Management and Leadership Skills for Medical Faculty: A Practical Handbook

266 Pages·2016·10.03 MB·English

by  Anthony J. Viera

Management and
Leadership Skills
for Medical Faculty
A Practical Handbook
Anthony J. Viera
Rob Kramer
Editors
123
Management and Leadership Skills
for Medical Faculty

Anthony J. Viera • Rob Kramer
Editors
Management and Leadership
Skills for Medical Faculty
A Practical Handbook
Editors
Anthony J. Viera Rob Kramer
University of North Carolina at Chapel Hill Kramer Leadership, LLC and
Chapel Hill, NC, USA University of North Carolina at Chapel Hill
Chapel Hill, NC, USA
ISBN 978-3-319-27779-0 ISBN 978-3-319-27781-3 (eBook)
DOI 10.1007/978-3-319-27781-3
Library of Congress Control Number: 2016935322
Springer New York Heidelberg Dordrecht London
© Springer Science+Business Media New York 2016
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Foreword: Why Lead Now?
This unique book is designed to bring hard-learned lessons, from within and beyond
academic medical centers, to medical faculty seeking to be efficient and effective
leaders in academic medicine. It is a book of “hows” that will help the reader negoti-
ate barriers and avoid pitfalls. We humbly offer our thoughts on “why” this topic is
so needed in academic medicine, including some observations on “why lead now?”
People come to leadership with at least one reason to lead, if not many. So please
take a scrap of paper, right now, and scribble down on it your reason(s) for being or
becoming a leader. Make two columns—a list of reasons you are doing this “for
self” and a list of reasons you are doing this “for others.” Take as much time as you
need making this list. We think it is important.
If you are like most people, like most leaders, there will be entries at least in the
“for self” column. There is nothing wrong, per se, if your mind first went there and
sort of got hung up thereafter. We are complex creatures in whom mixtures of public
spirit and self-interest always coexist. But we think you will be a more successful
leader, a happier leader, and a leader more readily followed if you are able to add to
the “for others” column.
To help you add to that column, consider how much angst and dissatisfaction
exists in healthcare right now. Much of it is reflected in troubling data about the
medical field. Because medical schools and academic medical centers, at least in
theory, exist to lead the field forward to a better place, there is much opportunity
right now to make a difference through leadership.
Here are just five of the many challenges facing medicine right now. Addressing
any of them might help you quickly identify a meaningful “why” that you can place
in your “for others” column.
1. Healthcare wastes too much money. There is general agreement that roughly
30 % of total healthcare cost is waste, that is, over $800 billion dollars a year. Of
every dollar spent in this country for any reason, 5 cents is for healthcare waste.
Meanwhile, the disparities between wealth and poverty are widening, and the
country’s decaying infrastructure is being neglected.
v
vi Foreword: Why Lead Now?
2. Healthcare is not safe enough. Estimates of deaths in hospitals from errors run
as high as 187,000 each year—that is, inpatient deaths alone. There is no credi-
ble estimate for outpatient deaths, which some experts guess to be higher. After
15 years of regulatory attention and effort, healthcare is not much safer.
3. Crucial research is not reaching patients. Over 15 years of data collected by
the Centers for Disease Control and Prevention now suggest that adverse child-
hood experiences are major contributors to adult diseases. This process likely
affects tens of millions of Americans, and there is research showing how to pro-
vide relief. We know things about childhood adversity and later health that we
have not acted on, leaving millions suffering unnecessarily.
4. Crucial research is not being done. We spend far more on research that exam-
ines how to treat diseases than on how to prevent them and on how to develop
new therapies than on how to disseminate ones that we already known are effec-
tive. These research priorities are often driven by the prospect of making money
rather than saving it, leaving crucial research unfunded.
5. Healthcare organizations suffer from too much top-down leadership. Across
healthcare, only half of employees in an anonymous national survey felt com-
fortable speaking up if they saw an error or bad behavior [1]. Yet modern leader-
ship theorists endorse creating bottom-up safety in which the initiative and
commitment of employees can revolutionize organizational culture and perfor-
mance (i.e., creating leadership “at all levels”).
In making the “why” list, we encourage you to take an opportunity to look inward,
into your soul, into what you really care about. This process is one of self-r eflection
and self-awareness in which you can examine your gifts in relationship to your work.
In doing so, you may identify a clearer purpose and meaning in being a leader.
No matter who the leader, no matter where or when, it can be hard for that person
to hold in a safe container those “whys” for leadership that are “for others.” The
danger of being harried out of the “for others” column is high, and the challenge of
maintaining inspiration is great. But some day, you will step down from your formal
leadership role. The battles, the rationalizations, and the likes and dislikes will slip
out of your consciousness. You will be left with this question: What did I do? Did I
make a difference?
The answer to those questions starts today and ultimately will lie on the scrap of
paper in your hand that has two columns. So too does the likelihood of your success,
as well as the opportunity to look back some day and smile peacefully about what
happened under your leadership.
Foreword: Why Lead Now? vii
About the Authors
Robert C. Whitaker, M.D., M.P.H., is professor of pediatrics and public health at
Temple University, Philadelphia, PA. Henry F. C. Weil, M.D., is senior associate
dean for the Columbia Affiliation at Bassett Healthcare in Cooperstown, NY, and is
professor of clinical medicine at the Columbia University College of Physicians and
Surgeons, New York, NY.
Philadelphia, PA Robert C. Whitaker, M.D., M.P.H.
New York, NY Henry F.C. Weil, M.D.
Reference
1. 2014 User Comparative Database Report. Chapter 5: overall results. March 2014. Agency for
Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-
patient-safety/patientsafetyculture/hospital/2014/index.html

Preface
According to the Association of American Medical Colleges (AAMC), there are
141 accredited US and 17 accredited Canadian medical schools; approximately 400
major teaching hospitals and health systems, including 51 Department of Veterans
Affairs medical centers; and nearly 90 academic and scientific societies. Through
these institutions and organizations, there are 128,000 faculty members who are
responsible for educating and training 83,000 medical students and 110,000 resi-
dent physicians.
The primary aim of this handbook is to provide these faculty and similar profes-
sionals with a contemporary, directly relevant resource about personal career devel-
opment, executive skills, and leadership principles, topics that are usually not
covered in medical school or residency training. Our emphasis is on practical skills
advice and leadership development, including personal improvement, which can be
used at any stage of one’s academic medical career.
Books and resources about general leadership abound, but we hope this hand-
book, tailored to medical faculty, will fill a niche that is increasingly important in a
climate of accelerated healthcare change, competition for available research fund-
ing, and increasing momentum for medical education transformation.
Chapel Hill, NC, USA Anthony J. Viera, MD
Rob Kramer
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