Leading Other Leaders: The Challenge of the Physician Executive

Coach's Corner
CSPE Newsletter

I recently had a wonderful opportunity to be a part of a family celebration.  My mother was turning 70, and my sisters and I decided that we would take her to New York City to celebrate.  Now, you need to know a bit about my family.  My parents emigrated from India when I was 4, and a car accident a few years afterwards left my mother widowed at age 32 years. Left alone in a new country with 5 daughters ages 16 years to 6 weeks old, my mother courageously decided that her daughters would have the best chance of a successful future if she stayed in Canada.  Years of sacrifice, dedication, devotion and support on her part have allowed us all to be highly successful.  I am proud to be the middle of 5 sisters, all of whom are bright and talented, and have executive professional positions that afford us a huge degree of responsibility and power.  Of course, we are very good at having opinions, making decisions, and being in charge. One of my friends quipped “You are all so used to being the one to make decisions; how did you actually manage to make decisions together about the trip?”

Good question!  It was actually not that hard, as this is what we have become used to doing.  The main factor was that we had a reason to work together towards a mutual goal – we wanted to give our mother a great celebration, and so we all wanted to do our best.  We easily appointed a ‘leader’, one of my sisters who is the CFO of a multibillion dollar organization in Montreal, and travels to New York City regularly and knows it well.  We had confidence in her, knew she was knowledgeable (and would also keep us all on track financially!) – in short, we trusted her.  She, in turn, knew us and our strengths and interests, and delegated us control and decisions based on that. My sister who has contacts in the hotel industry chose the hotel and booked us in; my sister who loves the arts chose the Broadway plays and jazz clubs we went to and reserved tickets for each evening; my sister who loves big cities planned our days; and I got to choose the restaurants and the wine.  It worked amazingly well! In our own area, we were given full control, and we all accepted and appreciated the work of the others.

It made me realize that these lessons learned in our family apply to all physician leaders.  Physician executives are leaders of other leaders.  Unlike the military, where the leaders are often working with young, inexperienced recruits, in medicine, the leaders are leading colleagues, who are bright, capable, knowledgeable, highly trained, and skilled; and are themselves, leaders. Physicians were initially selected into medical school based on their individual achievements, and then trained to be decisive, assertive and independent. 

Leading such peers adds an extra challenge for a leader.  These are people who think for themselves, can be quick to challenge, and like to be in control.  They are independent, and have many options outside the organization.  They have their own supporters and loyalties.  If they have been part of the process of choosing the leader, they may feel the leader owes them, and not the other way around.  There can be a sense of entitlement as they often bring special value to the organization.  As a leader leading them, your effectiveness will not based on what you do as an individual, but rather what you can inspire, engage and enable them to do.

Such leadership is based on persuasion and influence. Since your peers are not followers and have other options, you will not be automatically recognized as a leader.  You will need to work hard on ways to convince your peers that their interests lie with you. 

It is all about positive relationships.  You will have to

  • Work to build relationships, through multiple personal encounters, that ultimately create trust. 
  • Seek out peers with inherent leadership abilities, and letting them lead
  • Understand the needs and interests of the peers you are leading, through effective communication.  Talk with them regularly, listen intently.
  • Communicate effectively
  • They can create an environment where they can optimize the talent of the leaders they lead. They display respect and confidence in their abilities, treat them with dignity, are ready to offer feedback, support, and praise as needed.
  • Offer opportunities to plan and set goals, clarify job roles and identify how success could be measured...and then let them do it without overmanaging.

By positioning the leaders to succeed, one can help ensure the success of the entire organization.