Wednesday, July 4, 2007

Health Care Leadership – My Journey

I thought that as a way of introducing myself, I would spend some time letting you know more about me and how I got where I am today.

As early as I can remember, I always wanted to be a physician. I think that was because I had an aunt who was a director of nursing in a hospital, and my father, who was the manager of a line plant, was responsible for first aid in his job. My father was actually blinded in one eye, and I learned about eye and line burns on the job from him.

Whether those early experiences played any part of my choice to practice medicine or not, I always felt that it would be a profession that I would enjoy and have the skills for, and that it would allow me to feel good about serving others. As a teen, I found myself participating in community projects that served others, and I found great rewards in being a volunteer. I ultimately felt that some of that volunteerism was part of being in the medical profession.

As I grew older and knew more specifically what medicine would require, I made sure that I was academically prepared, and was very focused on my grades in high school and college. My first day of medical school, I went to a lecture and anatomy class and knew I had made the right decision.

I still feel that the best work I’ve ever done in health care has been my clinical work. I have always said—even as I moved into leadership roles—that I am a physician leader and not an administrative leader. I also recognized very early that just as in clinical medicine, you need to function within a strong team to provide excellent health care.

Consequently, I realized that as a physician, I could bring a strong clinical perspective to the table, but also needed to work with other people who could bring strong business skills to the table as well as expertise in other necessary services such as human resources, legal, etc.

I didn’t set out to become a “physician leader”, but I soon realized that I would be able to maintain at least some clinical focus throughout my career, even if I was not actively participating in clinical care. I began that career first as a general surgeon, then worked as a trauma physician in the Emergency Department, and then moved on to Chair of an Emergency Medicine Department. I founded and directed an emergency medicine residency program associated with the ER and developed a poison control center and a hyperbaric medicine program.

As I held my various positions and accepted new leadership roles, I realized that I always needed to be strongest in my clinical expertise. An excellent health care organization has to be driven by what is best for patients and their families, residents of their long term care facilities, etc., and I knew that should be my focus as a physician as well as a leader.

Now I do what I can to stay clinically attuned. I read as much clinical information as I can, and I periodically go to work in one of our three clinics. I have decided that my future clinical work will be predominately done in clinics for poor.

Clearly, as I look back in my career, I began as an informal leader. Even in high school, college and medical school, when I would see things that weren’t working, I would try to get involved with the group of people who could impact or change those things, make them work better. I think that as people see you doing that, they decide that maybe you should be put in a formal leadership role. So I was president of my high school class, Chief Medical Resident in my surgical program, president of the resident’s association in my training program, and then moved on to Chair of The Emergency department, Assistant Medical Director, Senior Vice President for Medical Affairs and then COO and CEO of several smaller groups. It was a progression, but it occurred because I was an informal leader and was always willing to do more than what was expected, more than what was in my job description, because my goal was always to achieve excellence wherever I was. It’s just inherent in my makeup, so that’s what I did. I didn’t start my career with the idea of becoming a CEO; in fact, that would have been furthest from my mind.

I feel strongly that good clinical physicians can be good health care leaders. But they have to be comfortable in understanding that they have to broaden their knowledge base, and they also can’t be overwhelmed with the authority and become arrogant. Many physicians make a mistake and create poor leadership because they know that in order to be a good doctor, you need to be clinically egotistical. What I mean by that is that when patient comes into a physician’s office, that physician must approach the patient with the mindset of, “I’m going to save your life. If I don’t know something, I will seek help. If you die, it will be not because of what I didn’t know, but because there was nothing else that could be done.”

Many physicians get into difficulty in leadership positions when they let that clinical egotism go to their heads and they become arrogant. Arrogance drives dictatorial behavior and the “I” mentality. Health care leadership has to be a consensus and a “we” mentality. Unfortunately, we need more physician leaders, but because of the inability of many physicians to understand the difference between clinical egotism and arrogance, they can’t make the transition.

I am a strong proponent of professional back-talking, which I think is one of the hallmarks of good leadership. This means that leaders need to listen to what they need to hear, not demand what they want to hear. I would hope that discussions with CHRISTUS leaders would be a robust exchange about things that others are hearing that they might agree with, include the sharing of knowledge and the presentation of good rationale behind what they might disagree with. I believe that we as leaders must be open, have strong listening skills and must be prepared to change our positions at times.

The responsibility of leadership and authority are not nearly as important to me as the accountability of leadership, which means that you must produce improvement and positive outcomes to be considered an effective leader.

As I have said before, I am hopeful that my years of experience might be helpful to others who work in health care field or are interested in it. I have had to create a sort of science as far as the art of leadership is concerned, and am frequently asked about what is required for a “journey to excellence” or to create excellent health care leadership. What do you think?

1 comment:

Jason said...

I was very interested to read your story about why you decided to pursue a career in medicine and how you got started towards that goal. I, myself, am working now towards medical school and always enjoy learning about what other physicians thought when they were in my place.

I hope that in the future we have more "physician leaders" as you described it. It seems that in today's health care society, there is indeed an issue of physicians in leadership positions becoming arrogant and distanced from what matters: the wellbeing and interests of the patients that we, as health care professionals, serve. Of course, being in a leadership position requires you put forth effort to become flexible and knowledgeable in the ways of business and administration. However, if this means forgetting about our true goals and why we decided to pursue a life in the health care field in the first place, then these efforts are in vain.