MGMA 2019: Making the jump from physician to physician-leader

Making the leap from a physician to a physician-leader can be a struggle, says Steve Quach, MD, CEO of CarePoint Health in Denver, in an October 15 session at MGMA 2019 in New Orleans.

Quach says that many physicians received little to no leadership training. Because of this, part of the complication in transitioning from doctor to physician-leader lies in the difference in clinical thinking and leadership thinking.

For example:

• a clinician acts as the subject matter expert while a leader is just a subject matter expert

• clinicians are authoritative leaders while leaders are more collaborative

• clinicians have a short term/tactical focus and leaders focus on more long term/strategic thinking

• physicians have a checklist-type mentality while leaders need to prioritize

• doctors use efficient, top down communication and leaders should have expanded communication with crucial conversations

• physicians delegate tasks and physician-leaders delegate responsibility

In healthcare’s current state, Quanch says the reality is a mix between a “team sport” where everyone has a voice and a hierarchy where doctors give orders and everyone else executes.

“That’s the meaning of healthcare,” he said. “Nothing happens without the stroke of a physician’s pen, or now the stroke of a keyboard.”

The problem arises when physicians take that same mentality into leadership positions, Quanch says. But he doesn’t discount the importance of physician-leaders.

That’s because physician leaders have credibility with physicians and other clinicians, understand the subject matter and the realities of practicing medicine. Non-scientific evidence suggests hospitals run by physicians produce better quality scores, Quanch says.

So he advised new physician leaders to consider the difference between authority-which is defined and limited in scope-and influence-which is broad and versatile.

“I would postulate to you that influence is the most important thing for leadership,” he says.

The CARVE method, explained

In order to create influence, Quanch advises physicians to use the CARVE method, which stand for: courage, authenticity, rational appeal, values, and emotional quotient.

Courage: The mental or physical strength to face danger, fear, or pain allows a leader to embrace the uncomfortable tasks that they are called upon to perform, champion change or unpopular ideas, tolerate risks that are required for success, and recognize and accept one’s mistakes and failures.

This raises challenges with physicians in relation to their training to do no harm, which leads to risk aversion, and their tendency to be mediators rather than leaders among other physicians, Quanch says.

Authenticity: Being genuine, real, legitimate, or true allows a leader to show behaviors which match with their expressed beliefs, demonstrate humility, and express an appropriate amount of vulnerability.

Quanch says he feels authenticity to be the most important facer in creating influence, but many physicians might have trouble with displaying vulnerability and relatability due to their experience as clinical leaders and subject matter experts.

Rational appeal: The ability to leverage intellectual reason appealing to the reasonable side of others allows a leader to recognize the importance of rationality in healthcare while effectively wielding data and empiric evidence.

Physicians can have trouble with this due to evidence-based medicine only supports 20 percent of current clinical practices and doctors are challenged to integrate both clinical and non-clinical rationale, Quanch says.

Values: The principles and standards of behaviors, and judgment of what is important which when shared increases employee trust in their leader, increases employee engagement, engages employees more than compensation and benefits.

Quanch did not identify any physician-specific challenges when it comes to values.

Emotional Quotient: The ability to understand and manage not only one’s own emotions but also those of others, along with values, can create an emotional appeal which can be more powerful than a rational appeal.

For physicians, this can raise the challenge of their training and experiences focusing all of their emotional intelligence purely into the context of the doctor-patient relationship, Quanch says.