A doctor in the operating room is at the center of a complex system of medical care that has evolved to balance quality against cost and technology against humanity. It is an environment that makes extraordinary leaders necessary. But what does it take to be a physician leader, and how can doctors prepare themselves for this type of leadership?
The answers to these questions will help shape the future of medical practice. Doctors themselves are already starting to organize in new ways, and the results could be significant. In a recent election, a majority of doctors at Mercy-Unity hospitals affiliated with the large health system Allina voted to become represented by Doctors Council. This is an encouraging sign, but unionization is not the answer for every doctor.
Instead, a more radical solution may be to empower physicians to band together in professional associations and federations that provide a platform for expressing their common interests and concerns in ways that have the potential to affect change. Doctors are activists in their own communities fighting addiction, smoking, e-cigarettes, and guns, and they’re also taking to social media to protest a host of issues that affect patients—from the price hike of insulin, which has forced many patients to ration it, to the Trump administration’s policy of separating children from parents at the border.
But the current structure of doctor organizations is ill-suited to these purposes. They are divided into corporate entities subject to public law and independent professional associations or federations (often called a “medical chamber” or an “association of medical practitioners”). There is little consistency in terms of the way these groups are governed, their legal status, or how they interact with each other.
This fragmentation of doctor organizations makes it difficult for them to speak with one voice on behalf of the profession, a vital part of their role in a democracy. When a large group like the Endocrine Society has to protest the prices of insulin, or when the American Academy of Pediatrics publicly decries immigration policies that separate parents from children, their voices are heard, but they don’t have the power to effect real change.
Doctors are being asked to lead in a unique way—the profession has never before been so diverse and polarized, and the balance of quality against cost and technology against humanity has never been higher. But it is possible to bring the strengths of the medical community together for the common good—and that requires strong physician leadership.
There is a wealth of literature that demonstrates the positive effects of physician-leadership on an organization’s performance. But few studies have examined the specific attributes of doctor-leadership that might account for these improvements. Some of these attributes include the presence of a clear, shared vision and values; clear, mutually agreed-upon aims; and internal, transparent sharing of performance data. In addition, there are also indications that a culture of trust and collaboration is associated with enhanced organizational performance.