Are physicians leaders?

It’s a loaded question, but one that deserves analysis. In my recently published book, MD 2.0 – Physician Leadership in the Information Age, I take a look at the evolution of the role of physicians and how we’ve arrived at the point where the traditional paternalistic physician is no longer feasible.

There are a lot of cultural and sociological reasons for why the leadership role of physicians is changing. The typical physician started as a hyper-focused student, most likely skipping the fraternity party to stay home and study the Krebs Cycle.

As a group, we’re trained not to take risks. We delay professional gratification on the assumption that if we succeed at our task-oriented work, in the end we’ll get the recognition and stature we deserve. 

But the world is changing. Healthcare today must be both physician-led and patient-centered. In this paradigm shift, effective leadership must be collaborative rather than authoritarian, proactive rather than reactive.

Making the shift isn’t easy for most physicians. The traditional physician-patient relationship is paternalistic, centered on our knowledge and expertise. We’re the heroes in this scenario. Changing our approach requires a shift in world view.

That’s why the subtitle of my book is “From Hero to Duyukdv.” Duyukdv is a Cherokee word that means truth, dignity, living one’s life the right way, and balancing the rights of the individual with the good of the group.

What I’m suggesting is it’s time to reframe how physicians work with patients (in part by taking advantage of tools enabled by advances in information technology, such as analytics). We need to reboot as MD 2.0 by adopting a more integrated, collaborative approach to our profession. It’s time to shed the training that made us such effective reactive managers and transform into proactive leaders.

What do you think about the role of physicians as leaders? Is it time to rethink how physicians approach how they interact with patients and other health care professionals?

Views expressed by Guest Bloggers do not necessarily reflect the views of “It Takes a Community” or Allscripts.

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About the author

Grace E. Terrell, MD, MMM, FACP, CPE, FACPE is a nationally recognized physician leader who brings more than 20 years of clinical and practice leadership to the development of this new literary work.

4 COMMENTS on It’s time to change how physicians approach leadership

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Mo says:

08/02/2012 at 10:49 am

“What I’m suggesting is it’s time to reframe how physicians work with patients (in part by taking advantage of tools enabled by advances in information technology, such as analytics).”

This is an interesting comment. I’m observing what seems to be a cohort split on analytics. Older physicians seem to feel that analytics are taking away from their control over a case. They feel they are being marginalized by data driven software; particularly with EHR platforms. This seems to be in line with your assessment of the traditional, authoritarian approach to medicine. Younger physicians tend to assess analytics from a much broader perspective and value it so. It’s likely that data will become more comprehensive and integrated into decision making tools. How do you think physicians will deal with sharing “control” of a case with analytic driven software?

    Grace Terrell says:

    08/03/2012 at 12:30 am

    Thanks Mo. My personal experience is that age is not necessarily the deciding factor in reaction to technology as it pertains to analytics. When my organization began implementing our Allscripts EHR in 2005, there had been an assumption ahead of time that individual success would be age dependent. It was not. It depended upon the ability to embrace change and understand how our new tools could enhance patient care, even in the challenges that any new technology inevitably brings on.

    In this fashion, I believe the aspects of care changed by analytics tools will also depend upon our ability to interpret those tools within the context of our professional experience as physicians and our professional obligations to do the best job with the tools we have at our disposal in our care of our patients. Physicians theoretically are scientists, who, while practicing their art, should use quantitative tools at their disposal to improve care. We can see these tools as improving our ability to identify patients with gaps in care or as some sort of threat to our authority and autonomy. That is an existential choice. I personally have not found it to be age dependent, although it may appear that way at times due to lack of familiarity with some of the data and tools and how to utilize them that might be more prevalent in older physicians.

    To answer your question more specifically (“How do you think physicians will deal with sharing ‘control’ of a case with analytic driven software?”) I mostly have to focus upon the nature of the physician-patient relationship at its deepest human level: it is about one individual helping another individual through those universal processes of health, disease, suffering, birth, death, wellness, etc. If technology and analytics can enhance that, it will ultimately be embraced by those who are the healers in our culture. This is not too different than the conversation in another century around that new technological innovation called a stethoscope, seen by some at the time as interfering in the closer physician-patient relationship, but now, of course, universally embraced and a ubiquitous symbol of our profession.

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Dike Drummond MD says:

08/02/2012 at 12:06 pm

Thanks for the post Dr. Terrell. Physicians and leadership is always an important topic and I agree that it is time for a shift in participation and effectiveness. Here’s the challenge …

Physicians adopt a default leadership style because of their position at the head of the clinical care team. The style is Top-Down, Command and control as evidenced by the doctor “Giving Orders”.

Apart from this default style which we absorb by osmosis in training – most doctors don’t receive any specific leadership training. And Top Down is inherently inefficient and divisive.

What physicians must learn for maximal efficiency in the office and to play any role in healthcare systems design is collaborative leadership skills. Then they need to participate rather than demonizing all managers, administrators and leaders outright.

The skills gap is as massive as the opportunity. And we do live in interesting times.

My two cents,

Dike
Dike Drummond MD
TheHappyMD.com

    Grace Terrell says:

    08/03/2012 at 2:35 pm

    Thank you for your thoughtful response, Dr. Drummond. I have spent a lot of time thinking about physicians and our preparation for leadership, which is part of what prompted me to write my book. I had the insight a few years ago that part of the problem might be the way we frame the concept of leadership. Often leadership is misconstrued to be the same as management, and that leads to some of the professional disassociations we experience in our day-to-day work life, not to mention the cultural aspects you point out.

    I read a quote from Fortune magazine from January 1970 not so long ago that perhaps was the beginning of our problems: “The time had come for radical change…The management of medical care has become too important to leave to doctors, who, after all, are not managers to begin with.”

    I believe that physicians might respond better to Peter Drucker’s remarks: “Management is about doing things right. Leadership is about doing the right things.”

    If we are able to use the better part of our nature to understand that both “doing things right” and “doing the right things” are important, then I believe physicians will step up to the challenges that face us.

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