A recent discussion among my colleagues about increasing physician leadership in this age of electronic health records (EHRs), Meaningful Use, healthcare reform and Accountable Care Organizations (ACOs) caused me to think about how a physician even starts to go about becoming a leader. I considered physicians in my own community who are recognized leaders and appreciated that their rise to leadership started by simply getting involved in something. Their leadership was born out of getting involved just like my colleagues were doing when they began discussing solutions to this particular issue!
Getting involved is a common attribute of physician leaders because there is obviously little merit or trust when a physician leads an effort without previously participating in a similar effort. Participation is the initial step to gain such trust. Once a physician gets involved with a successful initiative their community deposits a “coin of trust” into his pocket. If the physician obstructs progress, though, some coins of trust are removed. A physician who eventually collects a pocketful of coins is looked upon as a trusted “community leader” who is knowledgeable and experienced, even if he did not actually “lead” any effort. This is because many successful healthcare initiatives are known to be moved forward by people who are catalysts for collaboration and effective at resolving conflicts between stakeholders. One does not have to be an ACO board chairman or a formal project leader to be such a catalyst. In fact, it is often advantageous to be in a more neutral position when exerting that type of influence.
So an increase in physician leadership will initially involve an increase in physician participation in healthcare initiatives. A good place to start is with local health initiatives such as a Regional Extension Center (REC), health information exchange (HIE) or Accountable Care Organization (ACO). Participating in a local initiative provides physicians with the valuable experience of working together, perhaps for the first time, with multiple stakeholders. Physicians will see the types of communal efforts that are successful at promoting change. They will gain valuable knowledge about healthcare reform, health IT or other important topics. They will learn how public policy is developed. They will encounter the frustrations and complexity of efforts that fail. But they will learn to keep their focus on the long term and not be deterred by a short term failure that they come to realize will not matter at all in 40 years.
Understanding this process illuminates a path to increase physician leadership. It starts with the active recruitment of physicians into local, statewide or national activities. It is accelerated through concurrent education and training to hone leadership skills. County and state medical societies, who have established physician relationships and are experienced with physician education/training, are ideal entities to facilitate the growth of leadership. The medical societies could actively identify new and ongoing healthcare initiatives and contact them to ensure there is adequate physician participation. They could also assist with physician recruitment and training when needed.