I was recently invited to visit an academic anesthesiology department to speak to the residents about becoming a leader. In addition to recognizing the honor and privilege of addressing this important topic with the next generation of physician anesthesiologists, I had two other initial thoughts: 1) I must be getting old; and, 2) This isn’t going to be easy.
I came up with the following list of lessons that I’ve learned over the years. While some examples I included are anesthesiology-specific, the lessons themselves are not. Please feel free to edit, adapt, and add to this list; then disseminate it to the future physician leaders who will one day take our places.
1. First and foremost, be a good doctor. Always remember that we as physicians take an oath. In the modern version of the Hippocratic Oath commonly recited at medical school graduations today, we say: “May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.” Medicine is, and should always be, a calling. As a physician anesthesiologist, we care for the most vulnerable of patients — those who under anesthesia cannot care for themselves. Examples of anesthesiologists and other physicians who do not honor their calling exist in the news and even scientific journals, but we cannot follow this path.
2. Define your identity. We live in the era of the “provider,” and this sometimes causes role confusion from the perspective of our patients. We also don’t tend to do ourselves any favors. How many times have you heard someone say, “Hi, I’m [first name only] with anesthesia?” According to the American Society of Anesthesiologists newsletter, approximately 60 percent of the public may not know that physician anesthesiologists go to medical school. My friends in radiology say they have the same problem. While every member of the health care team plays a crucial role, we are physicians and need to be willing to lead. I’ve written before about what I love about being an anesthesiologist, and being the physician whom patients trust to keep them safe during surgery is a privilege that comes with a great deal of responsibility.
3. Consider the big picture. The health care enterprise is constantly evolving. Today, the emphasis is on value and not volume. Value takes into account quality and cost with the highest quality care at the lowest cost being the ultimate goal. The private practice model of anesthesiology has changed dramatically in the last few years with the growth of “mega-groups” created by vertical and horizontal integration of smaller practices and sometimes purchased by private investors. In this environment, all physicians and medical groups will have to consider ways they can add value, improve the patient experience, and reduce costs of care in order to stay relevant and competitive.
4. Promote positive change. Observe, ask questions, hypothesize solutions, collect data, evaluate results, draw conclusions, and form new hypotheses — these are all elements of the scientific method and clinical medicine. These steps are also common to process improvement, making physicians perfectly capable of system redesign. The key is establishing your team’s mission and vision, strategic planning, and goal-setting, and regularly evaluating progress. Books have been written on these subjects, so I can’t do these topics justice here. In my opinion, physicians offer an important and necessary perspective that cannot be lost as health care becomes more and more business-like.
5. Be open to opportunities. Thomas Edison said, “Opportunity is missed by most people because it is dressed in overalls and looks like work.” I have written previously about the merits of saying yes. As a resident or new staff physician, it often seems impossible to get involved. However, most hospital committee meetings are open to guests. Consider going to one that covers a topic of interest and volunteer for a task if the opportunity presents itself. Also, many professional societies invite members to self-nominate for committees or submit proposals for educational activities at their annual meetings.
6. Thank your team. Taking the first steps on the path to leadership is not going to be easy. There will be many obstacles, not the least of which is time management. A high-functioning health care team of diverse backgrounds, skills, and abilities will accomplish much more than what an individual can do alone. Celebrate team wins. Respect each team member’s opinion even when it differs from yours. Always remember to thank your team, and do it early and often.
A good leader should earn the trust of his or her team every day.
Edward R. Mariano is an anesthesiologist. He can be reached on his self-titled site, Edward R. Mariano, M.D. and on Twitter @EMARIANOMD.
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