‘ I’m a doctor”, you tell yourself, “I have earned the right to just do what I am trained to do. And on top of that, many of my patients don’t do what they are told and then blame me when they don’t see the recovery that they should! Someone should be leading them! They are the ones who don’t get it!”
Well……you are right, and you are right……. but where is the solution? The really great news is that the solution is literally within your grasp. It’s part of that leadership stuff! Many physicians are natural leaders, growing up as team captains, Boy Scout or Girl Scout leaders, class leaders, band leaders, science club leaders, and many other leadership roles. Many may never have had the urge, opportunity, or the personality to step into those roles, and that is ok too. By the time you were in medical school how many other activities could you lead anyway? You signed up to be a doctor, right? Yes, you did, but maybe there is more to that than what you were taught in school!
There were 661, 400 physicians and surgeons in the United States in 2008, according to the 2010 Statistical Abstract of the U.S. Census Bureau. This represents about 0.6% of all employed persons in the United States. As is the case with statistics, there is probably some variance. This number was probably close in 2010 however; it may have changed since then. The point of this is to show that you, Doctor, are actually part of a very exclusive club. Six tenths of one percent of anything is not very much. You achieved what you did through various levels of dedication, perseverance, focus, intelligence, and sacrifice. That is quite a list of characteristics, which are built on an additional list of values that you relied on to carry you forward. Was there any leadership involved? Yes! Absolutely there was, and that leader is still there for you to access. The traits that supported you through all your training are the traits of a leader.
For many years, leadership has been defined by looking at the effect leaders have on others. All the styles of leadership; autocratic, democratic, Laissez-faire, etc., address outward impact. Some claim there are four basic styles some six, it really doesn’t matter as long as we understand that leadership is dynamic and impactful. Let’s look at leadership from a different perspective. I have already given you a hint at where we are going……. self-leadership. All of you have all the basic skills of self-leadership or you would not have made it through your programs. At various times, I am quite sure, that you have motivated, cajoled, guided, mentored, acknowledged and rewarded yourselves! You created your own culture of excellence and held yourself to a high standard of performance. So, actually you know quite a bit about basic leadership.
Recent studies in leadership have shown some additional traits that make a truly successful leader. Empathy has proven to be a critical component that informs both self-awareness and relationships. Empathy is one of the competencies that Daniel Goleman lists under the domain of Social Awareness. It is part of his model of Emotional Intelligence, including three other domains, Self-awareness, Self-management, and Relationship management. He describes empathy as “sensing others’ emotions, understanding their perspective, and taking active interest in their concerns.” Why is this important to you? There have been several studies that now show that patients who feel they have been listened to, and have a relationship with their doctor, still rate the doctor very highly even with a problematic outcome. They trust that the doctor did the best he or she could and they are unwilling to place blame to blame on someone they trust and respect. The converse was also shown. Doctors with very high technical ratings and few errors get very poor patient ratings, even with good outcomes, if the patient felt the doctor was cold or aloof, didn’t communicate or establish a relationship. There are also studies, of which I am sure you are aware, that connect patient optimism with recovery. Where do you suppose that optimism comes from in many cases?
T he study of neuroscience has made great strides in the last 5 years in mapping and describing the brain and and oscillator neurons. As we interact with each other we cannot help but take in the nonverbal messages that are being transmitted. We tune ourselves to those around us. If we see someone smiling at us it is difficult not to smile back. Those are the mirror neurons engaging. When we match the movements or energy of those around us, the strength of a hand shake, hug, or open welcoming body language, oscillator neurons are at work. According to Daniel Siegel, for this rapport to develop, there must be full mutual attention. Ask yourself, “when was the last time I truly focused on my patient, accepted and understood their perspective of their condition, and made them feel heard?”. When it comes down to it, what people really want, is to be heard. If you hear them, they will trust you. If they trust you they will believe in you. If they believe in you they will follow you. Hmmm, sounds kind of like leadership doesn’t it?
T he tricky part is to really hear them, not just listen while you treat a condition. People are smart in unconscious ways. When your words and actions are not in sync it creates dissonance and that is recognized by your patient. So how do you train yourself to connect with your patients in a short period of time? Start by taking a moment before you open the door, do a few seconds of controlled breathing. This takes control of your reactionary brain, part of the limbic system, and pulls your awareness up to the thinking brain in the neo-cortex. Now you can choose how you spend that few minutes in the best way for you and your patient. You can choose to be curious about the patient, not just the condition. Ultimately this will lead to enrollment of the patient in their own care and improve compliance and recovery. The dynamic nature of medicine combined with the pressures of administration on providers continues to challenge the ability to establish trusting relationships with patients. Be creative; find other ways for developing better patient relationships. Improve the office environment and engage your staff in your vision. If needed you could hire a wellness coach who will spend the time with the patient, ensuring they feel heard, answering questions and providing follow up support. This is also a great tool to reinforce an optimistic attitude and compliance in recovery.
So, ask yourself another question, “Am I a leader that my patients and staff want to follow?” Do you set the example for your staff on how to lead? If you had to move, would your staff follow you, or are they just punching a t ime clock? Are you sharing all of you, not just the “MD”, with those around you? Are you burning out? Are you sacrificing your family? Have you any hobbies left that give you joy outside of your work?
Did you struggle with some of those questions? If so, you are not alone. That is why so many CEOs and business leaders have coaches. To truly see yourself you need a mirror, accurate and unbiased, non-judgmental. That is why athletes at the top of their game use coaches, to absolutely get the best performance they can, they need someone who only cares about what they care about. You have invested a lifetime in becoming a physician, are you where you want to be?
Captain Paul Westfield