Successfully guiding a physician organization amid the turmoil sweeping healthcare today requires a special kind of leadership. But exactly what are the skills needed to survive in the current healthcare climate?
ReveNews interviewed three McKesson physicians with wide-ranging experience in leadership development to get their thoughts on what it takes to prevail in these uncertain times.
David Nace, MD, vice president for clinical development and population health at McKesson, said the overriding challenge physician leaders are presented with is to manage high-velocity change in three critical areas:
- The way physicians are paid
- The manner in which they provide care
- The nature of the patient-doctor relationship
Specifically, he noted that the rise of value-based reimbursement has upended traditional physician expectations regarding work and compensation. At the same time, the transition from an individual practitioner model to an integrated clinical team is driving major adjustments in the way physicians think and work. Finally, increasingly informed and assertive healthcare consumers are requiring doctors to recalibrate the way they interact with patients.
“All of these changes are antithetical to what most physicians learned in medical school, so a lot of them are having a hard time getting their arms around what’s going on,” Dr. Nace said. “A transformation of this magnitude can be threatening and scary, especially if you feel like you have less and less control.”
Becoming informed can reduce the fear factor and the inaction that comes with it, Dr. Nace said. “Get involved, network, meet with other doctors and practices in your community,” he said. “Meet with payers, government officials, identify potential provider partners, read, learn, do everything you can to stay abreast of what’s happening.”
Michael Udwin, MD, executive director of physician engagement for McKesson, said the steadiest and most successful practices today are typically pursuing two basic concepts:
- Team-based care
- A strong work-life balance
“Empowering, supporting and encouraging the entire staff is essential, from the person answering the phones to the nurses and the physicians,” he said. “You’ve got to let each one of them know that they play an integral part in the success of the team, because they do.”
That sense of shared commitment is enhanced by articulating a long-term vision and identifying specific goals to support it, Dr. Udwin added. Whether those objectives are improving the patient experience, reducing unnecessary expense, enhancing quality and value or all of the above, it is important that the aims be concrete, sustainable and measurable.
“Leaders often fall victim to having too many goals and then pursuing them in a non-uniform, haphazard way,” he said. “The result is that the organization is first pulled one way and then the other. This can lead the staff to question and ultimately discount the leadership’s commitment to the goals.”
Supporting an appropriate balance between work and private life is also a key strategy, Dr. Udwin said. Increasingly, he said, many younger physicians have recognized that “it’s okay to earn a little bit less and have a little bit more free time.”
“If you can achieve a good work/life balance for your physicians, it should translate into a healthier environment in the office,” he said. “That means less stress, a happier staff and, ultimately, a happier patient population.”
Finally, Dr. Udwin said, leaders should remember that their behavior and words carry considerable weight. They should therefore avoid coming across as frustrated, angry or bitter, regardless of what obstacles the organization faces.
A Strong Communicator
Louis D. Wright, Jr., MD, a physician advisor to McKesson, said that whether the organization is a large, hospital-owned practice or a smaller independent, the same leadership skills typically apply.
First and foremost, Dr. Wright said, a physician leader must be able to communicate effectively. From contract negotiations to strategy development, good leaders can clearly articulate goals and challenges and, equally important, listen carefully to observations, questions and concerns.
Part of being a strong communicator involves being committed to uncompromising honesty, Dr. Wright added. That means holding people accountable for their actions and performance, telling the truth in all instances, and overcoming the tendency to ignore or downplay difficult issues.
A leader’s knowledge and understanding of the organization he or she leads, as well as the science of medicine, also are crucial, Dr. Wright said.
“Like it or not, fellow doctors will measure you by how good you are,” he said. “Every one of them thinks they’re the smartest person in the room. That’s their nature. But they will willingly line up behind a leader that they know is clinically very good. At the same time, a leader that doesn’t have a strong basis in medicine or the business of medicine, especially these days, is not going to be effective when he goes to the CEO or CFO to advocate for something.”
Beyond fostering a sense of inclusion and shared purpose, leaders must clearly articulate a vision amid the chaos of the current healthcare environment.
“The best leaders are visionaries that grasp the changes under way and can see through the clutter to identify a destination for the organization, as well as the most effective path for getting there,” Dr. Wright said.