Leaders or Just Managers? 5 Things to Do to Be a Physician Leader

With the US election just a day away, many people are torn between candidates who are "the lesser of the two evils".

While it is unfortunate that neither candidate has broad appeal to at least partially improve the USA's morale and unity, this election brings up a critical point of what many feel is the fundamental flaw under question: Trump and Clinton may be tremendous managers, but are they really leaders?

Managers are the bosses, the people at the top, those with the final say.

Leaders, on the other hand, are those who share their vision and inspire others to follow. While the best leaders are also competent managers, not all managers are leaders.

The essence of leadership versus management is hard to define, but here are a few quotes from those who were both competent managers and exceptional leaders.

"A true leader has the confidence to stand alone, the courage to make tough decisions, and the compassion to listen to the needs of others. He does not set out to be a leader, but becomes one by the equality of his actions and the integrity of his intent." — Douglas MacArthur

“If your actions inspire others to dream more, learn more, do more and become more, you are a leader.” — John Quincy Adams

“The supreme quality of leadership is integrity.” — Dwight Eisenhower

Neither of the major party candidates is known for his or her integrity, nor inspires Americans to be their best. But in the end, there is always impeachment!

While this is an unfortunate shortcoming of the two-party American system that has lead to low political morale, I have seen a similar binary manager mentality cause problems in the hospital. Many physicians think of themselves "above" nursing or other staff, and certainly above their patients. They have a managerial mindset that they are the bosses and their subordinates need to do what they say. This leads to sub-optimal communication, lower patient satisfaction and compliance, and even poor outcomes.

A physician-leader, on the other hand, realizes that everyone on the team plays a part in healthcare, including the patient. The physician-leader works for the benefit of others, not the other way around like the physician-manager sees things.

Here is a list of 5 things you can do to ensure you are a physician-leader.

1. As Douglas MacArthur put it, a leader has "the compassion to listen to the needs of others." In his book, Blink, Malcolm Gladwell cited a study by Wendy Levinson, MD, who studied doctors who had been sued multiple times and compared them to doctors who had never been sued. The difference was three minutes. The doctors that had been sued spent only 15 minutes with their patients, while those that hadn't been sued spent 18. Those three minutes of active listening make you a better leader AND could save you a lawsuit. (Or if you see things the other way, a lawsuit could save you 3 minutes per patient of active listening. You decide.)

2. A second leadership trait MacArthur knew was that leaders stand up when things are difficult. It is more easy to prescribe and move on instead of standing up to antibiotic resistance in the patient with cold symptoms for almost two weeks demanding antibiotics, or standing up against the opioid epidemic affecting the patient with back pain that refuses physical therapy but is crying for narcotics. A physician-leader can balance empathy and active listening with sustainable practices and long-term non-maleficence.

3. Physician-leaders inspire others. Whether taking the time to understand your patients to educate and optimally motivate them, or genuinely complimenting medical assistants and nurses for their best work, or even inspiring medical students or younger physicians to read and think a little harder, there are opportunities galore for the physician-leader to inspire or empower. As one of the greatest leaders of American history put it, "Everybody likes a compliment." — Abraham Lincoln.

4. "A good leader is a person who takes a little more than his share of the blame and a little less than his share of the credit." — John C. Maxwell. Physician-leaders don't display arrogance or hubris. Even though they went to medical school, residency, and have years of experience, they still realize that they can be wrong.

5. Lastly, the physician-leader demonstrates equality and integrity, and uses the actions of the two presidential candidates as case studies of the wrong way to go about this.