We Desperately Need to Re-Think Physician Success-Three Ways to Get Started

For decades our health system was reactionary and episodic.  It was not ideal for patients, for families,or for controlling the cost of care.

We only recently realized that we need, rather, than reacting episodically to illness, to invest in concepts like population health, in preventing illness and promoting well-being.  When people do get ill, we should be thinking about their care, holistically – resolving the issue and then keeping them healthy and out of the hospital.

It seems obvious when we say this out loud these days, but this was a novel idea not that long ago.

The way we think about supporting physician success, though, is still stuck in that reactionary, undisciplined, ineffective mindset.

Generally, the organization commits resources to physician “development” in three situations: (1) Physician Executive Leaders; (2) High Potential “Rock-Stars”; and (3) the “Disruptors”.

Alan Friedman, MA

Founder & CEO

J3P Health

Here are just a few of the problems with this approach:

  1. We don’t apply validated selection/hiring approaches to choosing physician executive leaders.  They are frequently NOT the right "fit" for the job, which does a disservice to the organization and the individual.  Once the hiring process is completed, we don't provide the support and coaching to be successful, compounding the problem.

  2. We don’t do a good job defining “high performers” beyond their clinical and research capabilities.  It’s often decades into their careers that these rock-stars start to learn about important skills like self-awareness, leadership, and communication.

  3. By labeling a physician as “disruptive” we stigmatize them, demoralize their colleagues and defeat the idea of creating a culture of psychological safety.  We then send them to a “program” for disruptive physicians in an effort to “salvage” them. Why not set physicians up for success from day one and avoid getting to the point that you need to send them to such programs?

  4. Perhaps most importantly, we waste valuable resources on these three groups with ineffective approaches, while doing almost nothing for the remaining 80% of our physicians!  See our previous blog on this topic.  Why spend all of that time and money recruiting well educated, talented physicians, only to leave their success or failure to chance?

A Better Approach:

I spend a lot of my time coaching physicians and physician leaders.  One thing I hear repeatedly is how much less frustrating their career would have been if they had been provided the right training, support, mentoring and coaching MUCH earlier (Blog). We can’t provide executive coaches for every physician, but we CAN create scalable approaches that will help us to accomplish our goals.

  1. Think about the entire physician workforce as just that – an incredibly valuable and important “workforce” to be managed professionally.

  2. Engage senior leadership to appreciate the need for this approach.  It’s needed to avoid physician burnout, to improve physician retention and career success. The goal should be to produce physicians who are not only excellent clinicians, but excellent teammates, colleagues and leaders.

  3. Empower visionary and motivated physician leaders – link them with talented organizational development experts who understand the unique challenges of this workforce – and create the same type of discipline and structure that we have for, as an example, nursing. What does this look like? 

Examples of interesting projects we are working on:

  • Physician “Foundations of Success Programs” – The new physician, in addition to a solid “on-boarding” effort, goes through a scalable, engaging program that creates an individual success plan with support and training during her/his first twelve months.  We understand each physician’s professional goals and aspirations, their preferred practice patterns as well as clinical and administrative/leadership interests.  We analyze their personality tendencies, which manifest as behaviors, which ultimately impact their reputation professionally. This foundation provides a heightened state of self-awareness. Finally, we combine this approach with introductory, but contextually relevant, engaging training on topics like communication, working in multi-disciplinary teams, leadership styles, and conflict management.  Then we monitor their progress closely.

  • Customized Physician Leadership Programming – Everyone focused on this topic.  The challenge as we see it that organizations take one of two approaches – neither, ideal:

  1. Sending physicians to a specific program.  These, certainly, have value.  Formal structured learning from recognized experts and the ability to share ideas and learn from colleagues facing similar challenges; and

  2. Having an established physician leadership organization send it’s experts to you.  They implement their curriculum onsite for you. 

We have found that a different approach works.  The more traditional methods have not proven consistently capable of getting physicians to embrace a new view of leadership and to work closely with colleagues in their own organization.  They tend to focus on “content” training.  Our experience has been that physicians come to these programs thinking that all they need to be effective leaders is “information”, but what they come to learn– is that they need real work on leadership “skills”.

Accordingly, our approach is to build a customized curriculum built around the specific challenges facing an organization and combine content training with a heavy dose of practical learning. This includes coaching on self-awareness, communication, and emotional intelligence skills.  This also allows the group to learn together and build trust – critical to converting the group into a TEAM. The result is goal congruent behavior on behalf of the organization, while accounting for the individual.

  • Scalable coaching for physicians, as early in their career as Residency – There is a growing recognition that GME programs need to commit resources to providing at least some limited coaching to residents.  One of our better received programs provided coaching for female surgical residents at UCLA, focused on their unique challenges and frustrations.

  • Physician, leadership, and nursing integrated learning onhigh-performing teams. As we expect people to work, effectively in high performing teams, we’ve seen success starting with department leadership, then integrating them, and the concepts with managers(who are starving for effective training) and then bring both together with front line staff to REALLY focus on how to build high-performing teams.  This provides physicians an excellent opportunity to practice and develop the leadership skills in a safe environment.

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Perhaps The Most Important Physician Leadership Lesson from Colin Powell - "Remain Calm. Be kind."

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Physician and Nursing Leaders - Improve Your Influencing Skills