The health care industry is in transition and because of this, new leadership styles need to be implemented to effectively lead and manage in this new paradigm. With the introduction of new laws, regulations, care coordination and payment models, health care providers need to adjust not only how they treat patients, but also how they work together. Long established leadership beliefs may need to change for physicians and other health care professionals as a team based approach becomes more necessary to be effective.
Healthcare is a very regulated industry and there have been numerous new laws implemented over the last few years that have changed how health care providers work within their organizations. This increase in health care usage can put pressure on the existing infrastructure and require new management techniques to lead teams through this transition.
Physicians, who are typically leaders within health care, now must balance changes in the industry along with new demands required to effectively lead teams through these exciting times. What may have worked in the past may not be successful today, so changes in leadership styles may be required to be successful in today’s environment.
When I think of a physician, I imagine a person who has intelligence, self-confidence, determination, and integrity – all of the attributes that fall under the trait approach of leadership. Beyond having the “right” personality characteristics, they also would have to have the appropriate technical skills to be considered a leader. Both of these leadership styles are described by Northouse in the text “Leadership: Theory and Practice”, whereas the trait approach has its roots in leadership that suggest that certain people were born with traits that make them great leaders, the compliment to trait theory is the skills approach that shows that effective leadership depends on three basic personal skills: technical, human and conceptual (Northouse, 2012). I have always felt that due to the extensive training a physician must complete, as well as their skills and experience, they have a certain “gravitas” that instills respect and admiration. This lends itself to the perception that doctors would naturally make great leaders.
But what makes a physician a great doctor, may not necessarily make them a great leader. Dr. Atul Gawande stated “Health care is moving towards teams, but that collides with the image of the all-knowing, heroic healer. We’ve celebrated cowboys, but what we need is more pit crews. There’s still a lot of silo mentality in health care.” This same sentiment was shared by Dr. Thomas Lee who stated “The problem with health care is people like me – doctors (mostly men) in our fifties and beyond, who learned medicine when it was more art and less finance. The only way to ensure quality was to adopt high personal standards for ourselves and then meet them. Now at many health care institutions and practices, we are in charge. And that’s a problem, because health care today needs a fundamentally different approach – and a new breed of leaders.” So the lone-ranger approach to health care may have worked better in the past when physicians managed solo practices and were in charge of their domain, but with the changes in health care, maybe this style of leadership isn’t the most applicable to be effective.
As physicians take on more leadership roles in organizations, the importance of having the right leadership style matched with the demands of the situation becomes apparent. This is described with the contingency theory approach where the leader’s effectiveness depends on how well the leader’s style fits the context. So for physicians that have not evolved their thinking in regard to how best to work in today’s health care environment, they may not be successful, but for those who recognize the changes going on and adjust their leadership style, they will likely be more successful.
The team leadership model provides a framework in which team members can figure out the best way to work together to accomplish their goals and work together. Within the health care industry, there has been a shift to new models such as the Accountable Care Organization (ACO) and patient-centered homes where care is conducted through teams of health care providers who share information and support each other in the care of the patient. These shifts within the industry are encouraging a more collaborative work-environment which supports a team centered approach but the specifics of what clinicians need to do can be unclear. Surveys suggest that clinicians want a greater leadership role but may feel unprepared or dis-empowered. Front line clinical leadership should be encouraged by giving physicians the authority to make micro-system changes, tolerating failure on some new delivery ideas, and creating pathways for clinicians who want to move into more leadership roles (Bohmer, 2013). By working on their leadership skills, physicians can transition from purely patient centered roles to that of leading broader teams.
When speaking about teams, I don’t want to lose sight of some of the most critical team members who are often leaders in their own right. This would be the nurse who is on the front line working with patients and leading teams of their own. Many of the same leadership skills that physicians have are also apparent with nurses. In a systematic review that looked at nursing leadership, after reviewing 48 papers it found that a combination of leadership styles and characteristics were found to contribute to the development and sustainability of a healthy work environment. Many of the same leadership skills such as teamwork and continued learning were mentioned, but the one topic that I think has even greater importance is that of emotional intelligence. This is the ability to motivate, communicate and manage conflict and can have a positive impact on staff, patient, and organizational outcomes (Pearson et al., 2007).
There are a number of different qualities that the health care leader of the future should possess as they will need to lead teams while navigating a difficult changing environment. Below are five qualities that will help define dynamic health care leadership in the future: (J. Stephen Lindsey & John W. Mitchell, 2012)
- The healthcare leader of the future will be an independent thinker who understands the emerging healthcare market.
- The healthcare leader of the future will be passionate about serving the needs of the customer.
- The healthcare leader of the future will be a change agent for their organization.
- The healthcare leader of the future will have the ability to motivate and inspire.
- The healthcare leader of the future will run a lean, high-quality organization.
Changing established norms can be very difficult, especially for physicians who have been trained in a certain way or hold long established beliefs of how they should function.
It wasn’t really until the concept of emotional intelligence was introduced that this started to resonate with me. As Goldman described in the Northouse text, “emotional intelligence consists of a set of personal and social competencies. Personal competence consists of self-awareness, confidence, self-regulation, conscientiousness, and motivation. Social competence consists of empathy and social skills such as communication and conflict management.”(Northouse, 2012)
The one thing that seems clear to me now is that times have changed and that there is much more value on a leader who is open to listening to others and participating on a team. Georg Vielmetter of the Hay Group speaks about how leaders in a “quick and nimble” management culture are able to engage with diverse employees more successfully if they come from more of a humble perspective. Vielmetter sums it up nicely in the following quote, “The time of the alpha male — of the dominant, typically male leader who knows everything, who gives direction to everybody and sets the pace, whom everybody follows because this person is so smart and intelligent and clever -this time is over. We need a new kind of leader who focuses much more on relationships and understands that leadership is not about himself…who knows he needs to listen to other people…to be intellectually curious and emotionally open…(and) needs empathy to do the job.” (LaBier, 2014)
I feel fortunate to be working in an area such as Health Care that is in such a state of transition as this is the time that true leadership can really make a difference.
Dan is a digital health evangelist with a BS in Industrial Engineering, an MBA, and an MS in Health Informatics along with 20+ years’ experience in product development, innovation, and marketing. Connect with Dan on LinkedIn or via email firstname.lastname@example.org