Friday, July 09, 2010

Doctors and Leadership

Fascinating stuff about doctors in leadership positions currently in the news. Here are some random ‘Trevor’ thoughts.

In my experience the best combination for the leadership of any healthcare organisation has two key elements.

FIRSTLY a doctor who is committed and interested in the leadership and management functions (but most important is still in touch with clinical practice - i.e. still meets patients!)

SECONDLY that doctor is supported by a manager who takes care of the detail.

In various leadership positions during my healthcare career I loved working alongside a doctor. Doctors in leadership positions, supported by good management make things happen.

Doctors carry far more influence than managers with their medical colleagues.

In an unhealthy manager-doctor relationship there will be a gulf between the manager and the doctor. Often, I’m sad to say, because of ego ‘competition’ about who is the leader.

The best managers recognise the doctor is the politically important figure and the manager role is a supportive one.

When I worked alongside a doctor who was leader, whenever I had a controversial thing to do I would always ‘use’ the doctor to help me get the message over to other medical staff.

Here is some revolutionary thinking for you – guess what?

Doctors take more notice of Doctors.

Some managers try to ‘take on’ doctors as if it is some sort of battle and the manager invariably loses that war.

I always took the view that my role as the manager was to facilitate change; implement plans and strategies; in summary make things happen. The doctor took the leadership/visionary role.

Despite what some managers like to believe, the REALITY is that doctors wield the most power, politically in healthcare.

When I worked in a management role with a doctor interested in the leadership management thing I cherished him/her and kept him/her happy by getting on with the detailed stuff of management while supporting the doc to make key leadership decisions.

Doctors are no different than the rest of us; they have exactly the same issues. If managers just get alongside them; take some time to get to know them; and work with them, there are so many win-win situations. I’ve seen managers fall on their sword because they didn’t understand this simplicity.

4 comments: said...

What would be wonderful, in my opinion, is doctors who, from the top down (I agree - doctors have the ultimate power of influence on the care philosophy of a given entity) imbue their organizations with a (w)holistic view of healthcare.

As a consumer, I know that preventive care is both crucial to health and undervalued by most doctors, who are trained to deal with symptoms and not whole body/mind/spirit causes. I'm not sure if you'll see my way on this one, but just thought I'd chime in!

Thanks, as always, Trevor for the food for thought.

~ Shauna Arthurs

Trevor Gay said...

Hi Shauna - absolutely agree with you. Some GP's I worked with had an extremely holistic view of health and referred many patients to non-medical services. I myself was referred as a patient to a chiropractor by my own GP.
Conversations and keeping an open mind is the answer to this old chestnut.

Anonymous said...

Hi Trevor,

I work on a surgical floor in a city with two hospitals: my hospital and what we euphemistically call "the other place". Periodically, the surgeons get mad at either my hospital or at the other place for some small policy change or whatever. In the first case, they send most of their patients to the other place. In the second case, the opposite occurs.

Personally, I find the whole process juvenile, as if the provision of health care was some sort of school yard brawl.

But as you say, it is a matter of egos and the awareness that politically, doctors have the upper hand. Thus the need to partner with them, which my hospital has been striving to do. The problem is that not all the surgeons want to be partners. They want things done their way or else. On the other hand, there are a few who are more interested in the business and political side of things.

Only by partnering with those interested surgeons to communicate effectively with their colleagues will my hospital be able to soothe the necessarily large egos of the other surgeons. Just my two cents.


Trevor Gay said...

Hi John – Happy Sunday and thanks for your comments as always! Juvenile is a word I’ve heard used before about these issues. Schoolyard brawl is another cracking expression – I may use that in future. Doctors are no different than managers in my experience – most of them play the game fairly and professionally – some act like kids. Actually I find managers more pretentious than doctors having worked alongside both all my career. I’ve been lucky that I’ve not had to work with any juvenile docs but I’ve certainly met childish managers.