Timothy V. Myers, MD
In a recent article titled “The Physician Leader’s 10 Commandments,1” Dr. James P. Paskert discussed what he believes are the ten most important points to remember as a physician leader.
We agree with Dr. Paskert. This article has prompted a good discussion of these ideas and how we can do our best to follow these basic tenets of great physician leadership within our teleradiology practice.
We wanted to give our take on adhering to each point as practicing physician-executives within a teleradiology practice, along with his list and salient points from the article.
The 10 commandments :
- People may not remember what you say, but they always remember how you made them feel.
“As physician leaders, we are trying to put plans in motion that will be sustainable, culture changing and that will achieve ‘buy-in.’ The most surefire way to guarantee that this won’t happen is to put people on the defensive.” JPP
DR: Communication can only be had if both parties are listening. Talking down to your audience, regardless of size, does not promote good communication.
- Happiness exists in the “gray zone.”
“The gray zone collects the best parts of black and white to arrive at a process or decision that benefits the most.” JPP
DR: Nothing is ever really black and white. A gray zone exists in every interaction. This is where consensus and collaboration can happen. By working together in this type of atmosphere, we can find the best solutions and create the best vision for our future and the future for our company and its clients.
- Think “and” not “or” for the win.
“As a physician leader, it is critical to learn how to craft win-win solutions. This requires a stakeholder view of problem solving.” JPP
DR: Interactions with colleagues or clients are usually not zero-sum, but they can be pushed that way. “As a physician leader, it is critical to learn how to craft win-win solutions. This requires a stakeholder view of problem solving.”
- Fifty-one percent is rarely enough—build consensus.
“As a physician leader, it is critical to learn how to craft win-win solutions. This requires a stakeholder view of problem solving.” JPP
DR: Politics teaches us that a simple majority does not provide a mandate for action. Even when there is not a “majority” opinion on a specific topic, a consensus or coalition can provide the ability to do great things.
- Become an attentive listener.
“The engaged form of hearing what another party is saying is very different from simply nodding your head as they speak or waiting impatiently for them to finish so you can again have the floor.” JPP
DR: There many quotations about listening, but my favorite two, paraphrased, are: If you have the right to remain silent, you should use it; and, the ability to speak in different languages can be very useful but the ability to be silent in any language is golden.
- Build a goodwill bank account with the physicians.
“…get to know as many of the docs as possible. Get comfortable with the culture and how the docs fit into it.” JPP
DR: As in politics, each physician leader has a constituency. Your constituency is the physician group that you lead. While you can have the power and authority to make changes, without the understanding and trust of your constituency, you will be able to accomplish very little. And, understanding the culture will help you to understand and predict how changes will affect your individual constituents.
- Never let your boss be surprised.
“When team members manage up, communication gaps are rare, handoffs are meaningful and complete, and you have good alignment.” JPP
DR: Simply informing more senior members of your team is not enough. You need to ensure they understand the landscape that you see as a physician and as a physician executive.
As a physician executive, one of the greatest issues to overcome is that we are not “business” people. Just as we covet the medical arena, so our partners on the company side covet what they know; the business side of operating a medical enterprise. Bringing these two together, the business and the medical, can be the most difficult process for the physician – executive team partnership. Communication, up and down, is the key.
- Nonclinical administrators can never be good clinicians, but clinicians can be great administrators.
“Physician leaders, with the requisite knowledge base, can evaluate processes and aid decision-making from a truly multifocal perspective—financially, ethically and medically.” JPP
DR: As with number seven above, bringing what we know as physicians and leaders of physicians to the table is our most important function. To be effective, we also need to understand the business/company viewpoint in order to be relevant in the conversations.
- Above all maintain transparency.
“In [communication], ambiguity and opacity are destructive and counterproductive.” JPP
DR: Honesty and integrity are your most important assets. Framing what you need to say takes time and thought when you can only divulge a part of what you know to your audience. If you don’t know something, say so. If there are areas where you can’t comment or just can’t be specific, say so.
- Use email respectfully and cautiously.
“Email is a double-edged sword if there ever was one.” JPP
DR: People who are sweet and mild-mannered in person can turn positively acidic in emails. The lack of direct person-to-person interaction promotes the feeling of being disconnected from what is being said and to whom it is being said.
If you have something to say to someone, and you wouldn’t call them on the phone and say it, don’t say it in an email. If you would say it in an email, consider calling them and saying it.
The famous quote from Shaw, “The single biggest problem in communication is the illusion that it has taken place,” applies doubly with emails. When sending emails, stick to one topic or message and make sure you are addressing the right individual or individuals. Blanket emails are the worst form of communication and usually don’t affect the change you want to see or get the message you want to the individuals who need to hear it.
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The role of the physician executive is difficult at best as we tread the very fine line between the company we work for and the physicians we want to represent. It is made more difficult because, in the end, everything we do should be done in an attempt to make our clinician partners more effective in serving and treating the patients who depend on all of us for their care.
Sometimes, in order to serve the higher good of improving patient care, sacrifices need to be made by the company and/or the physicians. Consensus building and collaboration through successful communication is key to making the changes that will have the greatest positive impact on the patient and patient care.
About Direct Radiology
As a physician led organization, the founders and senior physicians at Direct Radiology take these 10 key points very much to heart. Our radiologists are our most important asset and how we lead reflects not only on our company but our commitment to building a strong organization and physician group.
We “Un-corporate” teleradiology
We are a true partnership, owned and operated by our full-time radiologists and physician leadership. Our goal is to build a long-term, fulfilling teleradiology practice for our physicians while providing outstanding patient care and exceptional service to our clients.
Our Commitment
We work in collaboration with our clients, as an extension of the group. The strength and stability of our client relationships are more important to us than growth.
We are non-predatory. We do not displace or undercut existing radiology groups.
Cost-Effective Teleradiology Solutions
By eliminating executive salaries, private equity profits, and other corporate expenses, we are able to be highly cost-competitive while delivering superior quality and consistency.
Strong physician relationships make for better patient care.
In our experience, teleradiology works best when clinicians are familiar with and comfortable with the radiologist on the other end of the phone. Our clients are covered by small teams of dedicated radiologists who build trust with referring clinicians through frequent direct physician-to-physician communication.
- Paskert, James P. “The Physician Leader’s 10 Commandments”. Member Essay. April 2015. American Association for Physician Leadership.
