Leveling up

How to prepare for a leadership role — even as you’re just starting out.

By Laurie Morgan | Feature Articles | Winter 2019

 

If you’re like most new physicians embarking on your career, you might not be thinking ahead to a management role. Your priorities are likely finding the right place to practice and, above all, helping patients.

But even if you don’t envision running a health system, hospital department or independent practice in the future, you should still be seeking out opportunities to develop leadership skills. These abilities will bolster your career as a physician—whether you see yourself in a corner office one day or feel certain you’ll always focus on patient care.

After all, some level of leadership is inherent in every physician role. Staff will look up to you and expect you to lead the way, and your employers will rely on you to guide new initiatives and solve problems. Learning to lead better can help you not only advance your career but also care for patients more effectively.

Filling a gap in your medical training

Mark Deshur, M.D., says it doesn't take a title to be a leader. "Even without a formal role, you can make a difference in how things are being done." -Photo by Colin Lyons

Mark Deshur, M.D., says it doesn’t take a title to be a leader. “Even without a formal role, you can make a difference in how things are being done.” -Photo by Colin Lyons

Despite their benefits, leadership skills rarely get attention in medical school and residency. With so many clinical priorities to cover, it’s hard to make room for non-clinical topics in the curriculum.

“Lots of physicians don’t want to accept that management skills are important,” says Maria Chandler, M.D., MBA, founder of the MD/MBA dual-degree program at University of California, Irvine and president of the Paul Merage School of Business Association of MD/MBA Programs. “But this is a disservice to medical students. We’re telling them [clinical education] is all you need, yet it’s not true.”

This focus on direct patient care is admirable, but it may be shortsighted. Chandler believes management training helps physicians care more effectively for patients. For example, physicians with business knowledge can be better advocates for clinical priorities. She explains, “If you’re interested in preventing chronic disease, you can learn to make the economic case for that.”

That’s one reason Chandler advises all physicians to learn some leadership basics. She says they should do so “as early in their careers as possible.” Once there’s an “M.D.” or “D.O.” after your name, people will expect you to guide them, regardless of your age. Many of these people—including the nurses, MAs and other staff you’ll work alongside—provide essential support for patient care. Working well with this team will require training you didn’t receive in medical school, and some of what you learned might even be counterproductive.

Unlearning the superhero myth

According to Dike Drummond, M.D., CEO of TheHappyMD.com, many physicians enter the workforce with misguided expectations. “In medical school and residency, there are no leadership courses. You learn by osmosis, and here’s how it works: you see patients, reach a diagnosis and write orders, and the rest of the care team waits on you,” explains Drummond. “You’re taught subconsciously that only you have the answers. But what kind of leadership style is that for team-based care?”

As a result, Drummond says that most doctors internalize a “Lone Ranger, workaholic, superhero, perfectionist ideal” in medical school. This mindset not only burdens physicians; it also makes it harder for staff to help. Nurses and others will follow your lead. If they’re always waiting for your orders, they’ll be underutilized and probably less motivated, too.

And when staff members don’t feel supported as part of the care team, patient safety can be affected. “It’s been proven in numerous studies that a lot of people feel too intimidated to say anything to a physician—even if it’s a life-threatening issue,” adds Chandler. “Leadership training can help physicians learn to create an atmosphere of teamwork.” In a culture where staff feel comfortable raising concerns, patient care improves.

To build team leadership skills as a physician, Drummond says the critical first step is learning to listen and ask questions. “Your staff can always help,” he explains. “They want to help. But they’re not going to elbow you out of the way.”

Once you start asking staff how they can assist, Drummond says they’ll likely respond with many useful ideas. When you enable them to take on more meaningful roles, they’ll be happier and more engaged, too. That means more support and less stress for you as a physician, more attention for your patients and higher career satisfaction for the entire team.

New clinical and economic approaches are making the ability to lead diverse teams more critical than ever. Patient-centered medical homes require high-performing care teams, and alternative reimbursement models—with evolving definitions of value and quality—require physicians to lead change, sometimes in tandem with administrators.

Chandler says physicians don’t always see these opportunities as being directly tied to patient care. “Many doctors think of taking on leadership responsibilities and roles like serving on committees as a chore,” she says. “All some of us want to do is see patients—like a surgeon who’s tied up in an OR 80 hours a week and inadvertently gives up their input.”

But she says by getting involved in leadership, physicians can impact more patients while helping hospitals and health care systems make better decisions and reduce costs.

Don’t wait for an official title

In the business world, budding leaders learn the art of managing up, down and across—or in other words, finding ways to influence the workplace even when they aren’t in charge. Physicians can benefit from learning to do the same. This starts with recognizing opportunities to help not only their patients and their subordinates but also colleagues at all levels.

Mark Deshur, M.D., MBA, vice chair of operations in the department of anesthesiology, critical care and pain medicine at NorthShore University HealthSystem in Chicago, has found this to be true in his own career. He says he knew from the beginning that he would eventually seek some sort of leadership role, explaining, “I knew I wanted to be part of the decision-making process, not just subject to others’ decisions.”

Deshur learned early on that you don’t have to wait until you have formal authority to contribute ideas to improve your workplace. “We have so many people in my practice who are leaders without titles,” he says. “Even without a formal role, you can make a difference in how things are being done. You see an opportunity to do something a little differently and a little better, and that improves things for everyone else.”

And making suggestions isn’t just good for others. It’s also good for you. “It creates more career satisfaction and better engagement in the practice because everyone wants to feel that when you’re going to work, you’re making the place better,” Deshur explains. He adds that phrasing a suggestion as a question is a good way to persuade others without putting peers and senior colleagues on the defensive. “For example, you could say, ‘Do you think if we tried X, it might be an improvement?’”

At practices that welcome this type of input, younger physicians get to develop their leadership potential and prepare for formal management responsibilities down the road, Deshur says. He recommends assessing prospective employers by asking recently hired doctors if they’ve been allowed and encouraged to suggest changes.

Managing upward can be especially challenging in the medical world. Physician training favors on-the-spot decision-making, and this tends to develop reactive management skills rather than proactive ones. As a result, some supervisors only communicate with their subordinates when there’s a problem, which can be discouraging for young physicians who want to do well. Scheduling a regular check-in with your boss can help you confirm you’re on track.

Mentors provide invaluable guidance

If you nurture relationships with your boss and other experienced physicians, you may find they become long-term mentors. These mentors can be invaluable as you navigate key career decisions. “I’ve been very fortunate to have several mentors I’ve leaned heavily on,” Deshur says. “Even though my career trajectory was different than theirs, they helped me take a step back and think about what my strengths and weaknesses are and what am I interested in.”

Deshur didn’t have to look far for his mentors. He found them in his direct managers. “I was lucky that I had them right in front of me,” he says. “But if you don’t have mentors readily available, seeking out one or two people who can give you feedback and advice is so important. So many people have tremendous experience to share that you can learn from.”

Finding mentors may require effort and creativity, but one easy way to start is to keep in touch with older physicians you admired during your training. If your job takes you to a different part of the country, ask them to introduce you to respected colleagues in the area.

Joining your local medical society can also help you form relationships with physicians from a range of specialties, especially since society leaders are often interested in becoming mentors. The nurses at your new hospital are another great resource as they undoubtedly have insights about which doctors are most admired.

To MBA or not to MBA?

Deshur says finding mentors helped him prepare for another major step in his leadership plans: pursuing an MBA. “It was in the very back of my mind, since I’d taken business classes in college. But I kind of forgot about it during the early years in my practice,” he says. “Then my boss, who was also a mentor, told me how he’d gotten an MBA mid-career and asked me if I was interested in it.”

Deshur’s mentor urged him to enroll in the executive MBA program at Northwestern’s Kellogg School of Management. Because the program was located nearby and designed for working professionals, Deshur could enroll without leaving his practice. He credits his employer and fellow anesthesiologists for helping him through.

“You can’t do it in a bubble. You need the support of your practice,” he says. “My boss was very supportive. He helped me get the time off that I needed and encouraged the other 50 people in the department to support me.” Deshur’s colleagues ensured he was able to attend required classes on Friday mornings and swapped call schedules with him as needed.

“As a department, we’d benefitted from the leadership of my boss, who had attended the same program,” Deshur recalls. “So I think people thought, ‘If we help Mark take on more, that can help our entire group.’”

Often, the entire organization benefits when a physician earns an MBA, so your employer may also help pay for it. This is especially true if you’re promoted to a role that requires advanced leadership or negotiating skills, such as heading up a department, says Gregg Bass, communication and marketing specialist at Auburn University’s Harbert College of Business. And when tuition assistance from your employer isn’t available, you might be eligible for financial aid.

Auburn’s Physicians Executive MBA Program is pioneering a new wave of MBA offerings tailored to busy physicians who go to school while working full time. “The majority of our program is distance learning,” Bass says. Physicians can access the curriculum online on their own schedule. Five short residencies on campus at Auburn are required, but students get these dates in advance so they can plan ahead.

Chandler believes a physician shouldn’t put off pursuing his or her MBA. She says, “It only took me two years of being out of training [and] seeing patients to realize there might be something more I’d want to do later, besides only seeing patients for my entire career. The worst case is you wait so long that you realize the opportunities you’ve missed.”

The growing number of flexible MBA programs makes it easier to pull the trigger, even while working as a full-time physician. “They make all different shapes and sizes of MBA programs now,” Chandler says. “There are fully online programs, one-year programs, hybrids, evening-weekend programs—all kinds of options to fit the needs of people.”

Another reason not to delay: the skills and professional connections you’ll develop in an MBA program can open new doors. If you’re facing a career change or just feel ready for one, an MBA can be a powerful catalyst.

“We’ve had physicians who are taking on leadership roles in hospitals, physicians who want to leave practice to work in pharma” says Bass. “Recently, we had a trauma surgeon with many years of experience who realized he wouldn’t be able to do that physically demanding work forever and wanted to prepare for something new.”

New opportunities might also come in the form of entrepreneurship. Bass says several physicians in the Auburn program turned their class projects into real-life business ventures. Similarly, Deshur says getting his MBA encouraged him to turn a software program he wrote as a resident into a product. Today, hospitals and practices all over the country use his on-call scheduling solution.

If you already have a great idea that can really make a difference in the industry, Chandler says you might need business training to make it a reality. “I knew a couple of intensive care docs,” she recalls. “They were five to 10 years out of school. They were trying to help save lives by bringing telemedicine to rural areas where intensive care resources were scarce. I said to them, ‘You need MBAs to take this thing and make it big.’ They both enrolled while still practicing and building their venture. It’s hard, but if you’re motivated enough, you can do it. Knowing why you’re doing it—to achieve a goal, to learn a new set of skills—can make it easier to stay focused.”

Creating a healthier health care industry

Vidya Bansal, M.D., started a group for physicians of South Asian decent-a community that has helped her develop her own leadership skills. -Photo by Rachel Moore

Vidya Bansal, M.D., started a group for physicians of South Asian decent-a community that has helped her develop her own leadership skills. -Photo by Rachel Moore

Chandler believes pursuing an MBA is worthwhile not just for the career advancement but also for the personal development. It’s intellectually invigorating. “I found I missed school, missed learning,” she explains. “Doing the MBA while working was hard, but it filled the education void. If you’ve only studied medicine, it’s so intriguing to study something else.”

She adds that an MBA program is just one way to be a lifelong learner. Other development opportunities can also help physicians enjoy their careers. “I get emails from physicians who are many years into practice who are burned out,” she says. “I think one remedy to burnout is to give yourself additional skills so you have options. Your options can be in all different directions.”

Chandler believes today’s physicians can and must take on more leadership roles to improve the profession and make it appealing to the next generation of talent. “It’s like we’ve had blinders on,” she explains. “But we have to think about how to compete over the long-term with other employers who want smart, talented, young employees.”

Pediatrician Vidya Bansal, M.D., has found a way do just that—helping other physicians while developing her leadership skills. Early in her career as a pediatrician, Bansal wasn’t sure where to look for support. So she turned to Facebook and started a private group for physicians of South Asian descent: Desi Physician Moms. When Bansal first founded the group in 2015, it had only 14 members, but she’d struck a nerve. The group soon took off, and today more than 7,000 physicians are members.

“I started it for personal reasons, to find support,” Bansal explains. “I wanted a place where I could share and not feel alone.” What began as a hobby quickly became a lifeline for women physicians dealing with issues like domestic abuse and harassment at work. Over time, the group has evolved into a dynamic nationwide community with an annual conference, a subgroup to support single moms, and mentorship opportunities for medical students. Recently, it launched a foundation to help to women of all professions who are struggling with abusive relationships.

Along the way, Bansal has seen her leadership skills blossom. “To build the foundation, we had to build a team,” she explains. And in order to manage that team while building the foundation and keeping up with full-time clinical work, she’s had to learn to lead others and delegate tasks. Most of all, she says, she’s learned the value of speaking up for herself and for other women.

“What we don’t teach anywhere in medical school or residency is how to be your own advocate,” Bansal explains. “It comes down to being in control of yourself and what you will expect and accept. I feel great for the residents in our group who have a network of colleagues to tell them these things now. You have to find it from within. That’s what we’re trying to teach each other to do. It’s about unity and paying it forward and about fixing what we see that needs fixing in medicine and in women’s lives.”

Chandler emphasizes that everyone can find enrichment from learning at least a bit about leadership. It might not look the same for everyone, but whether you learn from an MBA program, a book, mentors or other activities, leadership training will benefit you professionally and personally.

“Developing a leadership mindset helps bring out some qualities you might not otherwise tap,” Chandler explains. “It allows you to express other talents. Learning about leadership and learning about business gave me a lot of personal satisfaction. You start to see the whole pie, not just the perspective of medicine.”

Laurie Morgan is a partner at Capko & Morgan, a boutique practice management consulting group. Learn more about our contributors on page 20.

 

 

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