shunned” by this. I was surprised to hear this attitude, and actually spoke up during the meeting. I said something along the lines of: “You mean you just sit there with your heads down when hospital leadership walks past you?”

You see, my attitude is very different. When I am on an acute medical floor with lots of patients, I view myself as the leader of that floor, even without any official additional title beyond my MD. This is my territory. If anyone non-clinical comes onto the floor, that’s my business too. And when the CEO or any other senior administrative soul walks past, I absolutely stand up and in my (I like to think friendly and composed) manner, say hello and introduce myself if they are with someone else! I want all of them to know it’s my floor they are on. I’m not sure my colleagues took my counter viewpoint at all well, but I would absolutely never just sit there with my head down if a senior administrator walks right past me and wait for them to make the first introductory move. I will make it clear that I am here, say a jovial hello and yes — welcome, to my floor and happy to answer any questions! Because when I’m at work, I am the CEO of my patients and the staff I work with.

Suneel Dhand is an internal medicine physician and author. He is the founder, DocSpeak Communications and co-founder, DocsDox. He blogs at his self-titled site, Suneel Dhand.

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