Physician engagement is paramount as hospitals and health systems navigate the transition from volume to value. And yet, it won't be enough to ensure organizational success. As the hospital field tackles clinical integration, population health and performance improvement to drive transformational change, it must rely upon physician leadership to reach its goals.

Developing physician leaders can be a differentiator that sets organizations apart. "Physician engagement and leadership are different at higher-performing organizations," says Ana Pujols McKee, M.D. Physicians at these organizations play a direct role in setting and achieving the organization's vision, she says. "The current shift in health care has resulted in greater physician engagement and increased physician interest in leadership roles," adds Peter Angood, M.D., president and CEO of the American Association for Physician Leadership. "As more physicians prefer to be employed, we need to be more proactive to ensure that they have adequate physician management training." Physician leaders can make an impact at all levels across the organization, Angood adds, in both formal and informal roles.

The main challenge, however, is that few physicians are adequately equipped to handle their new leadership responsibilities. "Most physician leaders are tossed into their roles without any prep work," says McKee. "They are not sufficiently prepared to take on their new responsibilities." In the past, the focus was on physicians with strong clinical skills, high volume and likability. Now the focus is on physician leaders with exceptional people skills — capable of communicating effectively and building trust and buy-in across multidisciplinary groups. Management training and knowledge of leadership principles are important characteristics of successful physician leaders. "Physician leaders must be able to build, collaborate, motivate and move strategy in the right direction," says Angood.

The onus falls on hospitals and health systems to grow physician leaders by equipping them for their roles. "More successful physician leadership development programs spend time on the people aspect, rather than the business side," says John Combes, M.D., senior vice president and chief medical officer of the AHA and COO for the AHA's Center for Healthcare Governance. Building knowledge of the business side of health care, including finance and human resources, remains important. The focus is on building self-awareness and emotional intelligence to lead and influence positive change within the organization.

One challenge to physician leadership development is that it competes with physicians' time. To secure interest, it's best to focus on the patient, says Combes. "It's important to show them that their development as leaders is essential for the success of the organization as a clinical enterprise, and not simply as a business enterprise," he says.


Case Study: Mountain States Health Alliance, Johnson City, Tenn.

Mountain States Health Alliance is an integrated delivery system with 13 hospitals in four states. In 2010, the organization revamped its physician leadership program to help build physician leadership bench strength across its various entities. "We were looking for ways to involve our physicians," says Morris Seligman, M.D., senior vice president and chief medical officer. "We want them to be part of the team, to help lead and drive important initiatives and strategy across the organization." The resulting Physician Leadership Academy comprises seven to eight courses over a two-year period. Physician participants are nominated by the hospital CEOs and CMOs. "We look for physicians who show promise or express interest in wanting to help lead," Seligman says. The courses are primarily in-person with online makeup sessions available. The CEOs attend sessions to develop shared learning and to enhance engagement. Seligman recommends providing opportunities to involve former participants in the program through social and networking events.


Physician competencies from top physician to physician leader

The competencies that make an individual a good physician are not the same competencies that make a physician a great leader. However, the heart of being a good physician leader is being a good physician.

Physician Core Competencies

1. Medical knowledge | Exhibit proficient knowledge of biomedical, clinical and cognate sciences and application of patient care.

2. Patient care | Provide compassionate, appropriate, effective patient care.

3. Practice-based learning and improvement | Continually assess and evaluate patient care practices and assess and assimilate scientific evidence.

4. Systems-based practice | Provide cost-conscious, effective medical care. Promote patient safety.

5. Professionalism | Demonstrate a commitment to carry out responsibilities. Adhere to ethical principles. Be sensitive to a diverse patient population.

6. Interpersonal and communication skills | Demonstrate skills that result in effective communication exchange. Work effectively with other members of the health care team.

7. Use of informatics | Use informatics to enhance patient care delivery.

Next-Generation Core Competencies

In addition to the standard physician core competencies, physicians need to develop and enhance the following skills to be effective leaders as the health care delivery system transformation continues.

1. Systems theory and analysis | Identify ways to improve the quality and safety of patient care through greater care coordination and process improvement.

2. Use of information technology | Effectively use information technology to improve the quality and safety of patient care.

3. Cross-disciplinary training and multidisciplinary teams | Understand and respect the skills of other practitioners.

4. Expanded knowledge | Develop greater understanding of population health management, palliative and end-of-life care, resource management and medical economics, health policy and regulation.

5. Interpersonal and communication skills | Further enhance interpersonal and communication skills to become a true member of the team. Demonstrate empathy and understanding of cultural and economic diversity. Practice excellent customer service. Improve time management. Enhance conflict management skills and provide effective performance feedback. Improve emotional intelligence, self-awareness and relationship management.

Source: "Lifelong Learning: Physician Competency Development," AHA's Physician Leadership Forum, 2012