Why Physician Leaders Need Help To Reframe Their Concept of Power To Avoid Burnout
Power and precision are the dominant psychometric traits that drive leadership behaviors in physician leaders, especially when under stress.
So says SurePeople, a data-analytics company that used their Prism psychometric assessment to create a portrait of over 2,500 physician and healthcare leaders.
And, stressful is more the norm than the exception when it comes to describing the leadership scene in healthcare systems and academic medical centers across the country.
Why is that?
Because physicians are elevated to positions of leadership based upon attributes important to the clinical department, but not necessarily aligned to the expected competencies used to evaluate and promote administrative and staff leaders.
Physicians are also not normally included in structured talent management and succession processes, and therefore are unlikely to be exposed to valuable leadership development experiences. Because of this, there is extraordinarily little historical perspective, research, or clear data on how to best help physicians in their new leadership roles.
While precision is a preferred trait for physicians, especially when in the context of a medical encounter, their concept of power may be served by a reframe in the context of their newly assigned leadership post.
The Story of a “Lucky” Newly Appointed Physician Leader
Dr. Todd is a successful physician in a regional academic medical center.
He’s well-liked and sought after by patients who trust his expertise and enjoy his patient rapport. Dr. Todd developed a new procedure that improved patient outcomes in his specialty, so he presented his findings and is now published worldwide.
He is the program director for the Resident program, and recently obtained a multi-million-dollar grant to establish a research lab on campus.
To “reward” Dr. Todd (and to ensure that he remains at the institution) he is promoted to the role of Medical Director in his clinical specialty.
In this new role, Dr. Todd is now also responsible for:
improving clinical procedures
quality metrics
patient experience
process improvement
budgeting, and revenue
In addition, Dr. Todd finds himself translating institutional strategy to the clinical department while also managing the impact of those decisions on direct patient care.
As the perceived decision-maker and ultimate authority, Dr. Todd now finds himself:
managing clinical staff
navigating organizational politics
collaborating across boundaries with nursing and operational leadership
serving on multiple committees
attending a new plethora of leadership meetings
Energetic, enthusiastic, and eager to help, Dr. Todd takes on his new responsibilities with devotion.
It only takes 6 months and Dr. Todd is a changed man.
Dr. Todd is fatigued, and his colleagues notice he is not as positive in meetings. He’s having trouble balancing his work and home life and has stopped his daily workout. He’s on his way to experiencing symptoms of burnout.
Why?
Because...Dr. Todd, as a physician leader, wasn’t made privy to the fact that clinical leadership is not synonymous with institutional leadership.
How Clinical Leadership and Institutional Leadership Differ
Effective institutional leadership is dependent on each team member bringing their best selves to the work and the team. Additionally, the team only thrives within the context of collaboration, psychological safety, mutually agreed-upon norms, and clear, achievable goals.
Physicians like Dr. Todd are elevated to positions of clinical leadership due to their clinical performance. Their expertise with innovative clinical procedures, attracting clinical talent, publishing, and landing critical research grants makes them “ideal” leadership candidates.
But those skills may not prepare them for the necessary tasks of their new institutional leadership role.
Things like defining strategy and vision, nurturing talent, practicing team development, planning, and managing budgets, and the delicate task of balancing institutional priorities with the impact on direct patient care are now all on the docket.
When physicians are elevated to positions of leadership without the opportunity to develop the needed people-based skills for these new responsibilities, it can leave them and their new teams feeling frustrated, ineffective, and energetically depleted.
The skills that supported the physician in their clinical role are no longer sufficient within the context of their new leadership role.
On top of these leadership arena differences, the traditional meaning of leadership will cast a darker shadow for Dr. Todd. He’ll need to emerge from what “power” historically meant for leaders if he wants to shift out of burnout and into a high-performing team.
Traditional Leadership Structures Promote a Concept of “Power Over”
Existing corporate leadership structures that are still widely followed today, were established during the 1950s and 1960s to support the management needs of that time.
Managers were responsible for production and throughput, with front-line workers representing resources of production equal to the raw materials used to produce the goods. Not a very human-centric approach...
Decision-making and authority ascended higher in the leadership chain because of promotions and were denoted with “higher” titles. This graded system created the culture of “power over,” with common titles of Manager, Senior Manager, Assistant Director, Director, etc.
The ultimate goal was to become Vice President or President. The higher the title, the greater the decision authority, budget authority, and hence, power, aka “power over”.
Likewise, academic and medical title structures, established over hundreds of years, support the same achievement of “power over” with titles such as Assistant Professor, Associate Professor, Full Professor, Section Chief, Division Chief, and Department Chair.
Following suit with corporate structure, decision power in the academic setting is greater the higher the title.
Leadership Today Demands a More Collaborative Approach
Leadership in the 21st century has evolved into a more collaborative approach.
Nowadays, decision-making and problem-solving are disbursed throughout the department or team. This allows employees closer to the actual work to make meaningful changes to tasks and goals that impact them on a day-to-day basis.
Gone are the days when decisions, changes, and improvements are made by leaders farther away from the front line.
Additionally, the business environment is changing at a much faster rate, especially in healthcare.
Encouraging decision authority as close as possible to the front line supports the business to shift more quickly so it can meet customer and patient demands.
The traditional concept of “power over” does not support today’s leadership environment.
Staff and administrative leaders have been immersed in these new leadership models for a couple of decades, thanks to talent management and leadership development programs provided by human resources.
In most medical environments, however, there is a divide between physician practices and administrative functions like HR. Enterprising doctors like Dr. Todd sometimes don’t get the help they need to shift perspective and lead effectively.
The Good News…Existing Skills Can Help Physician Leaders
In their medical training and throughout their residency and fellowships, doctors are taught to be confident, decisive, thorough, and resolute.
In the medical encounter or the operating room, these qualities are critical when emergent health crises arise or when tough decisions need to be made quickly. In many ways, physicians also support patients’ feelings of safety--that they are in very competent hands where their health is concerned.
Working with physicians and physician leaders, I also find them to be highly self-reflective, curious, and collaborative...All traits that are essential for effective leadership today.
In the clinical setting physicians often review cases with each other to achieve a more informed perspective. They call for consultations when needed from colleagues with different expertise. Even with their patients they ask pertinent questions and partner with them to obtain the best outcomes.
These behaviors all demonstrate the belief in “power with” and not “power over”.
But frequently when ascending to leadership roles, and under stress, physicians resort to their position of confidence, decisiveness, and resolution.
So, how can physician leaders transfer the softer skills of curiosity, collaboration, and consultation to their leadership role instead?
That type of shift involves overcoming the perception of traditional roles and hierarchies, and a reframing of their concept of power from “power over” to “power with.”
Revisiting Dr. Todd’s Leadership Assignment
After about 8 months, Dr. Todd was exhausted, frustrated, and feeling ineffective.
This was a significant shift in his overall well-being compared to before he received his promotion.
I saw Dr. Todd at a symposium and inquired about how he was doing. After some high-level conversation, he finally admitted he needed help.
As Dr. Todd’s leadership coach over those next three months, we uncovered that he viewed his Medical Director role in terms that made him responsible for the results of operational initiatives and issues.
We explored how he might shift his perspective to rely on his more curious and collaborative qualities to assist with his leadership duties. I asked him:
Who on your administrative team has expertise in this area that you can consult with?
If this were a clinical case, how might you collaborate with others to get a better perspective?
What are the advantages of involving team members in process improvements?
Instead of asking yourself, “What do I want to do” in this situation, how would your answer be different if you asked, “Who do I want to be?”
Effective Physician Leadership Requires a Subtle Shift in the Concept of Power
Top performers in every industry are frequently assigned to leadership roles.
That means elevating high-performing physicians to leadership is the rule more than the exception these days.
High performance and expertise do not automatically translate to effective leadership. In healthcare, frequently our most productive and effective physicians are “rewarded” with leadership appointments.
In these situations, it is critical that healthcare systems provide physician leaders with relevant and practical tools to support them in bringing their best qualities to their leadership.
Coaching offers a targeted solution that can be effective and efficient in helping physician leaders reframe the concept of power from “power over” to “power with.”
For guidance on how you as a new physician leader can make the “power with” shift, schedule a free strategy session with me.
Similarly, if you are charged with helping new physician leaders ascend to a leadership post and could use some guidance, reach out to me for additional resources.