Suddenly you’re leading…10 things you need to know

The pandemic has pushed many physicians into acute and demanding leadership roles, some formal, many not so, but all important. As we ease out of this crisis, as a coach I am seeing many physicians re-examining their roles. Some leaders are hanging up their spurs, or at least looking for coverage for some sort of sabbatical period, while others have got a taste for leadership and want to further develop this aspect of their career. I believe both are going to create an unprecedented demand for physician leadership knowledge, training, mentorship and coaching. While the quantity of physician leadership required has certainly increased, I don’t believe the skills required have changed. The pressure to perform in a crisis, however, has underscored for many physicians how little preparation for leadership medical education provides. This is really an acute exacerbation of long standing problem, that physicians mostly come to leadership from being tapped on the shoulder, not by graduation from a leadership career path. Most leadership training is provided after they are already in the job. Whether you are leading a small clinic, a community program, a quality improvement initiative or up to an international healthcare organization, listed below are my “Top Ten” areas where you need to have focused some thought and developed some skills if you are to thrive in physician leadership. Read: Pat Rich: Enter the magic land of physician LEADerShip Know why you are leading and who you are as leader: Leadership without a purpose is an empty existence. Know your purpose, your values, and your goals. Have a good reason for taking a leadership role, don’t be pushed in because it is your turn. While much is made of the important concept of servant leadership, if you are to find meaning and hopefully, joy in the role, leadership should meet your self-actualization needs as well those who follow you. Ensure the role allows you to demonstrate competence, develop relatedness to others and grants you more autonomy or control in your life; these are the key factors in successful self-determination. Understand and engage with your followers: Barbara Kellerman links following behaviour to engagement. Engagement is a physiological, not political process. Engagement requires nurturing group connections, providing reassurance on status and narrowing status gaps, creating certainty around expectations and process and supporting autonomy. Engagement decisions are made all the time, whether we are aware of them or not. Engaging your followers is everyday work, not something you roll out when you want something from them. Know how to motivate and delegate: Understand the passions of your followers and align tasks with those passions. Understand the difference between intrinsic and extrinsic motivation and encourage the former. Spend your time providing clear direction on a task, hearing concerns, providing meaningful follow up and celebrating success. The more of this you do, the more your team will do for themselves. Run great meetings, but only when you need them: Have well organized meetings that bring the right people together with clear understanding as to why they are there. Keep on time, keep good records and enforce good meeting behaviour. Know how to have tough conversations: Basic training and reading about how to have a calm, thoughtful conversation in tough situations is invaluable. This is, without doubt, the number one issue that physician leaders bring to me in coaching. Don’t back away from conflict: Conflict is a normal part of human experience. Many can be very successfully resolved using the skills of tough conversations. The job of a leader is to surface conflict and help people move past it. The reverse, bottling it up, is a recipe for explosions. Understand the nature and natural history of teams: Teams are like a new life form; they need to develop and mature before they really start performing. Without a bit of help from an insightful leader, many healthcare teams fester in early phases of dysfunction. The role of the leader changes during the team’s developmental journey. Manage time well: Avoid mistake number 1; taking a leadership role without making time for it. Know what is truly urgent and truly important and allocate time accordingly. Have developed strategies for saying “No!” Leave aside time for the unexpected. What keeps you sane, happy and healthy is also important and deserves equal access to your calendar with work stuff. Avoid Burnout: Burnout is not a “problem” or mental health issue. It is a place on the occupational landscape where you end up when you lose meaning and joy in work. You end up there when circumstances make you lose sight of your career goals (like a pandemic), when your work environment no longer supports you effectively, or simply when your goals and interests change, but your career path doesn’t. Stay attuned to what does it for you in all spheres of your life and explore strategies to prioritize those activities. Be strategic in changing the world: Understand the system you work in and its influence points. Understand the difference between the power that drives compliance (coercion, reward, legitimate) and power that changes motivation (referent or respect, information, expert) and in turn changes systems. Inform yourself about useful change models and use them to plan your change activities. Physician coaches are great resource for helping you become adept in all of the above areas. Both the Canadian Society of Physician Leaders and the Canadian Physician Coaches Network provide directories with detailed information on vetted professional coaches with physician coaching experience. Coaching is about moving people from good to great, and we need great physician leadership now more than ever. Dr. Malcolm Ogborn is vice-chair of the Canadian Physician Coaches Network. He is author of a recently published book “Sudden Leadership—a Survival Guide for Physicians.” He is based in Kelowna, B.C. and operates his coaching business, The Optimistic Doc from there.

Suddenly you’re leading…10 things you need to know

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