Investing In Physician Leaders: More Important Than Bricks & Mortar
Healthcare organization need to start investing in physician leadership coaching. It will solve physician burnout, decrease costs, and more. There is too much upside to not do. Physicians are too often placed into leadership roles without the resources and professional development needed to be successful. Administrators either, choose not to invest based on their own limited understanding of leadership, or point to the costs associated with coaching and professional development as a reason not to invest in their success. Some feel okay about this as they tap into the free resources offered through the internal HR department or send them off to a leadership conference. These resources are valuable and have their place, but a one-size-fits-all approach does not consider the unique experience of being a physician leader within the clinical and academic settings. Join Todd Redden on this solo episode as he discusses the top five reasons for investing in the success of your physician leaders, and how in the long run this investment will actually save the organization money.
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Investing In Physician Leaders: More Important Than Bricks & Mortar
Physician Leadership
One of the menu resources provided to you as a physician leader is through the Institute for Healthcare and Academic Leadership. If you followed our show, it's relatively new, so additional shows will be added, but I have a physician leader as a guest. We talk about best practices around leadership, perseverance, and other topics and we have many more plans lined up for you. I was thinking long and hard about physician leaders. I've run into some situations lately, particularly at the end of the year, where organizations would like to invest in their physician leaders, or other leaders within the organization were physicians who led physicians.
They shared that they would like to invest in coaching and leadership development for their physician colleagues or direct reports. The organization wouldn't support it financially. I see article after article of healthcare organizations that are expanding, growing, and building new buildings. I know the money is there and it's a drop in the bucket to invest in physician leadership relative to the overall budget and expenses that many healthcare organizations have.
I chose to go out on my own and invest in physician leaders and provide one-on-one coaching, leadership development, culture assessment, and building culture within healthcare organizations. I've taken the roles, responsibilities, experience, and training that I've had for many years of healthcare experience, both as a clinician and an academic instructor in higher ed and having been trained specifically in leadership. I've taken that skillset and I decided to commit it full-time to physician leadership. I now work with some of the largest organizations up and down the East Coast, as well as some going West across the country. These are large private and public organizations as well as some medium size clinics that are in private practice.
Investing In Leaders
What I hear more often than not from larger organizations is the cost associated with investing in physicians. I want to talk about that because it tends to be a bur under my saddle when organizations are unwilling to invest in physician leadership. The decision-makers often have a coach themselves, but they're unwilling to invest in coaching and leadership. It doesn't matter if it's through my services or others. This is not a self-serving show. I have a passion for physician leaders. I would not have gone into this work full-time if it wasn't for that passion. I feel this is a calling.
Having clinical experience myself in behavioral health, carrying the pager, getting up in the middle of the night and going to the ED to take care of a patient or to work side by side with physicians, I recognize over the number of years that I've worked and invested my time in physician relationships, investing in their development and well-being. I've recognized that this is a population that you need to understand the culture, having worked in both acute care and ambulatory care, and the physician experience.
I've had physicians in my office in tears because of a EMR that they felt was dangerous for patient care because it wasn't being utilized in the most effective and efficient way. I've had physicians who have relapsed and engaged in drinking because of their frustrations and the stress that goes with the noise, the distractions and all the challenges of being a physician within the healthcare environment. You bring us up to the current State of affairs with COVID and the amount of challenges that COVID has presented with healthcare and across the higher education experience. I want to tell administrators and physician leaders who lead physicians that investing in your clinical leaders and physicians is not only the right thing to do, but it's in the best interest of the organization.
Investing in your clinical leaders is not only the right thing to do but is in the best interest of the organization.
The Right Thing To Do
I like to understand the origin of words. I looked up the word investment. Interestingly, the word invest comes from the Latin word vestis, which means a garment or to adorn someone. When you think in terms of, “I hope you don't lose your shirt over this deal,” what they're saying is, “I hope you don't lose your adornment, your garment if you're investing financially.” Now, we often hear about investments from a financial perspective, and we don't tie to clothing, a robe or a gown. You think in terms of “dress for success,” putting a vest on someone and preparing them for success is where this word originates. Investing in your leaders is a way of lifting them up, supporting, encouraging, and inspiring them to be effective in their role as a leader.
Let's talk about the top five reasons that I believe are the primary reasons why you should invest in your physician leaders. I'll go back to my original comment when I was introducing this show, and that is it’s the right thing to do. If you're a leader and you're a physician leading other physicians or you are a non-physician administrator who has physicians reporting to you, whatever your role is or whoever your direct reports may be, it's the right thing to do to invest in your team.
There are tactical responsibilities. If people are checking boxes, we think that they are doing their job, but we don't understand beneath the surface how much a person may be challenging or they may have a genuine desire to be as effective as they can as a leader. Many times, leaders are given leadership roles but they're diminished to tactical responsibilities and management. Management is a very important role and has its place. The physicians that I've worked with want to influence. They want to be at the table and have a voice. Physicians want to be paid at a decent rate. They want a voice at the table. They want to be able to provide great patient care. They want you as leaders to minimize the noise and distractions, and they want to be left alone.
It's simple. They just want to do a great job. When a physician is put into a position of leadership or they've raised their hand and said, “I want to be a leader, be it a CMO or a chief among an academic group,” they want to be invested in. They want to know that they're being effective in the role. Physicians tend to be perfectionistic and want to be all in. If they don't have the support from their administrative team to be effective, then they're either going to be ill-prepared to be effective and walk away, or it's going to create havoc for those that they lead.
Physicians Are Wired To Lead
If you invest in your family, your friendships, financially, or yourself, why would you not invest in your leaders? It's just the right thing to do. Number two, physicians are typically wired to lead and whether they want a lead or not, they're thrust into these leadership roles by default. When a physician walks into a patient's room, the heads turn to that physician as the leader of the treatment team of the service line.
The patient, the PA, and the family look to the physician. The physician is responsible for the treatment of this patient, the outcome of this patient, and the liability associated with the procedures and recommendations that they are providing as a physician. Those who lead physicians need the resources and skillset in order to help their colleagues navigate through the challenges of being a physician.
We have to provide physician leaders with the resources to be as effective as they can be. While they're naturally wired to lead, they're often ill-prepared, and even worse, the roles and responsibilities associated with that job. It's usually ill-defined. Many physicians go into these roles with the expectation that they're going to lead or they've seen their colleague who may have been a previous leader and they've set the standard, but they would like to make sure that they're being effective.
Their job description is non-existent and many administrators will say, “We're going to put you in this role as a site-based Medical Director or as a Chief Medical Officer. You have these 4 or 5 tactical responsibilities. We also want to respect that you're busy, so we're not going to put a lot on you.” You can put the tactical responsibilities or the administrative responsibilities on a claim manager, service line manager, a nurse manager, but that physician wants to lead and they want a partner. One of the things that I provide as a service through the Institute for Healthcare and Academic Leadership is a co-leadership institute so that I can teach physicians to work in partnership with administrators or nurse leaders, particularly in the ambulatory setting.
Physicians Are Curious
These physicians are not wanting to provide quality oversight or to be involved in the hiring of a new physician colleague. They won't lead. They may be naturally inclined to lead, but if their responsibilities are ill-defined or ill-prepared, you're setting them up for failure. Number three, I have found physicians to be intellectually curious and very open to personal and professional development. Oftentimes more open to professional development than non-physician administrators. We put these physicians into a position and we don't give them the resources to be successful. I've found that in healthcare and higher education, far too often, we promote subject matter experts, but we don't teach them how to lead.
Physicians are naturally inclined to lead, but if their responsibilities are ill-defined, they will be set up for failure.
If you're good at financial forecasting, we'll promote you to CFO. If you're a good bedside nurse, then we'll make you a nurse manager having you responsible for the tactical responsibilities of making sure the supply closet is filled, the nursing-to-patient ratios are what they should be, or managing schedules and staffing. That's not to diminish the role of a nurse manager. It's important and I'm sure the job description goes far beyond that. My point is we raise people into these positions because of their primary training and the expertise that they have in their primary role, but then we don't invest in them as leaders within this new role.
We give them the title of Medical Director or Section Chief. They want to provide them with the development and training that they need. They may have influence among their colleagues or are well respected as a physician, but are they effective as a leader? Do they understand what the roles and responsibilities are? Do we encourage them? Do we clothe them? Do we provide them with the garment and invest in them in a way that they can be successful? Physicians want to lead at the top of their game, and we need to make sure that they have what it takes to be the best that they can be among their colleagues as well as their co-leaders.
Burnout
Number four, investing in the professional development of physician leaders minimizes the chance of burnout. I've said this in another episode, either as a host or as a guest, that no other job has changed more than being a physician, or any other career choice in the nation, in my opinion. You take, for instance, a CPA. A CPA may have newer software, bells and whistles, or ways to be efficient. You take an attorney, and maybe some of the laws have changed, the hoops you have to jump through passing the bar because exams may have changed, but for the most part, many professionals’ careers have not changed dramatically over the last few decades.
No other job has changed more than being a physician than any other career choice in the nation.
A physician's role has changed significantly. Everything from pay for performance to the quality metrics that are instilled that many physicians feel that the metrics themselves and the compensation models tied to quality metrics don't necessarily improve quality. According to Becker Spine Review survey from a few years ago. The EMR, the administrative noises, and the challenges of staffing lead to frustration and burnout. I have had physicians, as I've said in my office, in tears because of an EMR relapse from drinking, because of burnout.
It's taxing to be a physician and then to be able to lead physicians and help them navigate through the challenges of self-perseverance. To be successful as a clinician is challenging for physician leaders. Imagine the challenges that are placed upon a physician as a clinician and then multiply that exponentially when you create a leadership role for them. Many of them want to practice medicine because most physicians who stop practicing medicine in order to lead lose credibility with their physician colleagues. Physicians who have accepted administrative roles want to continue practicing medicine. They want to keep their skill sets sharp.
They want to maintain their clinical privileges within hospital settings, and they want to make sure that they can relate to their physician colleagues and the challenges that are facing physicians on a daily basis. If they want to continue practicing medicine, they want to continue in the academic environment teaching, or research environment, and they want to lead with very little time carved out and dedicated to administrative time, this in itself could be a challenge for physicians, but it can work. They can navigate through this and figure out how to balance all of this as well as the many responsibilities they have outside of the job.
Best Interest Of The Organization
Investing in physician leaders and helping them be successful in these areas in order to balance it all is of utmost importance. More often than not, if they don't see you investing in them, then they will either walk away from that leadership role or, in a worst-case scenario, they may check out completely as a physician. The final reason that I believe that it's important to invest in physician leadership is not based on altruism like the other four, but it's in the best interest of the organization for a couple of reasons.
Number one, investing in physician leadership mitigates risk. I've worked with physicians who have gotten themselves sideways with colleagues based on something they put in an email or based on a threat to their job, or they just didn't know how to manage employee relations-type issues. It has created lawsuits, other physicians quitting or having to be transferred from one clinical setting to another. It becomes costly to the organization, particularly when they're having to settle lawsuits.
The second reason is that it's in the best interest of the organization. It decreases long-term costs. It cost about $56,000 on average to replace a bedside nurse. Seven thousand nurses walked off the job in New York City because of labor disputes. Seven thousand exhausted and burnout nurses walked away. Imagine the impact that it's had on the healthcare systems that they were working for. Now, many of those may come back, but if you talk to anyone recruiting nurses, they can tell you there's a nursing shortage across the nation. It's a challenge to fill those positions and it's costly. Now, let's talk about the physicians on average, according to the American Academy of Family Medicine.
It cost an average of $250,000 to replace a physician. When you think in terms of downtime, the lost revenue coming in as a result of that vacancy, the cost of recruiting, the time it takes for people to interview and bring in physician candidates the cost of travel is $250,000 on average for a physician. I'll tell you, in that same review I referenced earlier, the Spine Review through Becker Healthcare, those that were surveyed is almost half. Forty-six percent said that they are planning a career change and 80% said that they are overextended or at full capacity. Physicians are burning out and frustrated. An effective leader can help them navigate some of those challenges.
If you don't invest in your physician leaders, it's going to cost you lawsuits, in recruiting, and in ways that you can't measure. I see organizations investing in buildings and equipment. They're expanding and acquiring new organizations costing millions if not billions of dollars. When I ask if they want to spend a few thousand dollars to make sure that their physicians are well-prepared to lead, I have organizations saying, “We’re not interested. We're not going to invest in our physician leaders for various reasons.” I've heard organizations say, “We're no longer going to hire coaches for our leaders within the organization.”
If you're an administrator and you're not investing in physician leaders, it's going to cost you in the long run. I promise you that your investment in coaching and leadership development for your physicians and other clinical leaders, others through the Institute for Healthcare and Academic Leadership or other organizations are going to cost you far less to invest in those resources than what it will cost you to settle a lawsuit or recruit a new physician. Give that some thought.
Closing Summary
In closing, the five reasons for investing in physician leadership are the right thing to do. Second, it's unfair to put a physician into a leadership role, even those with an MBA without investing in the resources, training, and development that they need in order to be effective. Number three, physicians want to grow. They'll limit their physicians to a title and invest in their development, so they have the skill set to be as effective as they would like to be in those roles. Number 4, physicians understand that to be effective, they have to discover ways to lead and not manage tactically.
This in itself will help mitigate burnout and help physicians be successful in managing all the many things that they take upon themselves as well as the many things coming at them that they have no control over. Number five, last but not least, it's in the best interest of the organization. If you want to speak in dollar amounts, it's in the best interest of the organization financially to invest in your physician leaders. I hope this has been helpful. Share the show. I encourage you to, if you're looking at this on YouTube or any of the other show platforms, subscribe so that you can get updates as we provide new shows.
Please push this out to your physician administrative colleagues and your specialty societies. I want to get the word out and make sure that the Institute for Healthcare and Academic Leadership is providing you with the resources that are needed. Look us up on IHALeadership.org and check out the resources that we can provide or connect with us. I love to chat with you and see how we can help. Until then, continue to have a great day. Invest in yourself, invest in others, and God bless.
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About Todd Redden
Dr. Redden is a thought leader, trusted advisor, and highly respected and recognized expert in developing leaders. He established The Institute for Healthcare and Academic Leadership with a unique perspective and insight into the ever-changing world of physicians, faculty, and healthcare/academic leaders. His diversified, extensive background includes serving as an executive leader in healthcare, coaching, teaching, developing leaders, and clinical psychology counseling. He is the founder and host of the Commit to Thrive Podcast.