VETERAN HOSPITALIST LEADERS remember their early leadership positions as painful but instructive. Here are some lessons they learned the hard way:
- Learn to flex. Young leaders at first don’t appreciate that “your relationships change as your role changes,” says Patience Reich, MD. Dr. Reich was previously associate professor at Wake Forest School of Medicine and medical director of Wake Forest Inpatient Physicians in Winston-Salem, N.C.”Information that would have generally come to me before didn’t come to me anymore,” she says. “When that shift begins to happen, you really have to go out of your way to keep an open door.” She refers to the process of making yourself more accessible as “flexing.””The person with the power has to do the flexing if you want people to feel they can bring you bad or even unfavorable news,” says Dr. Reich. “You have to show that you are open to listening.”
- Engage complainers. Young leaders should expect to be challenged by their colleagues. Sometimes, says Jairy Hunter, MD, who’s associate executive medical director for case management/ care transitions at the Medical University of South Carolina in Charleston, S.C., you need to just ignore what can be colleagues’ snide remarks.But when faced with chronic complainers within your group, action is needed. “I started giving those hospitalists leadership roles,” Dr. Hunter says. “I had them chair a committee or represent the group at an administrative meeting in my stead. They often came back and said, ‘I do not want your job.'”
- Cut through the bureaucracy. Hired in his first leadership job to turn a troubled program around, Dean Dalili, MD, who’s now a regional medical director for Hospital Physician Partners in Florida, wanted some quick, tangible signs of his new leadership. He brought in his own posters to brighten up the hospitalist office and talked the hospital’s IT department into switching out the group’s old, slow computers with brand new ones.That not only brought him some instant high marks from his group, but served as a good lesson in how to get things done.”You need to understand how to cut through the bureaucracy,” Dr. Dalili says. Too often, he adds, young leaders make the mistake of wanting to bring all their problems to their boss to solve instead of dealing with those concerns themselves.”Why should I bring every issue to the CMO, like we need new computers?” Dr. Dalili points out. “I solved that problem by developing a direct relationship with IT.”
- Divide and conquer. When presented with something new, “people can think very quickly and creatively about why something may not work,” Dr. Dalili says.When he has to propose something controversial to one of his groups, he’s learned to first discuss it with a few individual members. “Think about who are the most vocal, energetic people in your group, and sit down with them first one on one,” he says. “Get their buy-in and then expand that circle so when you bring the issue up to the group, you already have some support.”
Leading a hospitalist program can prove to be A tough road for young group leaders.