Tuesday, August 2, 2011

Seeking -- And Finding -- Physician Leaders

One of the more interesting and active discussions in our ACPE Network is about “Why aren’t physicians leading?". You’ll find all sorts of opinions and insight. I want to submit the opposite hypothesis: that physicians ARE leading. And doing it very well!

Here are just some of the recent pieces of evidence that demonstrate the effectiveness of physicians when they are in leadership roles:

1. The New York Times' health blog picked up Amanda Goodall’s newly published research in the journal Social Science and Medicine, in which she looked at the credentials of CEOs at US News and World Report’s Top 100 Hospitals for Cancer, Heart, and GI care. Though the numbers of physician CEOs in American hospitals is low, there was a strong correlation with physician leadership in the top performers. In fact, quality scores were 25-33 percent higher in the physician led hospitals than their non-physician led peers. Like basketball teams and research universities that she’s studied, which show that former players and researchers get the best results when they are in charge, the experience of being a physician adds a powerful dimension to leadership and results in health care organizations. Read about it here.

2. The recent US News and World Report ranking of the nation’s top hospitals was released last week. Of the top ten, nine are led by physician CEOs. Going down the list of Honor Roll hospitals, eleven of the top seventeen are led by physicians.

3.The American Hospital Association recently announced it was forming a leadership forum for physicians. This effort, led by physicians John Combes (a CPE) and Bill Jessee (last year’s ACPE Distinguished Fellow), has twenty other physicians on the Advisory Board. As we read the list of names, we noted that at least 75 percent are ACPE Members, CPEs, former faculty, or use ACPE as partners in their organization’s leadership development programs. Long-time ACPE faculty member and internationally-known leader in quality and safety – David Nash – was the keynote speaker for the physician leadership forum. It’s too early to know where this initiative is heading, but knowing the integrity and experience of the group, their leadership gives me confidence that the right topics, discussions, and recommendations will be made.

4. Anecdotally, we’re hearing from recruiters that health system boards are changing their views of physicians as leaders. Ten years ago, a token physician CEO candidate was requested. Five years ago, a physician candidate would be given serious consideration. Now physicians are preferred.

I have no doubt the growing evidence of physician leaders’ effectiveness will ruffle some feathers in the health care industry. As Dr. Goodall points out in her research, there’s a strongly held belief that doctors can’t manage or lead. I believe it’s true that the vast majority of physicians do not aspire to be in the CEO’s chair of a health system. It’s darn hard work that requires a certain personality and multiple skill sets. But for those who do find themselves attracted to that role, isn’t it time that they be given a chance by governing boards, and/or groomed for the role by their current health system senior leaders?

I heard recently from a highly reliable source that most hospital CEOs do not have an internal succession plan for their replacement. Well-run businesses outside of health care consider promoting internal talent, and grooming potential successors, as a key to the long term success of the enterprise. Does health care fail to do this because the average tenure of a CEO is just under four years? Or because fifty-seven percent of hospital CEOs have been in their jobs less than five years? Do physician leaders at the top performing hospitals view training potential successors as a priority?

As we look more deeply at the characteristics that make physicians particularly good leaders, we’ll be asking questions like these, and searching for metrics to show the differences. We don’t know what we’ll find, but that’s what research is all about!