Wednesday, September 2, 2009

Dx: Sick health system; Rx: Physician leadership


Heated emotions in town hall meetings. Partisanship in Washington reaching new levels of acrimony. The stress, uncertainty and hunches in the health care industry about what reforms will take place has sparked a new concern: we need more – and more effective – physician leaders to get us through this crisis. This is like watching a sick patient arrive in the ER with worrisome vital signs, and then continue to deteriorate as delays in diagnosis, turf battles over accountability and delays in treatment make the situation downright dangerous!

There’s a real yearning for physicians to step up to the plate and help create a more responsive and reliable system of health care. Like the competent, calm, and compassionate physician that defines the clinician of our best memories, we need to abandon the learned helplessness that is so common among our ranks and ask ourselves what we can do to lend a hand to our non-clinical neighbors, friends and professional colleagues who are searching for answers and reassurance during this crisis.

Last month a remarkable little weekend retreat occurred on Orcas Island, Washington. A small group of highly accomplished health system executives (only two physicians in the group) gathered at a small, remote home to grapple with how to motivate more physicians to see themselves as leaders - from the clinician at the bedside who can lead improvement in clinical care processes, to medical staff leaders, to the executive suites of health systems, insurance companies, and pharmaceutical firms. The pervasive theme was that health care is critically ill from decades of diagnostic and treatment delays and intra-industry turf battles. From our experiences in working with powerful and competent physician leaders in our careers, we believe that more physician leaders are needed to manage the healing process of this critically ill American health system.

We don’t know what message will resonate with physicians – if at all. For young physicians wondering what they can do to build on their medical degree, learning the competencies of leadership gives more career options. For physicians frustrated with the waste and inefficiency of clinical care, or wondering how to demonstrate competency in Part IV of Maintenance of Certification requirements, learning how to lead a clinical improvement project is an excellent way to create the change you want.


I don’t want to sit in the doctors’ lounge anymore and listen to how bad everything is. I want to hear, “This is what I’m doing to make a difference for my patients, for my nursing colleagues, and for myself.” Stay tuned over the next several months as we focus on key issues demanding physician leadership, and ask yourself how you can help.