Leadership. It’s a word used so often, in so many run-of-the-mill ways, that we tend to minimize its significance. In 2019, there is hardly a single résumé or CV that fails to include multiple references to leadership, or a professional development opportunity that neglects to cite it as a learning outcome.

Leadership is more than a throwaway word— it is a lofty ideal worth pursuing and practicing over the course of a lifetime.

Michigan is fortunate to boast many physician leaders; men and women who assume important statewide advocacy roles are able to advance policies that support quality patient care, while simultaneously nourishing their own professional growth as leaders, collaborators, and mentors.

But what does physician leadership look like in daily life, and why does it matter to physicians, their colleagues, and their patients?

Starting from Behind

Surprisingly, research shows most physicians begin at a distinct disadvantage where even their basic management skills are concerned. A pair of articles in the Harvard Business Review recently lamented the lack of management training physicians typically receive, and cited important benefits that arise when such skills are effectively developed—higher quality care, improved clinical outcomes, greater patient satisfaction, and better financial results.[1]^,[2 

“In medicine, we’re trained in patient care and all the many theoretical and technical aspects that accompany it,” says Roy Soto, MD, an anesthesiologist who serves as president of the Michigan Society of Anesthesiologists’ board of directors. “It’s our primary job, so it makes sense it should be our central focus. But it’s tough to overstate the importance of educating ourselves on what we’ve not been taught, so we can handle in-depth financial, management and strategic issues, as well.”

Most practical experiences tend to bear this out. In a world where physicians are trying to figure out tough issues like prior authorization, surprise billing, and an unprecedented amount of paperwork,[3] the need for strong management skills is rising in importance.

It’s also a world where real leadership is needed—leadership that advocates for the needs of patients, informs state and federal policy, seeks the opportunity to grow and innovate, and supports the advancement of important research.

But in a profession where even basic management training is often lacking, finding talented leaders ready to engage and lead on this broader level can be a challenge.

What Physician Leadership Looks Like in 2020

The default setting for generations of would-be physician leaders has been based on the relatively dysfunctional model of giving orders and expecting them to be carried out. It’s natural and grounded in decades of training suggesting that, when an answer is necessary, it is the physician who must find (diagnose) it and then tell everyone on the team what to do, or how to treat it.[4]

A growing body of research and practice suggests, however, that physician leadership is most effective when it is collaborative in nature.  Anand Thakur, MD, an anesthesiologist and pain management specialist from southeast Michigan who chairs the board of the Michigan Society of Interventional Pain Physicians, suggests collaboration can be an asset.

“It is hard for one person to do everything,” Doctor Thakur says. “Collaboration gives physician leaders an ability to keep learning and growing, to try doing things just a little bit better. Sharing that responsibility is so important.”

Doctor Soto takes the concept a step further. “As a leader, you need to recognize the Peter Principle at work in yourself—the point at which you have risen to your level of incompetence,” he chuckles. “Effective leaders need to be highly self-aware, so they can stay effective while learning and growing and helping others reach their own potential.”

Inspiration. Collaboration. Innovation and strategy. Self-awareness and the ability to listen well. For Michigan’s physician leaders, these are recurring themes they use to define leadership in themselves and the colleagues they most admire.

They’re principles that raise the bar well above mere technical knowledge and management capacity, and demand much more of physicians who wish to lead. While some leaders are born for the role, others must learn the skills necessary to inspire others and generate extraordinary results. The good news? It can be done—and the pathways already exist.

Here in Michigan, many physicians are honing robust leadership skills through a dynamic array of statewide medical societies—societies that are thirsty for knowledgeable, engaged members willing to share their expertise and grow as leaders.

Engaging at a Statewide Level

In Chicago at the 2017 annual meeting of the American Medical Association, delegates adopted a policy encouraging physicians to serve on the boards of healthcare organizations. In doing so, the association cited numerous studies showing “significant evidence that the participation of physicians in the governance of many health care organizations is associated with higher business performance, clinical quality and social outcomes.”[5]

A blog post shared by Forbes and The Physicians Foundation shines additional light on the need for statewide physician leadership.

 

With today’s challenges in the house of medicine, the shifting landscape of healthcare and the unpredictable fate of [state and] federal legislation impacting their work, it’s essential that physicians are directly involved in healthcare leadership to navigate a better way forward for the profession and patients.[6]

The problem? Too few physicians have the bandwidth to add statewide society work to their to-do lists.

“I think one of our biggest challenges is maintaining an engaged and involved membership,” says Perry Pernicano, MD, FACR and president of the Michigan Radiological Society. “In our busy lives there are many other demands, commitments, and distractions.”

Doctor Thakur agrees.

“Engagement is one of our core goals right now,” he says. “We’re being very deliberate as we set strategies and look for ways to get more of our members involved and speaking out on behalf of their patients.”

Of course, it is impossible to discuss physician engagement in statewide leadership societies without examining trends related to physician burnout.

A 2019 Medscape report shows that 40 percent of male physicians and 50 percent of female physicians say they are experiencing symptoms of burnout.[7] The biggest contributors to these phenomena are related to issues that have little to do with actual patient care, and are more closely related to external forces such as bureaucracy and paperwork.

 

This poses something of a chicken-and-egg problem for Michigan physicians. If they could free themselves from this heavy paperwork burden, they would have more time available for participation in statewide societies—which could, in turn, advocate for policy changes that can help alleviate the need for such extensive bureaucracy and paperwork and address these critical burnout triggers.

 

Perhaps the deciding factor in favor of statewide engagement over paperwork is what Doctor Thakur calls “the big win” of his role in the Michigan Society of Interventional Pain Physicians.

“I get to talk with other physicians who are facing the same challenges I am, and we can work collaboratively together to find good solutions,” Doctor Thakur says. “Especially now, when our state and nation are facing this huge opioid epidemic, it’s important for us to come together around ideas that work.

“As colleagues working in the same field, we know our issues better than anyone and we’re able to speak the same language, support each other, and share effective strategies with policymakers and the public.”

Darius Karimipour, MD, who chairs the Michigan Dermatological Society, says it’s particularly important to engage with younger physicians.

“Medical societies need to recognize the differing needs and desires of younger members to retain them and garner their participation in organized medicine,” he says.

New technologies and communications tools play an important part meeting those needs.

“One of the greatest challenges facing leaders today is the need to deal with the rapidity of change and stay in touch daily,” says Warren Lanphear, MD, FACEP, who chairs the board of the Michigan College of Emergency Physicians. “This high-tech world demands familiarity with social and other media, and you cannot ignore the conversations.”

Indeed, peer-to-peer social media tools are helping leverage physician learning and engagement. Sites like Doximity, SERMO and Daily Rounds offer connectivity to younger generations of physicians[8]—but are they a substitute for local, personal engagement with colleagues?

It’s widely known that face-to-face, personal interactions are more satisfying and nourishing than those that occur online[9], so it similarly stands to reason that this type of engagement is going to more powerfully combat the symptoms of burnout and foster greater professional enrichment.

In other words, physicians win—both personally and professionally—when they begin engaging with statewide organizations in their areas of practice.

From Membership to Leadership

At the Michigan Dermatological Society, the most important decisions Doctor Karimipour makes involve leadership transitions.

“I think identifying the next generation of leaders is very important,” he says. “Identifying people interested in society committee membership who are ‘do-ers’—that’s what strengthens committees and hence the society’s mission.”

It’s what Doctor Pernicano calls “getting the right people in the right places.”

“An important characteristic for a leader is a willingness to serve,” Doctor Pernicano says. “I view my position as one of service to the society and its membership—and to provide good service, one must be a good listener. We’re looking for people to be aware of and responsive to the needs and wants of our entire membership.”

In 2017, a study by Zenger and Folkman found that, indeed, listening is one of the most important characteristics of effective leadership. This research showed that “leaders with a preference for listening are rated as significantly more effective than those who spend the majority of their time holding forth.” In fact, this study found a direct correlation between a strong preference for listening and an individual’s position within an organization (see chart).[10]

 

One area where leadership through listening can take hold quickly is the development of an effective mentoring relationship. Statewide organizations offer tremendous opportunities for connecting with experienced colleagues and peers who can offer leadership models and advice.

“It’s critical that we all find excellent mentors,” says Doctor Soto. “It’s not always easy to do, but being involved in a medical association or society makes it far less challenging. I was able to locate four or five people I could learn from, and they’ve made a tremendous difference in my own career and leadership growth.”

Research supports Doctor Soto’s enthusiasm for peer mentoring among physicians. Having one or more mentors is shown to foster more satisfying and successful medical careers,[11] and statewide societies offer a rich soil for fertile peer relationships.

Doctor Pernicano says, “Do not think you are alone or that you have to do everything yourself. Be willing to ask for help and advice.”

The Challenges of Leadership

So, you’ve joined your statewide society and are starting to learn, grow, and develop in new ways. In fact, you’re now assuming a broader leadership role. What can you expect?

Today’s leaders say they work hard to keep their minds focused on the big picture.

“Our mission, core values, and vision—these are all vital and coexist together,” says Doctor Pernicano. “Not to get too philosophical, but like the past, present and future, they all are part of the same continuum. I work to organize and motivate others [around these items and our day to day activities, which lead us to them].”

While it’s important for a leader to keep an eye on the horizon, Doctor Soto says he also spends a lot of time digging for intelligence behind the scenes, so he can keep his members a step ahead of the curve.

“I’ve always got my nose to the ground,” says Doctor Soto. “I’m looking at what’s going on in Lansing, with the bigger picture, and trying to make sure we’re working together in ways that allow us to be nimble and responsive.”

This agility is what helps keep today’s leaders on the leading edge of policy and practice. In fact, Doctor Karimipour says the need for constant adaptation and growth are essential drivers for his organization. “What worked in the past may not work as well in the future due to changing needs and demographics, but education is the strength of our society. We are continually looking at ways of enhancing our educational experiences.”

Even as this important work is ongoing, an experienced leader also is working to understand the difference between catalysts that should serve as drivers of change and mere noise.

“The most important thing a good leader can do is listen to all sides of an issue before making a decision,” says Doctor Lanphear. “There are vocal, persuasive people out there that can lead you to forget there may be other viewpoints that have as much or more validity. It’s critical to hold off on making rash decisions.”

Doctor Thakur puts it very simply. “An organization can’t do 17 things at once,” he says. “Effective leaders have to identify one, maybe two goals, and dedicate themselves to moving the needles on them before going on to the next thing. It’s all about knowing where you can have an impact, and then going about the hard work of making it.”