How physicians can practice leadership, not just practice medicine, in their offices

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There are so many current issues in the primary care market right now that primary care physicians (PCPs) know only too well. These include but are certainly not limited to regulatory and administrative burdens, lack of funding and of reimbursement, keeping up with electronic records systems, and pandemic-related repercussions. Amid all these pressures, we can sometimes lose sight of the fact that physicians are caretakers first, businesspeople second. True, there’s inordinate demand on them to run successful (i.e., profitable) practices that can employ qualified staff, maintain adequate supply inventories, and simply cover the rent in ever-more-expensive buildings in accessible locations. But in the long run, a procedures-driven practice is going to be hard-pressed to compete with a patient-driven practice, especially in today’s market of online reviews everywhere, and of social media exposure of the slightest misstep.

As well-intentioned as we all know PCPs to be, it’s like the challenges are leading the tenor and direction of their practices instead of the doctors leading their practices. Doctors don’t necessarily think of themselves as leaders; they think of themselves as healers. But they are leaders, particularly those who run small to medium-sized private practices where they’re in charge of basically everything. And because full accountability ultimately falls to them, it’s worth considering ways and means they can hone their innate leadership abilities to nurture all aspects of their practice, guiding their staff to maximally functioning teamwork and their patients to maximally functioning health.

Leadership skill No. 1: Active listening

Michael L. Kaufman, MSW, PhD

A comment we hear all the time now is that doctors just don’t have enough time with their patients. This, in turn, has led to a loss of trust in physicians. There’s no denying that appointment times are limited, almost have to be limited, to keep a PCP practice viable. All the more reason to make the very most of your time with your patients. You can do this with the skill of active listening, which is less about how long you listen to someone and far more about how well you listen to someone, the quality of your listening.

Active listening isn’t just an abstract concept; there are a defined set of features and actionable steps to take to refine this capacity. When your patients feel truly heard and seen through meaningful engagement with you, they feel valued. When they feel valued, they genuinely believe you have their best interests at heart, they refer you to their friends, and they come back. When your patients continue to come back to you, you know you’re doing something right.

Leadership skill No. 2: Balancing priorities

Anyone in any type of leadership role is going to face this-or-that decisions, either/or quandaries that force them to pick between approaches or give more weight to one thing than another. One of the keys to adept leadership, however, is learning to balance both sides of an issue with tact and integrity.

This leadership skill comes into play with the ethical dilemmas PCPs often encounter. These run the gamut from privacy issues to end-of-life treatments to family interference. Let’s take a simple example of honest communication with a morbidly obese patient. You can gracefully ride the seesaw of people management by displaying both empathy and accountability when advising this patient; you can be both sensitive to their feelings and firm in your messaging that they need to change their behaviors for their own well-being. Leadership rarely entails choosing one stance and sticking to it. You’ll make far more progress leading people to desired results by practicing a combination of strength and compassion.

Leadership skill No. 3: Championing your people

The chaos of an overstressed office and an overworked staff can cause people to want to leave, to make job demands, to snipe at one another or finger-point when inevitable mistakes are made. But as the leader of your work environment, you have the power to guide your team to rise above the fray of the day-to-day and routinely keep the big picture in view.

In that picture, your people – your nurse practitioners, physician assistants, front desk staff – matter more than anything else in your practice. They’re the ones who keep the gas tank fueled, make the wheels go round, drive the engine that gets you from point A to point B. You could not do your job if they did not do theirs with exceptional proficiency and dedication—and the way you elicit that dedication is to see the greatness inside every single one of them. To identify and then foster their strengths. To mentor them and promote their career ambitions. To believe in them when they doubt themselves. To have their backs when yours feels up against a wall. By championing your people frequently and openly, you not only retain them, you create a devoted cadre of followers who trust and respect your leadership.

Leadership skill No. 4: Building alliances

A prominent roadblock for PCPs at present is the lack of communication among health care providers. This encompasses communication between nurses and doctors, between doctors and patients, and between insurance companies and, well, everybody! Its consequences include barriers to quality of care, compromised patient outcomes, and lower overall satisfaction ratings. The best way around this obstacle is to go right through it, following a route of cooperation instead of confrontation, partnership instead of partisanship, collaboration instead of division.

Hold monthly meetings with your staff to air out what’s impeding progress and solicit their ideas for solutions. Get on the phone with insurance providers yourself to negotiate terms and conditions. Form a network with local physicians to share difficulties and ways to surmount them. The end goal here is to unite as many concerned parties as you can, all rallying for the same benchmarks. As the commander in chief of your own operation, you have the wherewithal and influence to establish shared values among your team and enact a shared vision for your practice.

Leadership skill No. 5: Lead from the front

There are definitely times when those in charge should lead from the rear, allowing their staff to innovate and problem-solve on their own and granting them the autonomy to do their jobs as they see fit. But leading from the front equates to leading by example. And when it comes to very real impediments to your efficacy like physician burnout, you need to set the example and make clear that self-care translates directly to improved patient care.

You wouldn’t hesitate to advise your exhausted, overwhelmed mothers to take care of themselves so they can take better care of their children, right? The exact same thing applies to PCPs: How can you properly care for your patients if you’re not well-rested, focused, and in good physical form? When you allow yourself time and space to attend to your mental health, your team feels permitted and encouraged to do the same.

These are just some of the ways doctors can try to return to their roots, get a break from all the noise diverting their purpose, and remember why they became healers in the first place. The challenges facing PCPs comprise a complex issue with no easy answers, but there are things doctors can do right in their own offices as captains of their own ship with crews who long to follow an able leader.

In my book Doing Good & Doing Well: Inspiring Helping Professionals to Become Leaders in Their Organizations, I talk about more leadership attributes health care workers can bring to their positions – some more applicable to PCPs and some less so. But the paramount message here is that there is no helping profession more critical to the well-being of this country than doctoring. And yet this vital role is a hard one, and getting harder every day by the persistent hindrances to their calling.

Patients and the general population at large can alleviate some of the stress on PCPs by banding together in support of all the doctors they’d be utterly lost without, allowing them to prioritize their time and their tasks as they deem fit. As for doctors themselves, they can explain to their patients the very real concerns that are driving those priorities and ask for their patience and understanding so that their practices can survive to serve them. Most of all, by leading by example – actively seeking solutions to ongoing struggles and concentrating on people over paperwork – they themselves can help smooth the way to fulfill the oath they’ve taken for the betterment of humanity. An oath we’re all eminently grateful for.

Michael Kaufman, MSW, PhD, author of Doing Good & Doing Well: Inspiring Helping Professionals to Become Leaders in Their Organizations, has the heart of a helping professional and the head of a business executive. He rose from being an in-the-field social worker to the CEO of one of the largest private education companies in the country. He currently runs the special education management and consulting company he founded, dedicated to effecting positive societal change and improving the future prospects of K–12+ students with exceptional needs.