Career

Would you be happier in a leadership position? This hospitalist wasn’t


 

Who’s right for an administrative job?

Nearly any type of personality can make a good fit for an administrative post, said Dr. Jurica.

“If you look at most leadership teams, they usually have a team of people that have different personality types that complement one another,” he said. “You can be an extrovert, an introvert, Whatever kind of breakdown in personality you have can be successful.”

Certain attributes, however, are more helpful for executive positions, according to Mr. Dye, including comfort in dealing with ambiguity, a willingness to make difficult decisions, an aptitude for interpreting nonverbal cues, and the ability to demonstrate confidence, but not arrogance.

“Someone who is collaborative and cooperative, a good listener, and has a compelling vision for change in health care also makes a great leader,” he said.

The ability to balance and manage the needs of different groups is also key, said Heidi Moawad, MD, a neurologist, career consultant, and author of “Careers Beyond Clinical Medicine” (New York: Oxford University Press, 2013).

“Sometimes the needs of one group steps on the toes of the needs of another group,” said Dr. Moawad, who provides career resources for physicians at nonclinicaldoctors.com. “You have to be someone who isn’t so overwhelmed by pleasing everyone. You have to think fairly about the needs of all the groups involved, not just the loudest group.”

Is there a specialty best suited to an administrative role? Executive recruiters typically encounter more primary care physician candidates when conducting physician executive searches, according to Mr. Dye. This is likely because primary care doctors are usually the lowest paid of all specialties, and their pay scale may better fit with that of hiring organizations, he said. Higher-paid specialists, on the other hand, may be deterred from pursuing executive roles because of the possibility of lower pay. In addition, primary care physicians typically have traits that align well with administrative/executive functions.

“The nature of their clinical practice means that they are able to see the broad spectrum of the continuum of care and understand the system better,” he said.

Dr. Jurica stressed, however, that strong leaders can come from any specialty and that many medical backgrounds can fit an administrative or executive position.

“It’s more related to interests, desires, personality, and experiences over time as to whether they fit that role or mature into that role,” he said.

Just because you’re a great clinician doesn’t mean you’ll make a good administrative leader, Dr. Lalor said. Physicians can often fall into executive or leadership positions because they’re considered the best or most productive clinician in a group, he explained.

“The skill set is not 100% the same,” he said. “Not everybody is necessarily suited for it. They kind of fall into it and then have great missteps in their earliest experiences.”

Will you miss your former responsibilities?

Some physicians who enter the administrative realm really miss the clinical world and the satisfaction of helping patients directly, added Mr. Dye. He hears from many physicians who miss the “short-term nature” of clinical practice, meaning encountering a patient, determining an intervention, and moving on to another patient.

“Decisions are made, and the physician gets to see the result of those decisions,” he said. “One physician remarked to me that she lived her clinical life in ‘15-minute segments’ and that her executive world had many issues that went on for years, making it very frustrating to her that she was not really making progress.”

For physicians such as family physician Krista Skorupa, MD, who straddle both the clinical and administrative spheres, obstacles can arise in the form of time and balance. Dr. Skorupa splits her time between practicing family medicine and acting as vice president of medical practice for the M Health Fairview Primary Care Service Line in St. Paul, Minn.

“Most people will tell you it’s the balance that’s one of the hardest things,” she said. “You always feel like you’re doing one job not as well as you could because you’re trying to do two jobs at 100%.”

Dr. Skorupa said she has been fortunate to work for organizations that have provided the time and compensation for both jobs. But she warns that some institutions expect physicians to excel at dual clinical and administrative roles, yet fail to allot enough time or compensation for both.

Doctors going the executive route should also prepare for their work relationships to change – some for the worse.

Some peers may perceive a physician’s trek into administration as going to “the dark side,” Dr. Angood said. Attitudes from colleagues may change, and not everyone may be accepting of your new role, he advised.

And as Dr. Dhand experienced, conflict can stem from having to act as an intermediary between staff physicians and administrators. In his director position, Dr. Dhand had to relay administrative policies to his physician colleagues. The task was challenging because Dr. Dhand did not necessarily agree with the policies and felt they burdened already overworked physicians.

“I believe almost all physician leaders feel this way,” he said. “They walk in the same shoes as clinicians and know what a tough job it is. Yet, we are part of the system and have to follow rules and protocols. When you are the one giving bad news, you frequently become the fall guy.”

Is administration right for me?

To decide whether administration is right for you, start by talking to other physicians in the industry and asking questions, said Dr. Skorupa.

“I strongly encourage mentorship and network,” she said. “I learned a lot by just asking physicians who were in different leadership roles, to ‘Tell me your story. How did you get to where you’re at?’ It’s been hearing those stories that helped me craft my own.”

Consider joining committees within your local hospital or among your national specialty organization to evaluate whether the work interests you, Dr. Moawad advises.

“Getting some experience is important to see if it’s right for you,” she said.

Another way to measure your interest is by taking on a part-time job in physician leadership, Mr. Dye said. This allows physicians to try out leadership without leaving clinical practice behind.

“Dyad roles where physicians are paired with a nonphysician partner can also be helpful to physicians who are wanting to move slowly into leadership,” he said. “Typically, the physician partner in a dyad model also continues to practice clinically part time and thus does not lose that connection with medicine.”

In addition to getting some leadership experience, you may want to consider formal training in executive leadership. Many specialty societies offer formal coursework related to leadership, as do some hospital organizations.

The Society of Hospital Medicine offers a 3-course Leadership Academy that prepares clinical and academic leaders with skills traditionally not taught in medical school or typical residency programs. The society also offers a Leadership Capstone program for hospitalists with 3 or more years of experience, who are already leading or preparing to lead an academic, business, or clinical change initiative at their institution.

Physicians can find numerous courses and programs through AAPL, including the organization’s certified physician executive credential. The ACHE has a spectrum of career resources for health care professionals, including courses, competency assessments, and executive career coaches. Medscape’s Physician Business Academy also offers a course in leadership called “How to Become an Effective Leader,” which covers the attributes needed to become an effective leader and how to learn and develop relevant skills and traits.

Some physicians heading down the administrative road pursue more formal degrees, such as an MBA, MHA, or MMM, added Dr. Jurica. A business degree is not required, but degrees do have advantages, he said.

“The most important factor in preparing a physician for this career shift is taking on progressively more challenging duties managing people, running important projects, working with budgets, and honing your leadership skills,” he said. “However, there are benefits to having a degree. It provides formal education in these areas. Pursuing such a degree demonstrates a commitment to your leadership career and can be helpful when competing with other physician leaders for an attractive position.”

The reality is that more hospitals and health systems are recognizing the value of having physicians in leadership and executive functions, Dr. Angood said. Data show that health systems and hospitals with physician leaders perform better.

“This is because physicians not only have strong leadership and administrative capabilities, but they already have a strong sense of the clinical environment and how best to deliver good clinical care. It’s a double benefit nonclinical administrators are unable to match.”

As for Dr. Dhand, he doesn’t regret his stint in administration, despite finding out the path was not his calling.

“My experience was an eye-opener; I’m glad I did it,” he said. “I would change certain things looking back, like having lower expectations and understanding that change takes time. It’s also okay to be unpopular. I’m much happier now, though, only doing clinical medicine, and have found fulfillment through other nonclinical ventures.”

A version of this article originally appeared on Medscape.com.

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