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Real leadership 2010

September 2010

I try to write thoughtful (or brainless, depending on one’s perspective) essays rather than “twitteresque” posts about what ruined my lunch or is ailing health care on any given day. However, I just got back from this year’s SHM leadership academy and am inclined to post some brief comments.

My first observation: It is remarkable how much leadership potential now exists in our field. I base this declaration on the four times I have attended the leadership conference, the first as a participant and the latter three as a facilitator.

When I facilitated a group of 10 doctors in 2006, no one at my table was currently a medical director or lead hospitalist. Instead, it was a group composed of capable doctors posed to make that next step and intent upon arming themselves with the tools they’d need to succeed. Flash forward four years, and 80% of those at my table were currently medical directors–and 100% of them had the requisite skills to make the next step.

While the group had the same underlying level of leadership skills as at previous conferences, their maturity was remarkable. The dialogue had advanced from how best to schedule the night shift or get leadership buy-in to more complex discussions of how to operate budgets and expand programs.

And in another departure from the past, the participants generally described their groups as remarkably functional. That’s not to say that no one had stories of ongoing conflicts with administration or subspecialist groups. But notably absent were the “You got to be kidding me!” recollections of disrespect and disregard from hospital leaders, which were common fodder at previous conferences.

My second major observation: We will not have a glass ceiling. When you combine so much leadership talent with self aligned interests, there’s no question that the new trend toward hospitalists integrating themselves into upper level hospital administration is just beginning. Not a moment too soon, to my mind. Hospitals where the C-suite and the medical staff aren’t functioning on the same page will be too inefficient to survive in the future. And no one is positioned to deliver that unification than homegrown hospitalists.

The conference was also quite humbling. Before the meeting, I had the notion that there really aren’t that many hospitalists out there in our nascent field who are able to do what I do: lead a large group, successfully (or not, depending again on one’s perspective). This sense of self worth gave me more than a little comfort. But I have to report that I’ve now sat in a room of 120 people who could do my job without missing a beat and perhaps, gulp, do it significantly better.

I certainly hope that those who employ me are too preoccupied to read anything I write; otherwise, I have just lost all leverage in my upcoming contract renegotiations. (Such poor judgment begs the question of whether I learned anything from Dr. Eric Howell’s outstanding presentation on successful negotiation. Maybe the fifth time I see it, it will sink in and do the trick.)

My overriding take-home message from the conference? We are going to be much more than OK as we enter the tumultuous era of health care reform, which is where the rubber will finally meet the road. Hospitalist leaders simply have too much talent to expect anything but continued growth and prosperity for the hospitalist movement. For hospitalists, this is good news–and, of course, it’s even better news for our patients.