Karen J. Nichols

Physician Leadership


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severely handicapped as a leader. The medical and political climate speaks to the importance of this emphasis.

      Chapter 13 – What are specific meeting dynamics that can aid or sabotage your purpose?

       Physician Approach

       In the care of patients, there are not a lot of meetings that directly impact the care of a specific patient, other than a tumor board, which is carefully scripted and conducted in a very traditional way.

       Leader Approach

       The physician leader who doesn't understand the impact of meeting dynamics on effective leadership is seldom going to be able to achieve their desired goals. And will never figure out why. Thus this roadmap!

      Chapter 14 – How the physician leader functions as a whole person.

      This is a perspective chapter addressing issues that both women and men physicians and physician leaders must wrestle with. And this focus covers all the issues now seen in diversity, equity, and inclusion.

      Yes, the big picture summarized in this chapter is a strictly leadership thing, as the big picture for the physician is the patient. And that is as it should be.

       “I thought you said there were 11 topics. How did we get to 15 chapters?”

      Good question. Some topics are dealt with in two chapters. You will get the basic concept in one chapter and the practical techniques in the second chapter. And there is a bonus chapter dealing with issues of being a whole person as a physician, especially as a physician who is a woman, one of the minority groups in medicine, and who is coming from a specialty, internal medicine, that has been underrepresented in many organizations in which I have participated. Its not exactly a topic with defined principles and techniques in the same way as the other 11 topics, but it has pertinent and important perspectives for physician leaders from many diverse groups.

      This roadmap summarizes the topic and then provides the connections to the tried‐and‐true resource documents when you get stuck or are ready to dive into the details. Each chapter will present the idea in a basic outline and finish with some questions to guide your understanding of the main points. Each section will also finish with that list of top‐notch resources when you are ready to do the deep dive into the topic.

      You don't have to read this book in the order presented. You may be fully experienced on some of these topics. You may just need some specific pointers on one topic or another and can go directly there. My caution is that everyone must touch base with Chapters 1 (know yourself) and 2 and 3 (communications) to be sure you have those points nailed down, as everything else builds on them. I do have to add that even if you think you are very familiar with a particular “stretch of this roadmap,” you may find that you know the topic as a physician but don't have a full appreciation for the topic as a physician leader.

      1 Fox, J. (2006). Secrets of greatness. Fortune, October 20, 2006. https://archive.fortune.com/magazines/fortune/fortune_archive/2006/10/30/8391732/index.htm.

       “Wait a minute! I thought we were going to learn about leadership! This chapter is about knowing yourself. What does that have to do with leadership?”

      Yes, we are going to learn about physician leadership, AND you cannot be a leader if you do not know yourself. This is one of the most important points in the leadership journey.

       “But I DO know myself, it's just those other people who don't make sense.”

      I must admit I came to this topic with the same opinion as our novice leader. However, the truth was I did not really know very much about myself or how and why I looked at things the way I do. Let alone that there might be logical, well‐documented explanations for why others might look at the same things and see them differently than I do. Who knew? Certainly not me!

      The further unspoken implication here is I am right and they are wrong. As a doctor, I didn't have any problem making that assumption.

      I still remember sitting at my desk in my new dean's office about 10 a.m. on my first day, having looked through the two file drawers of papers left by my predecessor and thinking, “So now what do I do?” The idea of a “listening tour” was popular then, so I decided to try that approach. I asked my staff to book an hour appointment with each of the 15 department chairs. I laid out three or four questions to ask each one. They covered the usual concerns for anyone new in a supervisory capacity: What are the biggest issues facing your department and the COM? What should a new dean focus on first? I was ready!

      Note: I later discovered The First 90 Days: Proven Strategies for Getting Up to Speed Faster and Smarter by Michael Watkins (2013), an excellent guide for conducting this same type of listening tour approach. It is well worth a look when tackling a new position.

      What I learned from this listening tour certainly surprised me, but not for the reasons I expected. The answers were enlightening, helpful, and insightful. What I was not prepared for were the different styles and approaches of these people. I am going to describe each response and the type of interaction in the way I encountered these people and their approaches. Over time, I learned about personality classification systems and could go back and see that approach in each of these individuals. Suffice it to say, I just didn't get it at first. Stick with me and we'll circle back to examine each approach. Lest anyone try to identify each chair, I have combined some characteristics and comments to make the approach distinction more clear.

      The first chair came in with a thick document of notes outlining the recent history of the COM, what worked, what did not, advice for the future, and cautions regarding other chairs. I never even got a chance to ask my questions, as the entire time was filled with the narrative provided. Talk about “outgoing”!

      Statistics were the