Physician leader require special skills in a corporate environment

Physician Executive, July-August, 2004 by Barbara Menzies

Take a look at six communication skills required for physician executives to successfully operate in a corporation that includes non-clinical managers and executive

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Early socialization of physicians teaches them to take an aggressive posture in the acute management of patients. This attribute is reinforced by the medical school mantra "do no harm."

When multiple physicians are involved in the management of a patient they quickly fall into a "pecking order" that allows the physician with primary responsibility to have dominant status. Physicians generally accept a subordinate role only when there is vertical transfer of information from another physician during periods of "temporary teaming."

Physician executives in a corporation, by contrast, must take a multi-faceted approach in their interactions with clinical and non-clinical cohorts and superiors within the corporate work environment. That means physicians in management must develop a significantly different skill set to compete in the corporate world. The necessary skills include:

1. Fluency in bi-directional communication

Experienced physician managers realize they must be fluent in bi-directional communication. Bi-directional communication is the ability to switch from "sender" to "receiver" when communicating about various issues or initiatives. The key to mastering this concept is the physician's ability to quickly discern who has ownership of the initiative.

2. Support of superiors

Physicians in a corporate environment must link their accomplishments to the success of their superior. If you strive to execute at this level, everything else should follow and you will be highly valued. There needs to be a synergistic relationship between physician leaders and their supervisors.

The supportive relationship that the physician executive develops with his or her immediate supervisor should stimulate a level of appreciation, not just with the supervisor but with the supervisor's superiors as well.

The physician's projects must roll up and support the goals of the supervisor and ultimately support the strategic goals of the corporation.

Unfortunately, some physician executives may make decisions to undertake activities that are not aligned with the goals of their supervisors. This often alienates the physician and the supervisor, and is often particularly troublesome if the supervisor is non-clinical.

3. Business ethics

"Integrity is not what we do so much as who we are. And who we are, in turn, determines what we do." (1)

It is extremely important that what physician executives in a corporation communicate to others is also demonstrated by their behavior. Our human frailties don't allow us to be correct at all times but others should always perceive our motives as honest. Too often the daily challenges within the corporate environment bring significant conflicts over what is "the right thing to do" versus what is "politically correct."

The physician who takes a position to espouse "the right thing to do" to his supervisor and others but does it in a respectful, collaborative and charitable way may have some difficult times but will earn the trust and respect required for negotiating these difficult situations.

4. Global perspective operations

Historically, clinical care involves episodic processes championed by physician leaders. This way of working encourages short-term goals rather than long-term planning. In the corporate setting, this translates into physicians managing short-term tasks rather than long-term initiatives, which does not bring added value to a corporation's ability to address global issues.

Physician managers must strive to achieve long-term solutions to immediate problems and elevate these problems from the task level. This can be accomplished by developing systems and processes that identify problems earlier (root cause analysis). This should promote the creation of action plans that either eliminate the problems or impose efficiencies in a graded fashion (continuous quality improvement--CQI).

5. Building positive work relationships

Networking is a critical skill that individuals in corporate management need to assure their success. Physicians are acclimated to managing in very narrow corridors of expertise, which enables them to function fairly autonomously from other physicians and non-clinical cohorts.

However, success will be greatly limited if physicians lack the ability to network in the corporate environment. They must be willing to listen and take direction from non-clinical experts and support CQI for processes and programs.

6. Timely problem solving

Physicians appreciate the need to respond quickly and engage in creative problem solving when faced with urgent clinical situations. However, many do not appreciate the need to be just as responsive in a corporate environment when problems are declared urgent by non-clinical staff. It's important that physician executives take corporate problems seriously and react quickly to fix them.