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Surgical leaders understand the balance between administering care to patients and leading a practice

Article-Surgical leaders understand the balance between administering care to patients and leading a practice

Key iconKey Points

  • Physicians may be key in resource utilization, quality of care and further incorporation of technology.
  • Physicians may be in the best position to lead organizations and institutions in adapting to the sea change in the health care environment.

AUTHOR WARREN G. BENNIS, the seminal modern day authority on leadership, wrote: "Managers are people who do things right; leaders are people who do the right thing." In the clinical arena, surgeons have been trained both to do things right and to know the right things to do. Outside of the treatment room or surgical suite, however, the waters can get a bit murky.

A physician's first priority is the patient and, in administering care, he or she has been trained to act quickly, decisively and often alone. In contrast, as a group leader — whether of a care team, clinic, or corporation — a physician must consider long-term consequences, delegate responsibility and motivate, inspire and coach team members, a much different skill set.

In addition, physicians — even those in fee-for-service private practice like many cosmetic surgeons — tend to measure success primarily in the "soft" and often subjective metrics of aesthetic outcomes and patient satisfaction; executives measure the achievement of starkly quantifiable goals, often financial.

While no one expects physicians to stop focusing on the patient, in the impending political tide of health care reform, there is a presumption that physicians will take on an ever more "lay" CEO role — having to think increasingly in terms of quality and cost. "These decisions don't necessarily concern eliminating procedures rather...improving the process of getting a patient from point A to point B in a value-driven manner," says Richard W. Schwartz, M.D., M.B.A., in a paper he published on physician leadership.

Physicians, therefore, will likely be key in resource utilization, quality of care and the further incorporation of technology and, for this reason, are in perhaps the best position to lead their organizations and institutions in adapting to the coming sea change throughout the health care environment. Unfortunately, leadership experts tell Cosmetic Surgery Times , these potential leaders are often left unprepared to take the reins by their classic "eagles don't flock" medical training.

ON ONE'S OWN So to what degree does traditional medical training address management or leadership skills?

"The residency experience doesn't lend itself to those kind of details," says Leland A. Babitch, M.D., M.B.A., chief medical information officer at the Detroit Medical Center in Detroit, Mich. "[Residents are] not really dealing with a budget. They're not hiring and firing or evaluating people for performance. So having to do it in the abstract is difficult."

Instead, many physician leaders have learned these skills on the job. Outside curricula certainly exist in the form of masters programs (e.g., health service administration or public health) and professional association programming (e.g., American College of Physician Executives), but these must be pursued on an individual basis.

"Most [physicians] are forced to learn it on their own once out in the real world," Dr. Babitch observes. "And because of that, the ability to transition and become a leader in those areas is much slower."

MADE NOT BORN Companies across "secular" industries also complain about the dearth of leadership candidates, and therefore, some have undertaken to create their own programs. Among physicians, however, the intense focus on acquiring precise technical medical skills has often let the development of other ultimately beneficial studies go begging, resulting in "failings in nontechnical aspects of performance (e.g., communication, teamwork, situation awareness)." And, native temperments aside, genetics are not to blame: experts generally believe leaders are made, not born, meaning leadership skills can, and should, be taught.

"I think leadership qualities can be brought out in people," says Dr. Babitch. "There are different styles of leadership and each person has to find his or her own and then develop those skills to the best of their abilities." True leaders will adopt different styles to match the situation. Stellar leaders also share skills that include situational awareness, decision making, goal setting, communication, team building and teamwork, problem solving and creative thinking, conflict resolution and leadership. Their focus is often organizational and oriented to systems rather than to individuals. Even so, many feel it's important to maintain clinical responsibility. "Physicians on the path to leadership cannot leave the values of physicians behind, but they must leave some of the behaviors," writes M.B. Guthrie in "Challenge in Developing Physician Leadership and Management."

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