April 12, 2016

Why Physician Leadership Training Must Start Early

The Physicians Foundation awarded a grant to the Daniel Hanley Center for Health Leadership to develop and implement a leadership development curriculum for residency programs that can be employed across the country. Judiann Smith, Executive Director of the Daniel Hanley Center for Health Leadership, shared information about the innovative program, highlighting how it provides clinicians with the knowledge and skills they need to be more effective leaders in today’s complex and dynamic healthcare environment.

Q: Please tell us a bit about the grant and how it was utilized to develop a leadership curricula for residency programs.

A: Since we began planning the Hanley Center’s Physician Executive Leadership Institute (PELI) in 2009, practicing physicians and healthcare CEOs told us they were concerned that many physicians feel ill-prepared to assume leadership roles. As a result of insufficient leadership development training, physicians often don’t feel ready to lead a team, chair a committee or drive forward a quality improvement project.

The Physicians Foundation grant allowed us to design our PELI curriculum to provide basic hands-on leadership skills, create a supportive network of peers for current and emerging physician leaders, and ultimately build confidence among physicians. By the end of this year roughly ten percent of Maine’s practicing physicians will have completed courses developed by the Hanley Center as part of PELI. Nearly every physician we’ve worked with has said the same thing: leadership skills-building needs to start from the very beginning of their education and training. With this in mind, we engaged residency directors from across the nation to develop a curriculum that could be integrated into residency training programs in a wide array of practice settings.

Q: Why is your project important in today’s healthcare environment?

A: As the delivery system undergoes unprecedented transformation, there is a strong sense that more needs to be done to ensure that the clinician’s perspective is heard when important operational and policy decisions are being made across practice settings.

Without the insights and judgment of experienced providers, we run the risk that financial and business considerations will trump quality and patient care priorities. Simply put, our goal is to bring the physician’s voice to the decision-making table; few people understand patient and community needs more than clinicians. Nevertheless, far too many physicians lack the knowledge, skills and confidence to influence decisions and lead efforts to transform and improve care. Nearly every day we hear from physicians who struggle with interpersonal communications, addressing complex issues, dealing with various conflicts and harnessing the skills necessary to build and lead an effective team - all which require a high level of trust and collaboration. It is imperative that these skills are built into medical school and residency programs from the start to ensure the development of effective physician leaders.

Q: How has this program helped to engage residents and inspire physician leadership?

A: Up to this point, we’ve focused on developing a curriculum that can work within the context of an enormously busy residency program. Rather than add classroom time to jam-packed clinical training and practice, our curriculum relies heavily on trained physician mentors, independent study utilizing online content and projects that allow young physicians to practice newly acquired skills - helping them to address real-time quality and process-improvement needs. Now that the curriculum has been developed, we’re creating an online portal and will begin pilot programs at three residencies in three different states in 2017. By early 2018, we’ll use the feedback we receive from these residency pilots to refine the curriculum and make it widely available.

It is important to note that our work has been, and is in close partnership with, seasoned residency leaders at the Texas A & M Health Sciences Center in Round Rock, Texas. Texas A & M has helped us understand the need for residency programs to develop mentors and role models among faculty before launching a leadership development curriculum aimed at residents. It’s vital for programs to ensure that faculty have the skills, knowledge and experience that’s necessary to “model the way” for their residents. We’re convinced that a curriculum that provides practical tools that can be used immediately by residents will create a strong foundation for young physicians as they begin their practices and take on roles of greater leadership and influence. With the guidance and support of faculty and other physician leaders, we believe new generations of physicians will be better prepared to be effective leaders very early in their clinical careers.

Q: With physician burnout on the rise due to an array of regulatory and administrative burdens, how would you say this program helps residents remain energetic and enthusiastic about the practice of medicine?

A: Many highly experienced physician leaders have told us that much of the burnout they observe can be tied to a sense of “powerlessness” among clinicians. Many believe that their ideas for improving care are often ignored - along with their requests for new technology, more staff and better processes. Moreover, clinicians today often say that they feel more like production line workers rather than caregivers. We’ve come to believe that leadership skill building can help empower physicians and give them a greater sense of satisfaction when they observe their voice being heard.

Our leadership training helps young physicians learn to collaborate, work effectively with interdisciplinary teams and how to have “difficult” conversations. Not to mention, these skills enable residents to build trusting relationships with a wide range of colleagues, patients and others, while also learning the business and financial side of healthcare. In fact, physicians who acquire these new skills report a greater sense of satisfaction in their work and are more likely to volunteer for leadership roles and tackle tough issues with a greater sense of energy and enthusiasm.