Leadership is a practice, not a position, and the current challenges in health care require family physicians to authorize themselves to lead.
Fam Pract Manag. 2023;30(5):15-18
Author disclosure: no relevant financial relationships.
Family physicians walk with patients through dark times and joyful times, at the beginning of life and at the end. It's an important, difficult job made all the more taxing when issues beyond the exam room make it harder to care for patients. For example, you open an email announcing a new convoluted policy from a payer or your own health system that will force you to spend more time on administrative tasks. Or you're late to finish seeing patients for the day because your clinic is shorthanded due to executive-level financial decisions.
You might wonder, not for the first time, “Do these people have a clue how their choices affect my patients?”
As a leadership developer and coach, I've worked with physicians and other health care professionals who have outstanding track records for patient care but say they feel powerless in the face of system-level challenges. The problems feel too big to solve, and their “leaders” aren't helping. They feel there must be a better way.
KEY POINTS
Leadership is a practice, not a title or a position of authority. Therefore, anyone can do it.
Today's health care challenges require physicians and other team members to authorize themselves to lead because the problems are adaptive — there is no clear solution and progress takes a creative, collaborative, sustained effort.
Adaptive challenges are best addressed with a challenge-centric approach: rather than relying on one authority figure to hand down a solution, put the challenge front and center and gather ideas about how to address it.
REDEFINING LEADERSHIP AND REDEFINING PROBLEMS
Most people think leadership is a position, meant for a select few. It's not. Leadership isn't a title, like CEO or “the boss,” or even a characteristic, like charisma or a servant's heart. Leadership is a practice, and anyone can do it.
The traditional definition that equates leadership with authority prevents too many people from leading. They tell themselves that because they aren't in charge, they aren't responsible. This leaves the creativity, risk, and responsibility for progress on big, systemic challenges to someone else. The person in a position of authority, such as the CEO of a health system, does have a role to play in solving problems. But leadership at all levels is necessary for the organization or health system to improve, in part because today's most challenging problems are often adaptive, not technical.1
Harvard Kennedy School's Ron Heifetz, in his book Leadership Without Easy Answers,2 defines adaptive challenges as follows:
There is no clear solution, only progress,
Authority and expertise are not enough,
The work is not efficient or straightforward, but experimental,
Progress rarely happens quickly.
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