Senior Leaders: The Challenges and Triumphs

Coach’s Corner
CSPE Newsletter

You are now a senior leader.  A skilled manager.  You have had many years of experience as a physician executive.  You have vision, influence, strategy, insight, and confidence.  Looking back, getting here was relatively straight-forward.  You showed interest and initiative, attended leadership training courses and workshops, had an amazing mentor, and then learned on the job.  Hard work, yes, but your arduous medical education and training had prepared you for that. Yet, nowhere were you trained for the associated challenges that you have had to deal with, the ones that have little to do with your skills and expertise, the ones below that did not even merit a mention in any of the leadership courses.

Seasoned leaders have a track record of success, and continue to grow, apply their experience and define a path to the future.  They also continue to struggle with new challenges.  In my work with senior leaders, several issues surface regularly.

  1. Transitional challenges – the better you perform, the more likely it is that you are rewarded with a new role, and have to adjust and adapt to new demands in an unfamiliar environment.  The scope of the work has broadened, and your level of responsibility is greater than ever before.
  2. Dealing with Complaints – “The buck ends here” is even truer.  As more people report to you, more people complain to you.  Handling such disruptive and frustrating complaints effectively becomes a greater part of your day.  Complaints are not as enjoyable as compliments, but can be more constructive and instructive, and become opportunities to learn and advance.
  3. Loss of confidence – There are days when you wonder if you can do it.  “Is today the day when they realize what a fraud I am?” Every leader feels this at many points in their career. While we cannot entirely prevent this, we can understand where it comes from, and how to manage it, so we can believe in ourselves and inspire similar belief in others.
  4. Dealing with Failure – Not everything works out all the time. While it is not your fault, it is your responsibility.  No one is flawless; great leaders are not immune. Revealing any weakness, such as concern, anxiety, or uncertainty is perceived to be a sign of failure.  We feel that we must be invulnerable and infallible. However, we can learn to be deal with such situations and become resilient; to understand and promote the factors that enable us to face failure and suffering and bounce back, and learn, and grow. 
  5. Loneliness – It’s lonely at the top. We have less time than ever to connect with others, with greater responsibilities, more information being thrown at us to deal with, more meetings, and more demands. There is the need to be seen as strong, and there are fewer people around with whom we feel we can share our vulnerabilities.  Creating networks and building relationships to share with trusted colleagues is essential to maintaining integrity.
  6. Time Management – There is intense leadership stress, increased visibility, greater consequences to everything we do…and never enough time to do it all. Time management becomes a greater issue; we feel as if we are never off duty.  We have information overload.  We are rarely parted from our iPhones, and can hear that ‘ping’ heralding the arrival of a new message despite the surrounding noise. It can be difficult to delegate, deciding what to hold on to versus what to let go of. 
  7. Work-life Balance – We are constantly connected to our responsibilities via technology, and the boundaries between home and work have blurred.  How do we manage to separate the urgent from the important, and still have time for our families and ourselves?  It is essential, and possible, to maintain the relationships that are ultimately the most important to us.

The biggest challenge is ultimately finding a safe opportunity to discuss such personal issues confidentially with other top leaders.  The organizers of the Canadian Conference on Physician Leadership have arranged just such an opportunity for you.  Join your colleagues at a workshop focusing on such issues that will stimulate thought-provoking conversations on the challenges faced, and be inspired by the stories of triumphs.

Mamta Gautam is an Ottawa psychiatrist who specializes in treating physician patients. If you have a question you would like addressed in this column, please contact Dr. Gautam at Please include “Helping Hand” in the subject line. All inquiries will be confidential. Your questions will not be replied to, but may be selected to be answered in this column, which is intended to be educational, not therapeutic.