All physicians are leaders, not just those with designated leadership titles, such as department chief, chief medical officer, or CEO. Leadership – i.e., influencing behavior to achieve a desired result – is foundational to the role of doctor.
But we aren’t routinely trained as leaders. More critically, as brand-new physicians, we aren’t explicitly told we are leaders. Typically, we think a “physician leader” is someone who has been promoted to an “official” leadership position. This lack of awareness that all physicians lead limits growth that could improve our health care system and health outcomes for our patients.
Fortunately, leadership is a learned skill. Leadership training, beginning in medical school and continuing throughout a physician’s career, can benefit everyone around us. In a future state where every physician is educated and trained in fundamental leadership skills, the entire health care system will reap the benefits – nurses, technicians, administrators, finance departments, HR professionals, and doctors themselves. But the chief beneficiary will be patients.
Physicians are often directing the actions of small teams in our clinics, EDs, ICUs, and ORs – acting as “front-line leaders.” Drawing from numerous studies of leadership at the front-line manager level, it becomes clear that improved physician leadership skills can result in better teamwork, higher morale, and improved decision-making in every care site in all our health care systems. Better leadership results in improved retention, lower error rates, and better outcomes – the reason we all went into medicine.
Higher-performing teams and better staff retention
Teams in all professional environments have been shown to perform better with improved front-line leadership. Team members show improved cohesiveness and engagement and are more motivated to see their work through to the end. There is a feeling of excitement and privilege from being on the team.
Conversely, low-performing teams with weak leadership show increased levels of frustration. Team member actions become tentative, errors occur, and low morale becomes more prevalent, leading to increased turnover.
Attracting and retaining top staff is a concern for every health care organization, and staff turnover remains a problem. Across many industries, a top reason people quit is dissatisfaction with their direct supervisors. Good leadership at every organizational level of health care is a key to staff retention. Trust, caring, and longevity are the three key differentiators separating high-performing teams from low-performing teams, and all three are heavily influenced by strong, positive leadership. When people experience trust and a sense of caring in a team, they are more motivated to stay long enough to develop the synchronization that marks high-performance teams.
Better business skills and relationships with administrators
Doctors today face increasing burdens in meeting insurance-related and regulatory requirements. The amount of paperwork has ballooned in recent years, fueling physician burnout.
Leadership training for physicians can also involve developing skills and knowledge in some of the more administrative and business-oriented aspects of the job, such as human resource management, health care finance, or strategic thinking. A trained physician leader not only gains more competency in these areas but also learns how to better understand and empathize with administrative team members.
Historically, the tension between physicians and hospital management has not served health care well. Physicians have excellent clinical knowledge but often lack formal management training. Our administrative teammates typically have business or health care administration degrees and years of administrative experience but may possess limited clinical expertise.
These gaps can become more apparent when physicians are placed in senior executive roles. Accustomed to making authoritative decisions and writing orders, the physician may experience a bit of culture shock. Lack of understanding of basic business, finance, and management principles can be a handicap. Making structured, progressive leadership development an integral part of physicians’ education can help to shrink this gap and give health care organizations the confidence to hire more physicians in senior executive roles.
Improved financial results
A health organization’s financial picture also improves when physician leadership results in improved patient outcomes and satisfaction. A Medical Economics article reported that studies show a direct correlation between patient experience and profitability.
For this and other reasons, patient satisfaction matters. Value-based reimbursement is becoming increasingly common in medicine, especially since the passage of the Affordable Care Act in 2010. Patient satisfaction is routinely captured in surveys such as the HCAHPS (Hospital Consumer Assessment of Health Care Providers and Systems). High scores in the HCAHPS are not only being used competitively to attract more patients to hospitals and other facilities; they are also used to set reimbursement rates.
Hospitals now have a direct financial incentive to improve patient experience, and one way to do this is to ensure that physicians in our organizations are leading well in front of their colleagues, teams, patients, and families.
Given these benefits and more from improved physician leadership, making physician leadership a core competency can make health care better overall for everyone involved.
Leon Moores is a neurosurgeon and author of All Physicians Lead: Redefining Physician Leadership for Better Patient Outcomes.
