What makes a great physician leader?

Dear medical staff leader:
It is often assumed that the skills that make a physician an excellent clinicians also help him or her become a great physician leader. This is not necessarily the case; in fact, the skill sets differ significantly. Physician leaders are oftentimes well-respected clinicians. However, not all well-respected clinicians make great physician leaders. Let's take a close look at what skills make a great physician and what skills make a great physician leader.

Clinicians are taught in medical school and residency how to take a history and conduct a physical examination. Within minutes of completing these tasks, a physician creates a differential diagnosis list, prioritizes the most likely probabilities, and decides a course of action to include any further work-up and a treatment plan. The physician carries out these tasks quickly, almost instantaneously, and typically does so independently. The physician usually doesn't have meetings over a prolonged period, try to convince others to support his or her actions, and most of the time he or she doesn't even discuss the treatment plan with colleagues. Physicians are taught to make decisions, to act independently and quickly-an autocratic process all in all. 

To become an excellent physician leader, physicians must learn a set of skills that were not taught in medical school or residency. Physicians must learn how to be part of a team and refrain from making unilateral decisions and attempting to force those decisions on the medical staff, administration, and board. Physician leaders must learn to plan an agenda, run an effective meeting, build consensus, and slowly change "the medical staff culture." Leaders must learn to work behind the scenes, praise others in public, and accept the blame when things don't go well. They must also work tirelessly without expectation of thanks or praise and act as diplomats working for the overall good and serving the needs of others. Physician leaders must go back to "school" taking leadership, credentialing, and quality courses.
 
The transformation from excellent clinician to great leader is not easy. Few physicians advance to the position of medical staff president and fewer still will be great leaders. Great physician leaders do not simply appear de novo. However, they have devoted more time to medical staff issues than others, studied medical staff leadership more diligently, and have more experiences to share.

Joseph Cooper, M.D.
The Greeley Company