We are going to need new types of physician leaders to get the change in health care clinicians want.
When I observe current physician leaders, I notice the bulk often fall into two distinct groups. On one side, there are the out-of-touch and on the other the overwhelmed. Both types have positive and negative attributes. In my opinion, the successful health care leader of the future will draw from what works for both and add some additional traits to support a workforce that is innovative, engaged, and productive.
Typically, out-of-touch leaders have learned to outsource and delegate a lot of the tedious minutiae that can make their jobs overwhelming. This is a great skill to make their own lives work better. Unfortunately, the same mindset that allows them to release personal responsibility for every task can also cause them to neglect ownership of the negative impact their decisions have on their employees’ sense of well-being.
In contrast, overwhelmed leaders tend to skew towards an outsized sense of responsibility and empathy. It is wonderful they care. It is less wonderful they care about how everyone is doing everything … even beyond what is appropriate for their job description. Their classic physician perfectionism also makes it hard to let go of the issues the out-of-touch leaders easily put on someone else’s plate for the sake of their own well-being.
Neither being dumped on nor being micromanaged is an ideal scenario for a thriving workforce. Thus, both types of leaders can anger and annoy their employees. We in health care must figure out how to give physicians enough breathing room to achieve the full potential of their talents and strengths without exploiting them and driving them away from patient care. The tricky part is doing this while keeping the lights on and the malpractice insurance payments current.
Recently, that challenge has caused a shift in health care to being less focused on good care and more focused on revenue. That enhanced attention on finance has led many clinicians to feel like they have been sold out by their former colleagues who are now in the C-suite. Adding executive MBAs and leadership certificates to their medical degrees appear to have physician executives catering to the people writing checks rather than the ones seeing patients. Any previous effort to balance honoring the priorities of both seems to have shifted firmly towards the money people.
As someone who left clinical medicine and ended up starting a business with more enthusiasm than acumen, I fully understand how the idealism and altruism that bring one to medical practice doesn’t pay bills. There needs to be a realistic and strategic approach to the business of medicine for practices and hospitals to stay open. My experience also happens to make me believe it is possible to care for patients, care about clinicians, and make a profit.
There are many potential intervention points to improve the health care system in terms of service and revenue. Somehow, the go-to strategy continues to be heaping more responsibility on the clinicians. Young physicians see this and want no part of the clinical hamster wheel that looks like it is only getting faster and less effective for physicians and patients. Unlike many of my peers who use the term “millennial” like an epithet, I don’t blame them. Instead of encouraging early-career physicians to assimilate to the nonsense, I enjoy helping them be equipped to be the innovative leaders we need for the future of health care.
I commend the next generation of physicians for being aware of the self-care and reflection habits necessary to sustain a life of altruism, leadership, and personal well-being for an entire career. Rather than harangue them for it, I prefer to help them channel that natural tendency toward self-compassion into a skill set that allows them to improve the system for everyone. As a physician coach, I enjoy working with young people whose desire to effect change is grounded in the understanding that being well drives the ability to do good work.
In my opinion, every physician benefits from having the standard box of leadership tools, which includes communication skills, strategic planning, and delegation of duties. What I think is often missing from our current executives are some additional skills for self-awareness necessary to utilize these tools effectively and consistently. For instance, when attention to emotional intelligence and boundary setting is absent, you get the out-of-touch and overwhelmed administrators we have now.
As a clinician who burned out early, I value leaders who have both a theoretical and a personal knowledge of how satisfaction and well-being can be incorporated into successful lives. These are folks who pay attention to the state of being as much as the results of doing. They foster environments where employees understand how to be kind to themselves and to each other while still working hard. Unfortunately, there aren’t nearly enough of them.
Our current, dysfunctional health care landscape is a result of way too many instances of the blind leading the naked when it comes to success with satisfaction. It starts in medical education and continues into the health care workforce. In order to model and support thriving lives as clinicians for trainees and employees, we need leaders who are as intentional about personal and professional well-being and satisfaction as they are about success. When those leaders become more common, we may be able to return the practice of medicine to the meaningful and sustainable endeavor we all expected when we entered it.
Jattu Senesie is an obstetrician-gynecologist who blogs at Essence of Strength.
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