The Entrepreneurial MD for Women

Finding the balance between medicine and business

Physician leadership coach on "Leading Clinicians & Clinicians Leading"

Despite what you may hope, Accountable Care Organizations and Patient Centered Medical Homes are here to stay and demand heightened physician leadership.


As a physician coach working currently with colleagues in various physician leadership training programs, I appreciate that this is no easy skillset for us doctors, who have been trained in the "I'll write the order and tell you what to do" model, to acquire!


Here then is a brief summary of a useful NEJM article on physician leadership geared mainly to those physicians who don't have full-time executive or administrative titles but who instead are in informal leadership roles - committee chairs, project or initiative team leaders - without a big title, and lacking direct authority over your peers. You are having to rely on your skills of influence and persuasion.




"Front-line clinicians leading local systems have four key tasks.



  1. The most important is to establish the group's purpose by emphasizing that the goal is shared and the action needed is collective.

  2. The second task is ensuring that clinical microsystems can execute to achieve these goals.

  3. The clinical leader's third task is monitoring system performance.

  4. The final task is improving performance.



Clinical leaders must model the combination of humility, self-doubt, restless curiosity, and courage to explore beyond accepted boundaries that drives organizations to relentless improvement despite colleagues' preferences for stability and familiarity.

Leading peers in the 4 key tasks requires asking questions such as:



  • “What are we trying to achieve?”

  • “What is the best way to achieve it?”

  • “Are we getting the desired results?”

  • “What can we do to get even better results?”

  • And “are our systems keeping patients safe?



High-quality, comparative, unit-level and individual-level clinical and financial data remain the single most important motivators and tools for a clinical leader. Other critical resources include protected time, training and mentorship, and clear organizational expectations of clinician performance."

Philippa Kennealy ran a private family practice, and a hospital, before building her coaching business helping MDs launch and run successful practices and businesses. Visit her online atwww.entrepreneurialMD.com to learn more.
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