Physicians as Leaders: Who, How, and Why Now?

364 Pages·2016·11.788 MB·English

by  McKenna, Mindi, Pugno, Perry A

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Physicians as Leaders
Who, How, and Why Now?
Mindi K. McKenna,
PhD, MBA
Perry A. Pugno,
MD, MPH,CPE
with
William H. Frist,
MD
Foreword by
André L. Delbecq,
DBA, MBA, FACPE
Radcliffe Publishing
Oxford • Seattle
Illustrations © 2006 Benjamin James Pugno
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2006 by Mindi K. McKenna and Perry A. Pugno
CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
Version Date: 20160525
International Standard Book Number-13: 978-1-4987-9987-4 (eBook - PDF)
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Contents
Foreword iv
Why Read This Book? v
About the Authors vi
List of Contributors x
About the Illustrator xvi
Acknowledgements xvii
Prologue 1
Section I. Exploring Physician Leadership 7
1 Good News: Physicians Can Be Well-Suited to Lead 16
2 Overcoming Special Challenges Often Faced by Physician Leaders 24
3 Leadership Concepts and Competencies 38
4 Our Research Findings About Physician Leadership 53
Section II. Physician Leadership Pathways and Outcomes 63
5 Physicians as Experts: Leading Clinical Excellence 69
6 Physicians as Executives: Leading Organizational Excellence 79
7 Physicians as Pioneers: Leading Innovation in Healthcare 93
8 Physicians in Congress: Leading Healthcare Reform William H. Frist 109
9 Leading Physicians in Unique Settings 118
Section III. Stepping Stones for Successful Physician Leadership 127
10 Credibility Through Competence and Character 131
11 Clarity of Vision and Communication 154
12 Collaboration Through Commitment and Teamwork 171
13 Coordination of Decisions and Actions 190
14 Change: Enabling Resilience and Renewal 206
Section IV. Becoming a Compelling Physician Leader 229
15 Being a Leader: Reflection, Self-awareness, Focus, and Goals 234
16 Learning About Leading: Self-study, Training Workshops, and Formal
Education 250
17 Learning by Leading: On-Job Experience and Volunteer Leadership
Roles 261
18 Learning From Leaders: Relationships, Mentors, and Teamwork 271
19 Launching Other Leaders: Publishing, Speaking, and Advocacy 277
Section V. Tools for Assessing and Enhancing Your Effectiveness as a
Physician Leader 283
References and Further Reading 295
Next Steps 322
Biographical Summaries of the Physician Leaders Who Contributed
Insights for This Book 323
Index 345
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Foreword
Mature physician leaders considering whether to bother opening another book
on leadership may experience hesitations similar to my own. In all honesty, the
thoughts immediately flashing across my already overloaded mental “I should
read” screen were:
• Not another leadership book!
• I’m bored with the topic.
• What can be sufficiently new to warrant my time?
Such negative thoughts reflect realities mature professionals share. At the stage
in life when they engage in important leadership roles they have already been
inundated for years with leadership books and training programs. The first and
second book/program/symposium are very helpful. After that, additional expe-
riences are subject to diminishing value. The “next” book seldom adequately
connects with our “lived-in” leadership space. Given all the other forms of
professional development required by our fields, we are appropriately skeptical.
Yet, there are rare moments when leadership comes alive even for the
combat-weary professional. For me it has often been when exiting a particularly
stimulating presentation in the company of gifted friends who join together to
break bread. In a small circle of trust, we wrestle with the realities of our shared
leadership, avoiding illusions of romantic perfection, admitting to hardships,
and plumbing the richness of each individual’s life lessons. In such dialog hope
is sustained and new efforts inspired.
In Physicians as Leaders, McKenna, Pugno and Frist extend just such an invi-
tation to a shared conversation. Indeed, not just one conversation, but several
interrelated conversations bridging diverse leadership themes. Following
provocative, conceptually clear but terse reminders of important leadership
concepts, we then can enjoy as companions some of our nation’s most capable
physician leaders who open both mind and heart. This makes for an “enjoyable
read,” but never a superficial treatment.
Would you refuse such an invitation? All that is needed is to for you to
provide your own hors d’oeuvres, a favorite beverage, and a little quiet time for
self-reflection. (I can assure you self-reflection is very much stimulated by these
conversations!)
Or for those who are extroverts, consider inviting a couple colleagues to share
their reactions to one of the conversations at your regular “get together.” I
promise the exchange will be more fun and stimulating than small talk.
To summarize, I came to think of this book as “dinner conversations” that
were memorable, provocative, and informative. Physicians concerned with
transformational leadership requirements for creating a new future for health-
care will likewise savor the dialog.
André L. Delbecq, DBA, FACPE DBA, MBA, FACPE
Emeritus Dean
School of Business
Santa Clara University
July 2005
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Why Read This Book?
Perhaps you’re wondering whether to read this book, considering that your
time is limited and your work requires you to read too much already. We’d like
to help you decide. We believe you’ll find time invested in this book well spent
if…
• You secretly wish you’d chosen another profession.
• You’d like to know how to get patients (or staff) to trust and follow your
direction.
• You keep experiencing a nagging sense of discontent – a gut feeling that your
work ought to bring more joy than it does.
• You’re doing work you love, but want to be better at it.
• You’re extraordinarily gifted and wonder why you aren’t achieving extraor-
dinary results.
• You’re tired of racing through each day exhausted and frazzled.
• You’re uncomfortable with expectations being thrust upon you and aren’t
sure what to do.
• You believe you’re a fairly good leader, but would like to be more effective
or fulfilled.
• You’re a skilled physician, but a weak leader.
• You believe you have what it takes – but you lack training and proper guid-
ance.
• You have big hopes and dreams, but don’t know how to bring them about.
• You have great ideas, but can’t get others to listen.
• You’re convinced healthcare needs to change – but can’t imagine the gridlock
ever breaking.
• You’re stuck working with someone who makes your life miserable.
• You want to leave a legacy worthy of your calling and your profession.
This book is packed with advice from many contemporary physician leaders.
Their stories are inspiring, thought-provoking, and, frankly, perhaps a bit intim-
idating. Perhaps you may already count yourself among the ranks of leading
physicians; or perhaps you are not yet anywhere near that point – having just
recently begun your journey toward becoming an effective and fulfilled physi-
cian leader. Either way, you’ll likely identify with their depictions of exhausting
yet rewarding work.
The physician leaders who are profiled or quoted in our book were chosen in
part because they set forth such high standards. They inspire us to be and do far
more than we might have imagined. And yet, these physicians are accessible –
the type of colleagues you might run into at a conference, or chat with while
waiting in line at the movies. Diverse in their specialties, work styles, and aspi-
rations – these leading physicians share at least one thing in common. They’re
all passionate about making a positive difference in medicine. We’re talking
about genuine, heartfelt, live-it-out-each-and-every-day passion for truly great
healthcare. The kind of excellent healthcare we all want for our own children
and grandchildren, our parents and grandparents. So while you’ll find a great
deal of variety in these physicians’ accomplishments, you’ll also notice that the
truths they illuminate are really universal. Learn from them.
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About the Authors
Mindi K. McKenna, PhD, MBA holds a faculty appointment in the MBA in
Health Care Leadership Program in the Helzberg School of Management at
Rockhurst University. She is also the Executive Director of the Healthcare
Leadership Group, through which she helps physicians become effective and
fulfilled leaders. Dr. McKenna is an internationally recognized expert on lead-
ership, ethics, individual and organizational effectiveness. She frequently
delivers general session keynote presentations at medical conferences and
continuing professional development/CME training seminars for medical soci-
eties, professional associations, hospitals medical staffs and medical group
practices. Author of the book High Tech Medicine: Building Your Medical Practice
Using Computers and the Internet, Dr. McKenna’s articles have been published in
the Journal of Health Administration Education, the Journal of Invasive Cardiology,
Family Practice Medicine, the Leadership and Organizational Development Journal,the
Journal of Business and Strategy, and many other medical/management journals,
including those published by the American College of Physician Executives and
the American Hospital Association.
Dr. McKenna has over 24 years’ executive leadership experience in health-
care, having been Vice President of Marketing at Cerner Corporation, and
Director of Organizational Development, National Accounts and Federal Sales
at Marion Laboratories (now Sanofi-Aventis). She earned a PhD in
Pharmaceutical Science Administration with an emphasis in health care
marketing from UMKC School of Pharmacy, an MBA from Webster University,
and a BA in Industrial Psychology and Personnel Administration from the
University of Kansas. Dr. McKenna is certified through the Physician
Leadership Coaching Institute. She is a member of the prestigious National
Speakers Association – an “organization for experts who speak professionally”
– and serves on the Board of the Institute for Spirituality in Health. Dr.
McKenna is active in the Alliance for Continuing Medical Education, the
American College of Healthcare Executives, the Association for University
Programs in Health Administration, the Health Care Management division of
the Academy of Management and the Medical Group Management Association.
Perry A. Pugno,MD, MPH, CPEis Director of the Division of Medical Education
for the American Academy of Family Physicians, the professional association
representing the nation’s family doctors. He is also the Director of the Residency
Assistance Program, a peer-based, criterion-referenced nationwide consulting
group for graduate medical education that establishes the “excellence criteria”
for the discipline of family medicine. Dr. Pugno is an internationally recognized
expert in physician education and assessment. He has written and spoken
extensively on such diverse topics as leadership development, graduate medical
education, medical ethics, time management, financial management, domestic
violence and physician performance assessment. Dr. Pugno’s writings have
been published in the nation’s leading medical journals including the Journal of
the American Medical Association, Academic Medicine, the Journal of Clinical Ethics,
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About the Authors vii
the Western Journal of Medicine, Family Medicine, the Journal of the American Board
of Family Practice, Family Practice Management, and the electronic publications of
the American College of Physician Executives.
Dr. Pugno has over 27 years’ experience in educational administration and
leadership, and is the founding chair of the Academic Council of the National
Institute for Program Director Development. His diverse experience as a physi-
cian leader includes public, private, managed care, and academic settings. He
has worked as a postgraduate training director in multiple settings, as the direc-
tor of an urban trauma center, and as a corporate vice president for Catholic
Healthcare West, one of the largest integrated healthcare systems in the western
United States. He earned his MD from the University of California, an MPH
from Loma Linda University, and is board certified in Family Medicine,
Emergency Medicine and Medical Management.
William H. Frist, MD graduated in 1974 from Princeton University where he
specialized in healthcare policy at the Woodrow Wilson School of Public and
International Affairs and in 1978 from Harvard Medical School; spending the
next seven years in surgical training at Massachusetts General Hospital;
Southampton General Hospital, Southampton, England; and Stanford
University Medical Center. He is board certified in both general surgery and
heart surgery.
In 1985, Dr. Frist joined the faculty at Vanderbilt University Medical Center
where he founded and directed the multi-disciplinary Vanderbilt Transplant
Center, which under his leadership became a nationally renowned center of
multi-organ transplantation. He has performed over 150 heart and lung trans-
plant procedures, including the first successful combined heart-lung transplant
in the Southeast. Dr. Frist has written five books and more than 100 articles,
chapters, and abstracts on medical research.
First elected to the U.S. Senate on November 8, 1994, and re-elected on
November 7, 2000, Dr. Frist was the first practicing physician elected to the
Senate since 1928. In 2000, Dr. Frist was unanimously elected chairman of the
National Republican Senatorial Committee (NRSC) for the 107th Congress and
in 2002, was unanimously elected Majority Leader of the U.S. Senate. Dr. Frist
is particularly passionate about confronting the global AIDS pandemic. He
frequently takes medical mission trips to Africa to perform surgery and care for
those in need. As Senate Majority Leader, he continues to raise awareness
about the HIV/AIDS crisis throughout the world.
Senator Frist and his wife, Karyn, have three sons: Harrison, Jonathan, and
Bryan. He enjoys flying, writing, running marathons, and medical mission trips
to Africa.
The Foreword writer, André L. Delbecq, DBA, MBA, FACPE is currently the
Emeritus Dean, Santa Clara University, School of Business. Dr. Delbecq earned
a Bachelor’s degree in Business Administration from the University of Toledo,
an MBA and a Doctorate in Business Administration from Indiana University
with emphasis in Sociology and Applied Economic Analysis.
Dr. Delbecq began his academic career as a faculty lecturer at the University
of Toledo in 1959. After teaching at Indiana University and the University of
Toledo, he accepted an appointment as Associate Professor of Management at
the University of Wisconsin, Graduate School of Business in 1968, where he
served also as Chair of the Department of Management, Professor of
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viii About the Authors
Administration, School of Social Work. Dr. Delbecq’s academic pursuits
involved Fellowships at the Western Australian Institute of Technology and the
American Counsel of Learned Societies Contemplative Practice, and a
Distinguished Lecturer at the University of South Africa. He became Dean of the
Leavey School of Business and Administration at Santa Clara University in
1979, later serving as the Thomas J. and Kathleen L. McCarthy Professor of
Management. Dr. Delbecq has been Director of the Institute for Spirituality of
Organization Leadership at Santa Clara University since 1998.
Dr. Delbecq has been named by the American College of Physician Executives
as faculty member providing the single most valuable course and has been
named an Honorary Member of the American Academy of Medical Directors in
recognition of contributions to the education of Physician Managers. He is a
recipient of the Leavey School of Business Dean’s Award for Exceptional
Teaching, Research and Service, and of the Western Academy of Management’s
Presidential Award for Exceptional Contributions to Teaching, Scholarship and
Service.
Dr. Delbecq currently serves on the Board of Scholars of the Chief Executive
Leadership Institute, the Board of Directors of the Colleagues in Jesuit Business
Education, and the Board of Trustees of Ascension Health in St. Louis. Dr.
Delbecq has served as a member of the Editorial Boards of the Academy of
Management Journal, Health Services Research, the Journal of Management Education,
and as Executive Editor of the Academy of Management Review Journal.
Dr. Delbecq has researched organizational leadership, governance, adminis-
tration, and innovation, having been awarded educational grants from the
Department of Health, Education and Welfare, the Department of Labor, the
American Academy of Medical Group Practices, the American College of
Physician Executives, the American Group Practice Foundation, the Estes Park
Institute, and the National Health Service in London.
Dr. Delbecq’s works have been published in many prestigious journals includ-
ing Administrative Science Quarterly, the Academy of Management Review, the
American Journal of Public Health, Health Care Management Review, Health Services
Management, Health Services Research, Hospital and Health Services Administration,
the Journal of Applied Behavioral Science, the Journal of Management Education, the
Journal of Management Inquiry, the Medical Director, the Physician Executive, the
Training and Development Journal, and in many books and conference proceed-
ings.
Dr. Delbecq has been a frequent lecturer and guest speaker at various
academic and practitioner-oriented conferences, congresses, forums, retreats,
seminars and symposium, including, for example, the American Academy of
Medical Directors, the American Association of Medical Directors, the American
College of Physician Executives, the American Osteopathic Hospital
Association, the Institute for Health Care Improvement, the National Academy
of Sciences, and the Society for Teachers of Family Medicine, where he has
spoken on a variety of topics including medical management, organizational
governance, strategic alliances, innovation, change, and, perhaps most signifi-
cantly, the importance of spirituality in healthcare leadership.
Dr. Delbecq’s service to academic and practitioner-oriented organizations has
been remarkable. He has served as a consultant to the American Nursing
Association, the Deans of the American Medical Schools, the Department of
01-Prelims 30/8/05 9:12 AM Page ix
About the Authors ix
Health and Social Services, the National Science Foundation, and to many
hospitals and medical centers. He is a Fellow and past Governor, Board Director,
Committee Chair and President of the National Academy of Management and
many of its subsidiary divisions, past President of the Association of Deans of
Jesuit Schools and Colleges of Business, past Board Director for the American
Journal of Nursing Company, and past Chair of the National Advisory
Committee of the American College of Physician Executives.