Leading Clinicians and Clinicians Leading

Despite what you may hope, Accountable Care Organizations and patient-centered medical homes are here to stay and demand heightened physician leadership.

As a physician coach currently working with colleagues in various physician leadership training programs, I appreciate that this is no easy skill set for us doctors — who have been trained in the “I’ll write the order and tell you what to do” model — to acquire!

Here, then, is a brief summary of a useful NEJM article on physician leadership geared mainly to those physicians who don't have full-time executive or administrative titles but who, instead, are in informal leadership roles — committee chairs, project or initiative team leaders — without a big title and lacking direct authority over your peers. You have to rely on your skills of influence and persuasion.

Front-line clinicians leading local systems have four key tasks:

1. The most important is to establish the group's purpose by emphasizing that the goal is shared and the action needed is collective.

2. The second task is ensuring that clinical microsystems can execute to achieve these goals.

3. The clinical leader's third task is monitoring system performance.

4. The final task is improving performance.

Clinical leaders must model the combination of humility, self-doubt, restless curiosity, and courage to explore beyond accepted boundaries that drives organizations to relentless improvement despite colleagues' preferences for stability and familiarity.

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