Wednesday, October 8, 2008

Is Being a Health Care Leader Really Worth the Work?

I am often asked by leaders both inside and outside CHRISTUS how I got where I am in my career, and if I had to do it over, would I take the same path? I think the reason why this question enters the minds of many people in health care today is because the time and energy it takes to be a leader in our field is enormous.

This is probably evident by the short life that CEOS have in health care, particularly in large systems which average a 5-7 year span. In addition, the complexity of health care often creates challenges for leaders in balancing their personal and professional lives. Consequently, they ask frequently, “Is it really worth it to be a health care leader in 2009?”

For me, the answer to this question throughout out my entire nearly 40 years in health care leadership has been yes. Although I might say that my leadership journey officially began when I was selected to be the chief surgical resident during my last year of residency and was elected president of the house staff association during both my junior and senior years of residency. However, my leadership experience truly began during my secondary education, when I found myself taking on responsibilities that led me to become the editor of the newspaper, the assistant editor of the yearbook and the president of my class.

Because I believe that some leadership skills are innate, the characteristic I saw in myself early on which really did not need any development was the desire to facilitate the correction of problems or to fill voids by taking leadership responsibilities which no one else readily wanted.

Assuming these leadership roles early in my career caused me to understand that I really enjoyed taking on these responsibilities. Therefore, as I continued my college, medical school, residency and two years of military service, I again found myself seeking leadership opportunities which gave me the ability to say that I was truly making a difference in the environment in which I was living and working.

However, it was not until I returned to civilian life and was working in my first health system in the roles of the Chair of the Department of Emergency Medicine and the Director of the Surgical Educational program that I found myself reflecting on the question, “What are the competencies of a successful leader in health care?”

This reflection was motivated by two major factors. First, I found myself dissatisfied with the leadership of some people to whom I reported, and therefore had to ask the question, “What were they doing or what skills did they lack that I found unpleasant?”

Second, people began asking me how I became a physician leader, which then caused me to analyze the art of leadership (often those innate and interpersonal skills which one possesses) vs. the science of leadership (those skills and talents which can be taught and learned).

As a result of these reflections, I determined that there were lists of both curriculum and operational competencies which every health care leader needed to develop a leadership team that would be willing to follow his/her direction. Consequently, as I was promoted to the Senior Vice President and Medical Director of the Geisinger Health System in Pennsylvania, I immediately partnered with Susquehanna University to offer a health care leadership course which was required for all clinical as well as administrative leaders in the system. This one-year course made up of 12 three-day sessions consisted of required readings, lectures from external and internal faculty as well as problem-solving projects. In essence, this course provided the experience equivalent to a mini-MBA program and significantly increased my commitment to the ongoing development of leadership competencies as well as to life-long learning, since health care is an ever-changing environment.

Throughout this entire process, I continued to find that assuming leadership roles and developing educational opportunities for future leaders was as enjoyable and satisfying as it was for me to train surgical residents to assume the future surgical practices in America.

An additional question that parallels those listed above is whether or not I found the physician leadership role in administrative matters to be as satisfying as the clinical leadership roles which I had engaged in throughout my career.

Clearly, in the early ‘80s, I needed to pause and reflect on whether or not leaving a full-time surgical practice and melding administrative responsibilities with emergency medicine responsibilities would present me with career fulfillment. I decided to make this transition, believing that although I was improving the health of each individual I operated on in my clinical roles, as a physician leader, I would be improving the life of communities of people as well as training competent future health care leaders.

I have always believed that both tracks are equally important, but I am content that choosing the route to perhaps influence a greater number of people through my leadership responsibilities in health systems has been very beneficial and rewarding.

So in closing, my advice to people who are pondering the questions, “Should I take the clinical or administrative leadership track?” and “Will it ultimately be worth it?” My answer is very simple: follow your heart and do what you believe you will enjoy the most; make sure you have the competencies for whatever track you decide to take and remember: whatever role you play in health care, is a sacred role and if you are happy and if your loved ones are happy, it will be worth it.

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