Leading the Leaders
There was a time, not long ago, when most physicians were self-employed. Those days are long past. Today, over 70% of physicians are employed by hospitals or healthcare systems. That means that most physicians, and nearly all APPs, now report to someone else.
Leading medical providers is a tricky business. The whole relationship between employers and providers is in flux, and everyone is trying to adjust on the fly. With that in mind, here are a few principles that can serve as a guide:
1. Providers are leaders
They are trained to make decisions and give orders. They expect to be treated with the respect and appreciation that their training and hard work have earned. They won’t follow other leaders blindly. The only way to engage them in a strategy or direction is to convince them that it’s a reasonable course of action. They will demand to see the data for themselves. However, as leaders, they should also be expected to take responsibility for their choices and treat others with an equal level of respect.
2. Providers are problem-solvers
Both by selection and by training, medical professionals take a problem-solving approach to life. They weigh evidence, and they try to draw logical conclusions for themselves. When included in the problem-solving process, they are smart, insightful partners. When excluded from that process, they second-guess every solution that is proposed.
3. Providers are self-interested
Not more than anyone else, but equally so. The days of physicians as a protected class who offered limitless altruism and sacrifice in exchange for extraordinary privilege are long gone. Healthcare systems treat providers as employees, and they can be expected to act like employees. They will defend their rights and what privileges they still have.
4. Providers are service-oriented
Although medicine isn’t the “calling” that it once was, providers still go into medicine to serve others. The welfare and wellbeing of their patients is a strong motivating force. Their patients' needs may occasionally conflict with their self-interest, but are also sometimes aligned. Providers know that when they are overly rushed or overwhelmed, the care they deliver suffers.
5. The job has changed
Older physicians look at today’s providers and say they’ve gotten soft, but in my opinion (after over 30 years of practice), their job has gotten harder. Sure, we had to work longer hours back in the day, but we had much more control over our working conditions, and we were better paid. Over time, providers have been asked to see more and more patients in less and less time. And the expected workload, in terms of documentation, data entry, and asynchronous work, has grown exponentially.
6. Medicine is now women’s work
In 2022, women made up 53.8% of all medical students, and that number is rising. Among APPs, 86.9% of nurse practitioners and 66.4% of physicians assistants are women. In a country where women continue to handle the vast majority of child-raising and household tasks, those numbers have major implications for issues around work/life balance. They also have implications as an older generation of male physician leaders must adapt to a growing number of female providers under their supervision.
For any well-functioning healthcare organization, the engagement of their providers is a crucial part of their success. If you can lead them effectively, not just as employees but as willing partners, all of your goals will be closer and more easily attained.
