Leadership roles allow physicians to make a difference

A message to all physicians from David O. Barbe, MD, MHA, chair of the AMA Board of Trustees, on the importance of physician leadership and how to get involved.

By — Posted Aug. 12, 2013.

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Only four years into my medical practice, while I was still finding my way as a physician, I attended a meeting of the Missouri State Medical Assn. One of the more senior members approached me that night and asked if I would like to become a vice councilor, or regional board member.

I was honored by the request, but I was also startled. I was only beginning to understand what it meant to be a doctor. What made him (or me) think I could make a difference on the board of our state's medical society?

In the end, I took the position, which somewhat to my surprise proved to be very interesting and rewarding. That role at the MSMA exposed me to people I wouldn't have met and stimulating ideas I hadn't thought about. I found that it was complementary to what I was doing day to day, so it actually helped me in my medical practice. It also helped me realize early in my career that more and more decisions about medical practice were going to be made outside the exam room, and if doctors, including me, were going to influence how these decisions were made, we were going to have to step up and get involved.

For me, that first leadership opportunity opened doors that otherwise would have been closed. It also gave me an opportunity to make a difference.

I was lucky. I had good mentors at the MSMA who were patient and saw potential in me that I didn't recognize in myself. Like most of you, my medical training had not prepared me to lead an organization or even a medical team. I had no idea leadership was a skill I would need.

Students today do recognize that need, and so do medical schools: Teamwork and leadership training are both high on the list of subjects being addressed through the 11 AMA grants announced in June to Accelerate Change in Medical Education.

This addition to the medical curriculum is past due. We have an urgent need for physician leadership on many levels. The most obvious is in the politics of health system reform.

Since I have been AMA chair, I have had time to look back along my own path, and I have come to several conclusions regarding physicians and leadership. I am sharing them today in hopes it may give some of you ideas and motivate you to act. Your talents are badly needed.

  • Leadership opportunities often come unbidden. Take advantage of these opportunities.
  • The first step toward leadership is participation. If you are invited, get involved. If you see an opportunity, volunteer. They will be glad to have you. And no, you are never too young or too old.
  • If you see something that needs changing, speak up. Physicians are regarded as leaders in our society, and other people will be inclined to listen to what you have to say. This is true whether you want to wrestle with an issue facing your medical staff, you want your community to add bike paths, or you want your church or civic club to explore ways to provide medical care to the underserved.
  • Participation and leadership happen at many levels, and there is no lack of opportunity. At first, get involved where you are most comfortable and where you find a cause worth your time and talents. Consider neighborhood or civic groups, political meetings and community gatherings, not to mention your medical staff, local and state medical societies and the AMA. These groups all have boards that need members and committees that need workers, and all of those committees also need leaders. On the professional front, surveys have shown that one source of physician frustration with hospitals is a lack of physician leadership or representation on hospital boards. That offers another opportunity.
  • For those so inclined, physicians can make a big difference in party politics. Right now, there are a total of 20 physician members of the 113th Congress — three senators, 16 representatives and a delegate from the U.S. Virgin Islands. Numerous physicians hold seats in their state legislatures and city councils.
  • Keep in mind that leadership is generally a result of cumulative experience. That means beginning with a small job and working your way up. Sometimes it's hard to believe you're really making a difference, but think of it as deferred gratification. Anybody who has gone through medical school and clinical training can surely identify with that.
  • Being a leader doesn't always ensure popularity. I've noticed that the more visionary a leader is, and the more he or she strives to take people to a different place, the more difficult it can be.
  • Some people are born leaders, but most of us have to learn how to lead. Some of the skills we all need daily in this world of team-based medicine are the same as those found in good leaders: being able to delegate, being a good listener and being able to manage the give-and-take of negotiation.

Medical societies often offer leadership training, as does the AMA, and we will soon be adding more. In the meantime, you can find existing opportunities on an AMA website.

The AMA Foundation also presents a number of possibilities for leadership. Additionally, the Foundation supports its members' meaningful pursuits on a local and national level. For more, go online.

If you are a member of a hospital medical staff, the AMA Organized Medical Staff Section has developed a number of leadership webcasts. Topics include “Leadership in Health Care Change,” “Leadership Perspectives on Providing Accountable Care” and a basic “Primer on Meeting Management.”

In July I wrote about professionalism, a subject that is important to me. The idea of physician leadership is another, but this is one that I write about with a sense of real urgency.

As we watch our new health care system take form, I believe that the only people who are looking out for the primacy of the physician-patient relationship are physicians. Every day, decisions are made that could significantly affect the future of that all-important connection. Physicians must play a role in those decisions.

Our patients are counting on us. As their doctors, we must not miss this chance to make a difference by being willing to step up and lead.

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