Physician Leadership

This week, my CBS Money Watch blog focused on what the Supreme Court’s decision means, and doesn’t mean. The bottom line is that business has been demonstrating leadership by reducing costs in the industry, while politicians threw mud at each other.

The purpose of this blog is to reflect on what we can learn from the real story of the heroes of healthcare: the physicians who stepped up leadership. About 12 years ago, two fellow USC professors—one from the School of Policy, Planning, and Development (now the Price School of Policy) and one from the Keck School of Medicine—and I decided to get serious about the ailing healthcare system by empowering physicians to lead it. My mentor in executive education, Mike Duffy (now Dean of Strategic Relations at the University of San Francisco), inspired me with the vision of doctors becoming caregivers for a sick industry.

As associate dean and early spokesperson for this degree (the Master of Medical Management), I’d travel around the country pitching the concept of physician executives. When most doctors heard the word “leader” they were skeptical. Some said it sounded like charismatic people leading group cheers. To others, the word “manager” made them cringe. Physicians often said “manager” was a term that meant someone had “sold out” and had “gone to the dark side.” And then came the word that made some leave the room: “entrepreneur.” Physicians have a particular scowl that they must learn in the endless hours of residency. With that disdainful look, some said the term sounded like “used car salesman.” I’d also used the word “intrapreneur,” meaning a person who leads growth-oriented strategies within an organization. One doctor said: “that sounds like a used care salesman with a better ID badge.”

All these years later, the MMM program is going strong. We have turned out graduates who are leading all sorts of initiatives in healthcare. What happened?

The USC story is a tiny part of a much larger movement: Physicians returning to their roots as leaders, managers, and yes, entrepreneurs. Physicians in the United States were some of the original entrepreneurs as the country moved west. In some small towns, there would only be a couple of “businesses”—the market to buy staples, and the doctor. Physicians were also leaders not just in healthcare, but in industry and government.

The revolution of “the other side” in the 20th century meant that doctors opted out of the discussions on policy and reimbursements, often leaving the attorneys, lobbyists, politicians, and MBAs to make the decisions. Predictably, with the voice best able to reflect the care for the patient removed from the debate, the system became more complex, and as Harvard’s Michael Porter pointed out, value destroying.

Physicians are the new rock stars of healthcare for one simple reason: they have the most influence on patients. Should a patient get an expensive CT scan to rule out something they probably don’t have? Only a physician can discuss the possible benefits alongside the medical risk from the radiation. The physicians are in the best role to counsel patients on prevention. Doctors have taken the lead in using motivational interviewing to get patients to actually change their behavior, from quitting smoking to losing weight.

This story comes down to people focusing on who they really are. Doctors have always been leaders, even when they forgot. Thank goodness that leaders from within their ranks, like HealthCare Partners’ CEO Dr. Bob Margolis, reminded them.

What about you? Regardless of your job, title, or degrees, the strongest part of your leadership platform may come from who you really are, that you forgot. Often, what we most resist is the key to becoming who we really are. It’s worth thinking about and I’d love to get your thoughts in the comments.

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