Every Doctor is a Clueless CEO Part 2: The Importance of Leadership and Culture

My first blog discussed the importance of long-term planning when a medical school graduate is looking for that first job. The next series of blogs will take you further down the path of finding that perfect place for you to land.

What do you think is the most important attribute for a medical enterprise, whether academic department, private practice group, or within a corporate environment such as Kaiser or hospital-owned practices? In my opinion, leadership and culture at the top of the list. Leaders are called on every day to make the big and small decisions that determine the direction of an organization; and I use the term organization to refer to the smallest of groups on all the way to an entire department or company.

What Is a Leader?

In time, you will become the head of a practice section, academic lab, or some other type organization; but for now, you need to judge the leadership of the entity you will be joining. First, it’s important to understand what a leader does and what they’re responsible for. Specifically within healthcare, medical leaders are ultimately responsible for the following tasks:

  • Daily administration
  • Ensuring efficiency
  • Controlling overhead
  • Communication
  • Compliance
  • Meeting Facilitation
  • Performance Management

What Makes a Good Leader?

It is important to note that although leaders have a large amount of responsibility it does not necessarily mean that they are the most effective. So what defines a good leader? In my mind good leaders have the following traits:

  • Have and own a vision for their organizations.
  • Effectively communicate their vision.
  • Model good behavior.
  • Establish and set the tone for treating patients and fellow workers.
  • Make the tough decisions even when there are adverse consequences for people they like.

Let’s Talk Culture.

As I mentioned above, an important role of a leader is to determine the culture of their organization. Over the years, I have come to view culture as the most important attribute of an organization and biggest determinate of its success. If you set a strategic direction for an organization that goes counter to the prevailing culture, the strategy will fail. A study quoted in an AMA publication noted that the biggest reason doctors leave one organization or group for another was a bad fit with the culture.

So, let’s further define culture. Simply put, culture is the way we do things, the way we treat each other, the patients, the employees, the referring doctors. Culture sets the tone of a group. When you join a group, you gradually imbibe the culture; you drink the cool aid so to speak. If not, you leave.

If you learned a very conservative approach to patient care and you join a group that is more aggressive in testing or operating, you will begin to mimic the group or you will leave. The opposite is true as well. If you truly believe in frequent testing, operating earlier than necessary and you join a conservative group, they will sniff you out. They will insist on your changing your ways and if you don’t, assuming the group has strong leadership, you will be forced to leave. In our group, the only times we have asked someone to leave is when the new doctor had much looser indications for surgery, was very aggressive and unable or unwilling to change. It is simply impossible for all but the most stubborn of people to persist in a group with a different mindset or culture.

How To Find The Right Culture

If you’re a young doctor looking for your first job, look to the culture of a prospective employment opportunity first and foremost. How do you do this; how do you find out such culture. Spend some time, observe how people treat each other and how they treat patients. Ask about the culture as you interview and check the organization out in the community. Doing this type of diligence before you commit is the most important thing you can do. Don’t be ashamed of it either; your prospective employer is doing the same about you. Remember that a poor cultural fit is the most frequent reason for a doctor to leave a practice situation so do your diligence.

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