Take a Quiet Lead
Great leaders are not always in the
spotlight. They succeed in growing
their practices with quiet confidence and persuasion. Hone your
leadership skills to shepherd your practice to success.
their practices with quiet confidence and persuasion. Hone your
leadership skills to shepherd your practice to success.
Great leadership is the crux of every
successful marketing campaign. When a big company is doing
poorly, the board of directors immediately assesses who is
leading and what his vision entails. If the CEO is not up to
snuff with respect to marketing, a search for new blood ensues.
Although most medical practices are not the stuff of Fortune
500 companies, they benefit from great leadership nonetheless.
As the great French military leader, Napoleon, once said,
“There are no bad soldiers, only bad officers.”
Some of the problems
we physicians face when it comes to leadership is a lack of
training and a paucity of role models. Although the latter is
slowly changing, the former is not. Most of us have never taken
the business and health-care management courses that would at
least level the playing field with respect to our colleagues in
health-care administration. Harvard business professor Joseph
Badaracco says, “Most physicians simply weren’t in
leadership positions [in the past]. They saw patients, worked
out problems with any other doctors in their practices, and
supervised a nurse or secretary or two.” Badaracco notes
that the status quo is changing. “With managed care, many
more physicians work in large organizations, have management
responsibilities, and need leadership skills. My guess is that
this trend will continue,” he says.
On the other hand,
there is no better way to learn a skill than to do it. Or more
precisely, the only real training for leadership is leadership.
As veteran actor Peter O’Toole once advised struggling
actor Michael Caine, “If you want to play leading parts,
then only play leading parts. It’s better to play Hamlet
in Denver than Laertes on Broadway.” The bottom line is
that regardless of whether we have formal training or not, we
still need to assume responsibility and leadership when it
comes to making our practices a success.
Barbara Le Tourneau and
Wesley Curry concur that the old world ways have given way to
new customs and challenges. In their book, In Search of Physician
Leadership, they write that in
the past, “Physicians were like artisans—they were
experts on medicine and on what would work for individual
patients. This cottage industry resulted in many small
‘shops’ geared to the needs of individuals.”
They were not leaders of hospitals or innovators of strategic
marketing plans. In many instances, they were not involved in
any sort of financial decisions. Not so today. It is the
exception rather than the rule in today’s health care
when a physician does not have to concern himself with
decisions relating to the financial health or the marketing and
continued success of his parent institution—whether it be
a private practice, academic setting, managed care
organization, or hospital-based medical practice.
What makes a leader?
So, if we are to achieve successful
practices through marketing and leadership strategies, what
qualities do we need to become great leaders? Should we be
strong willed, opinionated, willing to stand our ground, and
tirelessly push our agenda? No, says Badaracco. In his
best-selling book, Leading Quietly: An
Unorthodox Guide to Doing the Right Thing, he writes, “…the most effective leaders
are rarely public heroes. These men and women aren’t
high-profile champions of causes, and don’t want to be.
They don’t spearhead ethical crusades. They move
patiently, carefully, and incrementally. They do what is
right—for their organizations, for the people around
them, and for themselves—inconspicuously and without
casualties.” Badaracco calls these men and women quiet
leaders “because their modesty and restrain are in large
measure responsible for their impressive
achievements.”
Badaracco believes
that physicians are often quiet leaders, capable of
“impressive achievements” as they work to unify
their colleagues and hospital administrators as well as devote
themselves to central tasks such as marketing. Badaracco notes
that physicians often work in complicated organizations and
they get things done through persuasion and cooperation and
patient effort, rather than by giving commands. He writes that
the stuff of great leaders is: “Practical
ingenuity, honesty, and the hard work of drilling down a
problem…” He believes these are qualities that many
physicians need to develop and maintain.
Badaracco’s colleague
at Harvard business school, John Kotter, has penned a new book
called The Heart of Change in which he provides real-life examples of
how people change their organizations. Kotter writes that,
“People change what they do less because they are given
analysis that shifts their thinking than because they are shown
a truth that influences their feelings.”
Kotter offers an
eight-step strategy for leading successful change in large
organizations which will likely work in smaller settings as
well.
1. Increase urgency. People need to be
telling each other, “Let’s go, we need to change
things!”
2. Build the guiding team. Create a
powerful group that can guide change.
3. Get the vision right. The guiding team
needs to develop the right vision and strategy for the change
effort.
4. Communicate for buy-in. People should
agree with the change.
5. Empower action. Encourage more people
to act on the vision.
6. Create short-term wins. Momentum builds
as people try to fulfill the vision, and fewer people resist
change.
7. Don’t let up. Continue making
changes until the vision is fulfilled.
8. Make change stick. Reinforce the
winning behavior despite the pull of tradition or a change in
leadership.
How will
physicians’ attempts to market their practices be
affected by them becoming better leaders? Kotter believes that
it can only help. “Anything that can be done to help docs
see the need to learn and act as leaders [will help establish
and grow their medical practices],” he says. Kotter notes
that he is concerned with so many physicians leaving medicine.
Perhaps with better leadership skills, more power over daily
activities, and established marketing plans that ensure job
security, this trend will be curbed.
Le Tourneau and Curry
write that there are some core “skill sets” that
physician leaders should hone. They include:
• clinical competence
• excellent interpersonal
skills
• personal management
competencies (e.g., time management, the ability to establish
and sustain goals, and the ability to manage one’s
emotions)
• computer literacy and
information system skills
• quality improvement and
management applications (e.g., utilization review, clinical
pathway development, etc.)
• system thinking and
organizational design (e.g., “…encourage the
examination of long-term consequences of particular
policies”)
• transformational leadership
competencies (e.g., defining new organizational vision and
change as well as inspiring others)
These skill sets are
like any other qualities that one must develop over time. We
all have areas where we excel and other areas where we can
improve. Leadership and marketing are intertwined. In a
business, as well as in a medical practice, one can’t be
effective without the other. Moreover, both are essential
components of nearly all successful medical practices.
Of course, no one develops
and implements the perfect marketing plan overnight, and no one
becomes a great leader in an instant. These achievements take
hard work and practice. With practice, however, one can inspire
others to achieve amazing things. As the victorious Napoleon
replied when he was asked how he made his army cross the Alps,
“One does not make a French army cross the Alps; one
leads it across.” g
Julie K. Silver, MD is an assistant
professor at Harvard Medical School and the medical director of
one of Spaulding Rehabilitation Hospital’s outpatient
centers. Dr. Silver teaches a non-fiction writing and
publishing course for physicians at a resort in Falmouth,
Massachusetts (www.seak.com). She is the author of numerous books,
including the soon-to-be-released Chronic Pain and the Family (Harvard University Press).
