How do physicians acquire the necessary leadership competencies to embrace successful integration? In order for physicians to participate in the integrative strategies identified in a previous blog, they must have the leadership competencies to do so. There are numerous requirements for physicians to be an effective leader, both in the clinical and administrative areas. These include:
1. Understanding that leadership and management are professional disciplines
2. Appreciation of the key economic, political, and legal forces that have an impact on healthcare and physician practices
3. Mastery of fundamental planning, marketing, financial, and employee-relations skills
4. Understanding the distinct roles of governance, executive leadership, and operations
Having accepted and fulfilled these basic requirements, the physicians, often with others help, must do a thorough self-assessment of the level of their competencies in relationship to the list of competencies required to be successful. Such lists, which are almost identical, have been formulated by such organizations as MGMA, ACHE, and ACPE. All these organizations keep their lists current and provide both periodic training seminars and formal fellowship programs to obtain the necessary skill sets. The competencies critical today would include leading change, developing effective teams, and leading for results. However, seasoned physicians leaders today agree that their development followed the 70/20/10 Rule:
About 70 percent of the leadership organizational learning occurred on the job, 20 percent from drawing on the knowledge, coaching, and mentoring of others, and only 10 percent from formal learning in the classroom, workshop, or now e-learning.
With a strong commitment to developing and maintaining the necessary leadership competencies, physicians must seek opportunities to partner with their administrative counterparts and assert themselves in organizational planning, program development, and operational management. In due time, they can assume responsibilities for increasingly complex programs and challenges. They must remain current regarding national trends and Federal and State Regulations, and continue to scan current books and articles pertaining to such, which are often available electronically.
One rule often ignored and not written about frequently, is the need for the physician leaders to maintain their credibility as “white coats”. One of their major roles will be to lead other physicians to new practice standards and processes, and practicing physicians will most likely be influenced by their peers who they still see as “real doctors”. This credibility begins with the physician leaders stating that they are “physician executives” rather than administrators. By stating such, they are reemphasizing that they bring to the leadership table the clinical perspective, which then must be integrative with the efficiency and financial perspectives of the administrative team members. Practicing clinical medicine part time is most helpful, but if doing so is impossible, reading current clinical literature so as to continue to demonstrate a clear understanding of the clinical challenges faced by those delivering the care is an imperative.
Because of the significant challenges to integration articulated in a previous blog, the physician leadership role is not an easy one. As a result physician executives must maintain a strong self-esteem to weather criticism from what once may have been their clinical partners. While developing this tolerance for stress, it is helpful to develop a network of professional associates both internal and external to the organization who can serve as a forum for both formal and informal brainstorming.
In the end, each physician who wishes to be actively involved in the integration process must make sure he or she has the competencies required to be successful. This requires a commitment to personal self-evaluation and education, as well as to a life-long learning process to acquire or strengthen the skills that are needed to lead successfully in this ever increasingly complex healthcare environment.