I initially trained as an obstetrician, then as a high-risk maternal-fetal medicine specialist. I did that for many years and got a lot of satisfaction out of improving patients' lives. But early in my career, I got an opportunity to also take a leadership role in not only providing direct patient care and create systems, policies, procedures, and cultures that provide the best possible care for hundreds, if not thousands, of patients. It was a career-changing opportunity for which I will always be grateful.
What I learned in the process is that I'm just as happy to be one step removed from clinical care if I'm making it all work seamlessly and improving the lives of many; being the one who receives thanks from the patient individually isn't vital to my job satisfaction. I found that I can make an even bigger impact by putting some of the analytic and problem-solving skills that I developed to really improving the lives of not only patients but also faculty and staff. I think that if I had to describe myself, it would be as somebody who makes sure things get done properly for the benefit of everybody; you must take care of the team that provides the care so that the patient gets the best outcomes.
Advice for Medical Students:
Most of us in academic medicine take great joy in sharing our wisdom with medical students. I like to think the advice I give to those who have chosen to work with the sick is a bit unusual but extremely practical.
Advice for Doctors After Residency:
So, what do I tell physicians contemplating a leadership role? First off, is that you're never prepared for any job. At most, if you are really making a career leap, you will have about 65% of the skills required to be successful. What you need to do is: A) have confidence to rise to the challenge, and: B) be willing to say, "I don't know" and learn in real-time. That's been the case every time that I've had a leadership role, from being the chief operating officer of a five-hospital system to the chief operating officer of USF Health. You learn the role by keeping your mouth closed and ears open, enforcing upon yourself a period of observation, and working to improve the environment you find yourself in.
Collaborate and Persevere
Finally, no discussion of training leaders would be complete without a mention of change and change management. Here, I absorbed quite a bit during my training in Six Sigma while at Yale, and the main thing I realized is that physicians usually just focus on half of the following equation (more ):
Q X A=E
Where Q=the qualitative or technical solution; A= the acceptance and engagement of those impacted, and E=Overall Effectiveness
As scientists at heart, most physician leaders spend an awful lot of energy on the technical side of the equation. They work hard until they have a "Eureka!" moment. They look at it from every angle to make sure it is as perfect as it can be. Then what do they do next? Younger leaders, yet to be burned, start rolling it out immediately. What happens as a result? Usually not what was expected -- sometimes things even get worse.
Why is that? We tend not to focus enough on the acceptance or engagement of the solution. For physicians especially, if they don't have a voice in the change or a hand in crafting it, the solution becomes something done to them rather than something accomplished with them. It is therefore essential to have a deliberative and collaborative process.
Don't be afraid to have some naysayers on the team -- you may be surprised at how quickly they come around when you ask their opinion and seriously consider it. Once this is done, approach your implementation with care. Socialize it well. Change is scary for people, and for those firmly entrenched in a way of life or a way of doing things, change can be terrifying. Though rare, some may go to great lengths to subvert your efforts, and personal attacks may be one of the weapons you will need to fend off.
Keep in mind though, that if you aspire to be a physician leader, this is the life you have chosen. The road will be filled with some triumph, but surely with some bumps along the way. Just remember all the people, especially the patients, who are counting on you to persevere.
, is a former tenured professor of Ob/Gyn at the Morsani College of Medicine of the University of South Florida. He is the former COO of USF Health, COO of the Ohio State University Health System and interim dean of OSU College of Medicine and was chief of maternal-fetal medicine at Yale University.