I was impressed, recently, by the house staff president at a large state university program who initially invited me to speak to all of the residents and fellows on the business of medicine.
At the conclusion of my lecture to the 150 residents and fellows, this outgoing president vehemently noted, "My wife is experiencing some of the exact things that Dr. Mason referred to in her lecture. She has received a couple of employment contracts, one of which was pretty good but was rescinded. The other is, in fact, an income guarantee, and we now know that an income guarantee is a loan. But we have to understand everything else to from malpractice and tail coverage to finances." Then, in a voice as empowering as I have heard from a resident recently, "Guys, we have to understand IT (the business of medicine) ALL!"
Now, that's what I call leadership -- the communication of transparency, authenticity, and empowerment.
Today, our young physicians are petrified. Being launched into the real world of healthcare today means practicing in an environment that is in flux and promises to keep on changing. Understanding it all for young docs must include wrapping their minds around career and professional development decisions, learning the business or medicine and practice management, as well as becoming financially literate, both personally and professionally.
Privileged to have met some of the brightest minds who also emphasize some of these same non-clinical, but essential physician attributes, I asked of my colleague, Dr. Kenneth Cohn, the founder of Healthcare Collaborations and the original Doctorpreneur himself, about how young physicians can integrate themselves into the new healthcare landscape. I love his tips below:
According to Dr. Cohn
We're facing an issue where we don't have control of our time, revenue or our future. Because of the 1970s where physicians decided that they "couldn't handle" the business side of medicine, there was an influx of decision makers made these decisions but who did not value the doctor patient relationship.
Couple this historical evolution with the traditional ways that physicians have been trained over the years. Traditional emotional intelligence models for medical training include:
- Command and control model -- in which hierarchy extends down from the attending
- Pace-setting approach -- which holds, "You follow my example. If I have to tell you what to do, then you don't deserve to be here."
However, neither of these models builds team cohesion. Instead, physicians must learn new ways of relating to each other and with the decision-makers in their healthcare arenas.
Physicians must be part of every leadership team in the 21st century
Physicians need to learn new ways of relating to decision-makers and to colleagues, and here are some concepts that can be followed:
- Embrace servant leadership is a concept describing that one leads to help. This model would ultimately promote "Change done by us" instead of "Change done to us."
- Strive for win-win negotiation process emphasizes the fruits of collaboration instead of the win-lose scenario traditionally taught. Unfortunately, more often we see compromise, which is lose-lose for both sides.
- Become more comfortable with conflict management. We are in the middle of transformation from volume- to value-based metrics. Conflict is inevitable, but this conflict, managed appropriately, can help us get through change instead of allowing conflict to cause fear.
- Adopt a mindset based on inquiry instead advocacy. Advocacy states, "I disagree." However, inquiry states, "How can we do this together?"
Overall, Dr. Cohn and I agree that physicians must become more comfortable with change, which is a challenge for each individual. Combine this with understanding the business aspects of medicine, and every physician can maximize our ability to participate changing healthcare moving forward.
Take home points
- Every physician is a leader. We should embrace this de facto leadership position in order to positively influence the direction of healthcare at every level, for the sake of our patients, for the sake of our profession.
- Understand all aspects of the business of medicine
- Become more comfortable with change: embrace servant leadership (change done by us); strive for a win-win; be willing to moderate conflict inherent to change in medicine; adopt a mindset of inquiry
