Author + information
- Christopher M. O’Connor, MD, FACC, Editor-in-Chief, JACC: Heart Failure∗ ()
- ↵∗Address for correspondence:
Dr. Christopher M. O’Connor, Editor-in-Chief, JACC: Heart Failure, American College of Cardiology, Heart House, 2400 N Street NW, Washington, DC 20037.
As we enter into the most dynamic year of health care in the past 50 years, the need for physician leadership has never been greater. Our aging population, emphasis on chronic care, and requirement to interpret large datasets, performance measures, and outcomes have placed a unique challenge on health system leaders. Currently, only 5% of physicians are in positions of leadership in health care systems. This may reflect the fact that physicians do not receive leadership training in medical school or residency and, yet, are often trusted in leadership positions at later stages of their careers.
Today, I am asking cardiovascular specialists to step forward, understand, and obtain leadership training and work to position themselves to be leaders in complex health care systems as we move into a new era of health care delivery. Through our traditional training, the emphasis has been on clinical diagnosis and treatment, definitive decision making, and an individual-oriented approach to health care. In leadership positions, often the decisions are not clear cut and are made with imperfect and imprecise information requiring a team-oriented approach. Decisions are often consensus driven and are not only for the short term, but also the long term. However, physicians are well suited to play a role in the leadership of health systems if the goal is to focus on the shift from volume- to value-based health care, the emphasis on wellness and population health as opposed to sickness, new methods of care delivery, and integration of research with patient care.
Cardiovascular specialists have been uniquely exposed to experiences in the inpatient and outpatient setting in a balanced fashion and have witnessed the role of the intensive care unit, general hospital care; the adoption of technology and evidence-based medicine; and the emphasis on transparency of outcome measures, interpretation of large datasets, optimization of core measures, disease management, population health, and risk assessment. Given these experiences, cardiovascular specialists have been uniquely positioned to take on greater roles of leadership in health care systems. However, leadership cannot only be inherited through the DNA of our parents and grandparents; the skillsets must be learned. There are several accepted skills that physician-leaders should acquire to be successful. These include:
1. Problem-solving abilities with a clear understanding of organizational strategy, project management, and theme-based leadership.
2. Technical knowledge and leadership technical skills, which include health care systems, information technology, human resources, strategic planning, legal issues, health care policy operations, and other important aspects.
3. Communication skills with a deep understanding of how to communicate to a large segment of the health care team, including physicians, nurses, and other health professionals. This communication occurs through many methods of oral and written communication, town hall meetings, electronic communication, and social media.
4. An understanding of emotional intelligence, such as the ability to evaluate and manage oneself in the context of others and the ability to provide reflection in a 360° fashion for oneself as well as others (1).
5. A commitment to life-long education, training, research, and learning.
In particular, this skillset of leadership includes understanding one’s own abilities and other’s abilities, accepting the talents and limitations of many that you must lead, and avoiding an authoritative top-down approach to leadership. These are skillsets that are counterintuitive to what we learned in medical school, residency, and in our clinical practice. Thus, health systems should be committed to providing a curriculum and encouraging opportunities for the physicians who express an interest in leadership as physician-executives. Finally, “meta-leadership” is one model that could be embraced as a guide to calibrate leadership, productivity, and activity (2).
The dimensions of meta-leadership include leading up, leading across, leading beyond, and leading down. Becoming a successful leader through these concepts includes positioning yourself with great people, constantly being curious about the capacity to lead, being able to cope well with uncertainty, and understanding there is a limit to what you can control or what you can know. As described by Daniel Goleman (3), motivation and social skills will enhance your ability to be a successful leader.
So, as we enter this dynamic new phase of health care, heart failure remains one of the most important areas whose priority is not forgotten. My call is for those cardiovascular specialists who have an inclination to change the way we deliver health care to education, training, and research become part of the leadership team that will guide us through the next decade. Why? Because, it is what is best for our patients.
- American College of Cardiology Foundation