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THE LEADING EDGE: SPECIAL ISSUE
From M.D to Top Exec |
Volume 3 Issue 5
October 2012 |
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 Whether or not physicians hold formal leadership titles, by the nature of their work they are in positions of leadership every day - in emergency and operating rooms, at patient bedsides and at the helm of their own medical practices. But along with those advanced medical degrees and years devoted to learning specialized skills, few have ever received formal leadership training. In fact, some of the traits they acquired in medical school - to be skeptical, look for what is wrong and always double-check - can even backfire in leadership roles. In this issue, we spotlight four healthcare leaders - Kim Post, Dr. Robert Ziltzer, Dr. Craig Primack, and Dr. Ronald Fischler - who share their insights on what it takes to be an effective leader in healthcare today. |
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Medical Leadership and What Physician Leaders Need
During their medical training physicians learn to be skeptical, look for what is wrong and to double-check. It's a formula for being a top-notch physician - and a difficult boss. While doctors devote much of their lives to their medical education, rarely do they receive training for their leadership role.
One recent emergency room study found that attending physicians spent less than 30 seconds listening to the patient before taking over the conversation. Not surprisingly, patient satisfaction scores in this emergency room were below standard. Listening is one of the most important behaviors that people look for in their physician, and in their leader.
"I was trained to trust only myself," reported a surgeon at a leadership conference. How does a physician leader build trust with his or her team if they have learned to trust only their own judgment? Leaders who haven't build trust with their teams encounter resistance and make little forward motion. Physician practitioners may trust their own medical skills and judgment, but when it comes to leading, they need to learn how to trust others.
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An Interview with Kim Post
Vice President and Administrator, Thompson Peak Hospital, Scottsdale Arizona
 Kim Post joined Scottsdale Healthcare in 1991 and has held numerous positions throughout the organization prior to her promotion to vice president in 2007. Most recently, she served as an administrative leader in the pursuit of the prestigious Magnet award for excellence in nursing care. She is certified in Advanced Nursing Administration (American Nursing Credentialing Center). She is a member of Sigma Theta Tau, American Nurses Association, Arizona Organization for Nurse Executives, and the Association of Women's Health, Obstetrics, and Neonatal Nurses.
TLE: What helped you prepare yourself for your new leadership assignment?
KP: I have spent the last 21 years at Scottsdale Healthcare's three campuses. You are only exposed to what you see, and it is important to get a perspective beyond your immediate horizon. I have had mentors and coaches in and outside my organization. I did a fellowship at Wharton that gave me an instant, international network that has been a powerful contributor to my success. I have a community of support that I can draw on whenever I need it. With my clinical nursing background, I can tap into the clinical side, but I also belong to a group composed of CEOs and COOs that I can draw from. I am a lifelong learner, and I am always either in school or thinking about what I have learned.
TLE: What is the best advice anyone gave you?
KP: A physician leader gets credit for this. He said, "You have to understand everyone's perspective. Listen to their point of view, process it all and then make your own decision. You won't satisfy everyone, but you at least included them and listened." He was a good listener and I could see how it made a difference. When I took over, people were upset with the previous leadership. I brought them together and listened. I offered a structure to help people participate: engage them, get feedback, and then move forward with a decision. Something complex can become manageable when you apply this process, and I have done it frequently. Another physician once told me, "If you always do something right for the patient, it will be OK." That was good advice too.
TLE: What are the biggest challenges you face in your current role?
KP: I have to work on my own balance and make sure I allow myself time to have a life. Now that my children are out of the house, I could easily work 20 hours a day. As a hospital administrator, it becomes financially harder and harder to find resources. I have to challenge my staff about what we have always done - about what works, what doesn't work. I like to test out new ideas and models. For example, we had a nurse manager leave who was achieving mediocre results. Instead of immediately filling the role as we always have, we are holding back and exploring a new leadership model that partners a business manager with a practice manager. I am confident we will figure it out.
TLE: What is the most impactful leadership lesson that you learned?
KP: Never underestimate the number of people you need to get to the table to make a decision. In a highly volatile situation, especially with physicians, there will always be someone who criticizes that you left them out. It is easy to overlook someone. If you have built trust, and do make a mistake or miss someone, they at least know you weren't pulling something over on them, and will give you the benefit of the doubt. When you screw up, say you are sorry and acknowledge your mistake.
TLE: Which of your qualities and skills have helped you the most?
KP: Three things have helped me: I would say first, my creativity. I come up with some real zingers sometimes, but I am not afraid to try new things that address our problems in unique and effective ways. Second, change doesn't bother me, but I know it bothers others. In this business, change is coming and you had better be open to it. Finally, and maybe the most important, I am a good relationship builder. When I took this new position, I had so many people offer me help and support. They wanted me to succeed. I like people and I find it very rewarding to watch them grow and develop. In fact, I am mentoring several people right now formally and a number of people informally. That gives me great pleasure.
TLE: What leadership attributes do you look for in your own leadership team?
KP: You can't hire people who are just like you, but you need people who are confident in their ability to lead change. They need to be passionate about learning a different way to do things, and committed to what we are trying to accomplish. If that excites and interests you, come on aboard! But if it makes you uncomfortable, this isn't for you. I look for people with different strengths on my team, but they can't be afraid of data, and they must be highly skilled communicators, especially with physicians.
TLE: If you could define your leadership philosophy in one sentence, what would it be?
KP: I like "Hard on issues, soft on people." (Fisher, Getting to Yes). By that I mean holding people accountable but building trust. Another might be, "When you lose the passion - get out." Never lose the passion. |
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An Interview with Dr. Robert Ziltzer and Dr. Craig Primack
 Dr. Ziltzer and Dr. Primack are Board-certified in Pediatrics and Internal Medicine and by the American Board of Bariatric Medicine. They are also members of the American Society of Bariatric Physicians and the Obesity Society and founding partners of Scottsdale Weight Loss, they have built one of the most successful weight-loss programs in the country.
We asked Drs. Ziltzer and Primack, both of whom are routinely named among Phoenix Magazine's "Top Docs of Arizona," [about their leadership challenges and lessons learned in building and leading their growing medical practice.
TLE: What are the biggest challenges you face in your role as a medical practice leader?
Dr. RZ: When you are the main source of practice revenue, setting aside the necessary time to manage a practice is always a challenge. We have found that weekly meetings with the management team help keep us moving forward. The greatest challenge as a medical practice leader is understanding the different ways in which we each communicate. Once I understood my own priorities and values, as well as the priorities of my staff, I learned to communicate better to each individual.
Dr. CP: In most medical practices, physicians have to play a dual role. First and foremost, we are the technician, providing medical care, and we are also the leader. There is not usually enough time in a day to do both, so obviously your primary duty has to be seeing patients. The secondary duty becomes managing your practice. Running a practice properly needs more time than a busy physician can properly dedicate.
TLE: Which of your qualities and skills help you most in your role?
Dr. RZ: There are often many solutions to a problem. I try to think creatively to find solutions that will work for both our staff and our systems. Because I do not have all of the answers, I strive to find consensus. I also try to ask the right questions that provoke the right solution to a given challenge.
Dr. CP: For me, my analytic nature helps me to evaluate what is needed and see the problem through to a solution.
TLE: What leadership attributes do you think others like yourself need to successfully navigate the challenges of leading a medical practice?
Dr. RZ: As physicians in training, we learned to give orders and have them followed. This does not work in a medical practice. It will kill morale. If you are a dictator, you'll have little buy-in from staff and lots of turnover. Involving staff in decisions is key to getting buy-in and preventing resistance. Your staff is more aware of problems and may have a better handle on how to correct them.
Dr. CP: I think you need to be organized and have patience and drive.
TLE: What attributes do you look for in your own team?
Dr. RZ: Most importantly, we look for team members who can understand and share our vision. They have to have core values of integrity, enthusiasm for our cause and belief in our mission statement. We also want our employees to be engaged and involved in our efforts. We love it when our staff feels comfortable enough to disagree with a decision and share their concerns. However, once the team has made a decision, team members must be willing to support that decision.
Dr. CP: As we build our team, the specific attributes we look for actually vary from position to position. We try to define those qualities before we interview and then try to find the right person for each role.
TLE: What keeps you awake at night?
Dr. RZ: The marketing side of our bariatric practice is critical to our success and a constant challenge. This is a big difference from the traditional medical practice that we once ran. I think the marketing side keeps both of us up at night. Traditional advertising is being replaced by social media and we are always trying to explore ways to tap into that.
Dr. CP: I agree. It's marketing, marketing, marketing these days.
TLE: What is the most important leadership lesson that you would pass on to new physician leaders?
Dr. RZ: Listen to others. Be in the moment. Have empathy not just for your patients, but for your staff and colleagues as well.
Dr. CP: I would also add, make sure you are ready for the challenge of running your own practice. It takes many different skills other than seeing and treating patients. You have to be ready to grow those skills in yourself. |
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Medical Leader Workshops We Offer:
Mentoring for Leadership Development
Many organizations embrace mentoring to promote leadership development and leadership succession for high potential employees. Participants in this four-hour workshop identify the roles and responsibilities of mentoring partners in promoting leadership development and review the tools and strategies mentors use to ensure mentoring success.
The Medical Executive Committee Challenge
For hospitals and Medical Staffs seeking to undertake meaningful change, we provide several types of consultations. We work with medical staff leaders to help focus the vision, values and goals of their organization.
Leadership Intensive for Hospital Managers
This three-day intensive workshop is designed for managers and supervisors who seek to raise their level of effectiveness in their leadership position. Beginning with a 360-degree feedback instrument prior to the workshop, participants learn key leadership skills and concepts critical to their success.
Tools for Medical Practice Leaders
The high volume of a busy medical practice, coupled with reduced reimbursements of managed care, and the economic downturn, contributes to stress, low morale and high turnover.
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Seven Lessons Learned on One Physician's Leadership Journey
Ronald S. Fischler MD, FAAP, Clinical Associate Professor, University of Arizona College of Medicine, Phoenix Founder, North Scottsdale Pediatric Associates, PC
 Dr. Ronald Fischler served in many leadership roles over his long and diverse career. He served in the Indian Health Service, where he was the clinical director of the five-doctor medical staff at a rural hospital on the San Carlos Apache Reservation. Later, as a member of the faculty of the University of Arizona Health Sciences Center, he created and led a child development clinic. At St. Joseph's Hospital in Phoenix he built new child development and child abuse programs in collaboration with community groups. He is the founder of North Scottsdale Pediatrics, a 12-doctor, two-office private pediatric practice. At Scottsdale Healthcare Shea Hospital, he played a number of leadership roles, including the chair of Pediatrics, Continuing Medical Education and Credentials as well as president of the medical staff of 1,400 community physicians.
His term as president began with a fiscal crisis that exposed trust and communication issues between physicians and administration. By working closely with physician colleagues, he strengthened relationships and formed new alliances with the administrative team. In his most recent leadership position as president of the Arizona Chapter of the American Academy of Pediatrics, Fischler helped the organization grow and infused new energy and vitality into the board by attracting new and more diverse members.
We talked with Fischler and asked him to reflect on his career and leadership experiences. He shared seven key insights he gained along the way that hold important lessons for us all:
- Listen.Seeking out influential colleagues and key leaders and asking for their perspective laid important groundwork for the work ahead. Not only did I gain understanding about the dynamics and history of the organization, I also got others' viewpoints of what needed to be done. Listening helped me gain their trust and my willingness to listen to them prompted their willingness to listen to me.
- Formulate a vision and communicate it widely. Earlier in my career I didn't understand the concept of leading with a vision. I led more with a carefully crafted plan, which I thought was reliable and more than sufficient. I always wondered why others didn't get on board. A vision, I learned over time, is something very different. It is a message of unity that appeals to a broad population. If you have listened to a spectrum of voices, it should feel like apple pie and motherhood and should be an easy sell.
- Slow down. This is an antithetical message for me, because I tend to want to make progress quickly. I have always been dissatisfied with the status quo and drawn to opportunities where change was needed. What I learned the hard way is that if you try and change things too quickly, especially before you have earned trust, you will likely encounter resistance.
- Hold people accountable. This seems obvious in a discussion about leadership, but it is much harder to hold people to their commitments when you are not directly in charge of their paycheck. As head of a medical practice, it is much easier to get people to perform. Getting results from volunteer board members and medical staff requires more reliance on influence and relationship building rather than positional power. I also had to remember that gaining accountability doesn't mean just openly confronting disappointing performance and managing the conflict that arises as a result. It also means celebrating and recognizing successes, which is not a natural talent of mine. I have had to get a lot better at that and am still learning.
- Communicate progress. Sometimes when you are moving at a fast pace, you forget to stop and let your constituents know what you are doing. I never used to see the value in what I viewed as a kind of self-promotion ("Hey, look at what I am doing as your leader.") I see it differently these days. People need a sense that things are moving forward. It's called "small wins," and it helps generate enthusiasm and gets people on board. Communication by blog, newsletter (printed or electronic), website or at staff meetings - they all work.
- Don't take it personally. Easy to say and tough to do. It can feel like an affront if someone walks out of your meeting because they don't like a decision or if you receive criticism after your actions didn't produce the results that everyone had hoped. But it isn't personal. A close friend, a confidante, past leader or wise spouse can remind you not to take it (or yourself) too seriously. I also found a peer group in our national organization's leadership training academy that created a network of support I could draw on.
- It's not about you. I find it is impossible to completely remove my "ego " from my leadership. If you are willing to step up and be a leader you have to believe in yourself and your ability to make things happen. Still, you need to strive to keep your ego from getting in the way. There is a difference between willingness to serve and needing to serve.
For Fischler, being a physician leader has been a very satisfying part of his career. Leadership provided a welcomed change from his patient care responsibilities and an opportunity for deep and lasting personal growth. Each new leadership position taught him an important lesson that he says "has made me better at what I do, not only as a physician, but also as a parent, husband and friend."
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We help individuals and organizations achieve excellence through leadership development. To do this, we provide customized training, facilitation, consultation, and coaching services (on-site and virtual) that improve the quality of leadership and mentoring. We partner with clients to create sustainable mentoring support structures and processes and roadmaps for creating a mentoring culture. We offer innovative and comprehensive leadership development programs to enhance individual and organizational learning and accountability. Our long-standing relationships with clients around the world are testimony to our ability to facilitate results that matter. |
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