I couldn’t agree more with Dr. Khullar, author of the New York Times article, “Good Leaders Make Good Doctors” (view article here).
Indeed, there is a fraction of doctors I would estimate at 10% that enjoy and thrive in leadership positions. I am one of them. I discovered my leadership as many do by falling into a leadership vacuum. Once there, I found that among medical groups that fraction of colleagues all worked harder than most doctors, but I also found a sense of agency that has prevented burnout in my brain and heart: I love leading doctors! Together, docs in groups with leadership have the potential to revolutionize how healthcare is done. Well led doctors create superior health outcomes at lower cost.
The best leaders are clinicians with broad knowledge of medicine, a passion for improvement, and an engineer’s brain for redesign. Usually, they are not CPAs with sharp pencils on the bottom line, although some are. Most docs in leadership do best with a professional manager at their side. The best medical groups and hospitals have this kind of dyadic relationship.
Sadly, too many in healthcare seem to prefer a more hierarchical leadership structure better adapted to assembly lines, with one supervisor for teams in a fractal layering up the hierarchy. These often miss the business needs and constraints with a clinician in charge, and miss the clinical side of business decisions with a non-clinical manager in charge. Dyad at every level is far better for keeping patient care in the forefront while leading with sufficient resources financially to make the organization thrive. Physician leadership is too commonly grossly undervalued by the government, the payers, the hospitals, and by some medical groups, and certainly by patients, for which the structure and culture of the system is invisible except at a marketing level.
So, three cheers for physician leadership! So why is the pay at 105% of those without leadership responsibilities, and the work 130%? Folks need to “get it”. The top organizations do. What about the rest? Today we have too many leaders who are doctors in name and little practice experience, and many others who have no power while sitting in “leadership” positions. That won’t do either. Doctors create most of the cost of the healthcare system with their orders. Breed and train their leaders and support them to improve the value of healthcare, for a change!
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