Medical Staff

Is There Anyone Capable of Taking Charge Here?

Medical Staff Affairs Monthly, March 11, 2009

There is nothing like a crisis to raise the fundamental question about leadership, "Is there anybody capable of taking charge here?" While this is certainly relevant on a national and international level, what about in your medical group, hospital, or healthcare organization? Leadership in healthcare organizations can be problematic, as many clinicians are dismissive of the importance of leadership in driving change and improving the chances of success. This is true until the chips are down. It is then that everyone looks around and says, "Where are the leaders now that we need them the most?" In other words, who is going to help guide us through this crisis, bridge us across this chasm, or lead us out of this morass?

Given the current state of affairs, it should come as no surprise to see a definite uptick in the interest in governance and leadership challenges. In the February 2009 McKinsey Quarterly, Mountford and Webb accurately point out three factors that stand in the way of clinicians embracing leadership:

  • An ingrained skepticism among clinicians about the value of time spent on leadership
  • The weak or even negative incentives for clinicians, especially physicians, to take on service leadership roles
  • Most organizations provide little-to-no provision for nurturing clinical leadership capabilities through education, development, and training of clinicians for leadership roles.

In light of all this, a fair question becomes how then to proceed? At the March 2009 American Medical Group Association (AMGA), several sessions and presentations on governance and leadership were featured. One presentation developed by J. Gregory Stovall uses an agricultural analogy to guide the way. He posits four steps:

  • Creating fertile soil, which means to develop a culture of leadership in the organization. Of course, strong leadership is needed to drive and shape cultural change, but you have to start somewhere.
  • Planting good seeds, which is the identification of potential physician leaders and recruiting them to the culture of leadership.
  • Watering and fertilizing, which refers to providing the structural support of leadership education, development, and training.
  • Harvesting the result by assessing the return on investment (ROI) in developing leaders.

On a more practical level, another question may be where do we start if we have nothing or where do we go next to improve what we do have? The temptation is to jump to an internally developed, externally facilitated, or national seminars dealing with leadership training for clinicians. However, as Mountford and Webb state, there really should be a prior step. That step is for the organization to define what it truly needs from clinical leaders. To achieve those needs, what personal skill development and management tools are required? What attributes and behaviors are to be fostered and encouraged? Are there differences between the roles and responsibilities needed that require different sets or subsets of leadership skills and training? Are there differences between the clinical professionals needed for success? And where is the greatest need for leadership training: the medical staff, the board, the management team? After a thoughtful analysis of these questions, the path that needs to be followed should become clearer.

Finally, The Greeley Company has always recognized and taught that a competent clinician does not automatically mean a successful transition to a competent leader. In fact, the opposite is often the case. The successful transition requires a commitment to acquire and develop the necessary personal growth and external toolkit to be able to effectively lead change. This includes, at a minimum, communication skills, principles of negotiation, management of conflict, strategic-thinking abilities, and collaboration with diverse stakeholders in the organization. This is no easy task, but the payoff is the development of a cadre of strong leaders. When the crisis comes, there is now an answer as to who is capable of taking charge. And taking charge does not mean command-and-control. It means shaping the vision, creating the sense of urgency, driving the cultural changes required for organizations to recognize and embrace their fundamental core values and mission, while simultaneously being able to flex and adapt. This leadership can strategically help organizations to become and remain successful in this very chaotic healthcare environment, characterized by tremendous conflict and cataclysmic change in which we all live. Please let us know if we can be of help in providing help in the identification, development, education, and training for leaders in your organization.

Until next time, be the best that you can be.

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