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Learn to Lead


Everyone has it within his power to say, this I am today, that I shall be tomorrow.— Louis L’Amour

Professional advancement means different things to different people. For some, it is important to be the leader of their medical group—whether it is a hospital group or a private practice. For others, it means being associate professor or department chair. And, for a few, it will mean becoming the chief executive officer of a hospital or healthcare company. Much of this comes down to trying to make a difference to the patients and other people around us, as well as trying to bring about improvements in healthcare.

To many physicians, trying to make a difference has been limited to making sure we are doing a good job—diagnostically, pharmacologically, and emotionally—for our individual patients. However, as we become adept at serving the individual patient, we often feel a need to take on more challenges. Medical staff leadership is one way to affect the care of many by directing the actions of the group.

Healthcare is a large component of our country’s economy, and this is not likely to change. In addition, it is an area with many challenges: the aging population, the uninsured population, new pharmaceutical developments, and medical device discoveries. There will be a continued demand for individuals who can understand this very complex intersection of business and medicine.

Historically, the chief executive officer of a hospital or integrated system has been a non-medical person with business expertise in healthcare. Hospitalists may fill this role more and more in the future. Hospitals are increasingly recognizing that the expertise of committed physician partners is critical to their success.

Fill in the Gaps and Offer Your Help

How many times have we heard our colleagues complain that “the problems never change and nothing gets done around here”? No doubt, change is tough, but taking a role in your department or at your hospital is a way to start. Many hospitalists are filling in the leadership gaps as other specialists move to outpatient centers or into the office. Posts that have traditionally been held by cardiology or urology are changing.

Give some thought to where you might help out. A commitment to something as simple as the Pharmacy and Therapeutics Committee can lead to changes for all the patients as well as get you started on your new career path. Every chief of staff and vice president of medical affairs is looking for volunteers who are interested in projects and can follow through. This applies to department chairmen as well. Given the commitment we all have to our patients and our lives, the offer of help for even just one project is a breath of fresh air to those who have the responsibility for the group or department. Depending on your area of interest—patient safety, quality improvement, patient or medical student education, or process improvement—a project can be created that furthers your institution and addresses your interests.

Worried that there is no room for you at the table? Think again. If your department chair or chief of staff is not asking for help, it may be that their requests have fallen on deaf ears for so long that they have stopped asking. If you have identified a project that interests you, it may interest others also. Ask if there is a way that you can work with others on an existing project. Alternatively, ask if there is a project that needs doing that has no one to do it. Many projects need a political and medical champion; they would welcome your offer to help. Volunteer and be prepared to take on a project that is not your favorite but that may give you experience for other projects. Your initiative will certainly get the attention of the chairperson or others because you are solving a problem for them.

Ask, Listen, and Learn

In addition, this is just a beginning step that will lead to further leadership positions for many. Gaining experience with what works and with how you can accomplish initiatives will lead to bigger opportunities. Embedding yourself in the fabric of your organization provides an opportunity for others to see you work and interact. Seek the advice of those whom you trust and who appear to be successful. Listen to feedback and adjust accordingly. Take classes on leadership, financial performance, process improvement, or in areas that appeal to you and that address what you want to accomplish. Before you know it, you will be chief of staff, division chair, or chief medical officer. Knowing where you want to end up is always an advantage, but many individuals find their way through different experiences and exposures. Sometimes where you end up is not what you expected, but the journey is usually interesting.

Different career choices come at different times. Focusing on family, whether it is making time for children, caring for elderly parents, or supporting a spouse’s career choice may require less career focus for a time. However, as your responsibilities change, new opportunities arise. Finding a mentor or trusted individual who can advise you during these times is helpful.

Develop and Demonstrate Executive Expertise

As the hospital environment changes and hospitalists become the primary providers of care in the acute care setting, they will become hospital coordinators, in conjunction with the emergency department and other specialists. They will develop a knowledge that can be leveraged to improve processes, reduce errors, and improve outcomes. A different set of skills is needed to be successful as an executive. It requires a different way of problem solving; it requires studying and applying new lessons. The successful person develops this new expertise. The effect this person makes in applying these new skills will lead to increased roles and responsibilities. There will be continuing demand for individuals who can access, plan, and implement change within our complex systems. There will also be continuing challenges in healthcare, including the areas of medical education, research, the uninsured, and the aging population. Skills acquired now could be applied as the vice president of medical affairs or as chief medical officer.

Historically, the chief executive officer of a hospital or an integrated system has been a non-medical person with business expertise in healthcare. Hospitalists may fill this role more and more in the future. Many individuals are starting their careers in the hospital. This experience will allow them to develop skills their prior colleagues did not have. It will expose them to teamwork, results orientation, and mentors. We are a young group of professionals with many career years ahead of us. Hospitals are increasingly recognizing that the expertise of committed physician partners is critical to their success. This combination of interest and opportunity will groom many individuals, some of whom will affect healthcare for generations.

Bringing our knowledge of medicine to business, and creating crossroads and interactions, can advance our careers at the same time it improves the healthcare of others. This type of career path is not out of reach for you, and to think it all started with the Pharmacy and Therapeutics Committee. TH

Dr. Gorman is the president of SHM.

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