Preparing the Right Physicians to be Exceptional Leaders in the 21st Century

This chapter describes evidence-based strategies found to most effectively maximize the Return On Investment (ROI) of physicians' formal leadership training programs. Recognizing that no two prospective physician leaders are exactly the same, formal leadership training programs cannot be most effective if these do not allow for organizational and situational differences as well as critical differences among physicians' demonstrated personalities and leadership styles. When selecting prospective physician leaders, the authors advocate for an individualized process which requires “Diagnosis Before Treatment,” “Three Dimensional Screening,” and the application of “More Effective Alternative Strategies” in order to avoid committing the “12 Deadly Sins.”

The Cohort Model

This chapter is written through the reflective and analytic lens of a Business School Dean with 35 years in higher education and focuses on the trends and future of the healthcare industry. Specifically, the chapter examines the planning, implementation, and identified outcomes of a cohort designed Executive MBA program. The issues highlighted in the first half of the chapter relate to 1) investing in individuals and the organizations they serve, 2) enhancing organizational capacity, and 3) implementation of pragmatic strategies to ensure an organizational leadership pipeline. The second half of the chapter suggests strategies as to how Chief Executive Officers, healthcare organizations, and partnering higher education institutions can develop both individualized MBA programs and professional training to ensure the development and retention of an energized healthcare leadership pipeline consisting of individual team leaders and change agents.

Developing a Clinical Leadership Pipeline

Healthcare systems are embarking on efforts to improve organizational leadership as a lever to promote organizational efficiency. Such efforts have a solid base of research attesting to their effectiveness, and some view them as particularly cost effective. This chapter fills an important gap in the literature on healthcare systems leadership by presenting (1) a rationale and approach from the perspective of a healthcare systems chief executive officer for understanding the strategic planning, resources, and expenditures associated with efforts to prepare, hire, evaluate, develop, and support clinical leaders; (2) a theoretical foundation and framework for a systems approach to an organizational healthcare leadership pipeline; and (3) a sample case study describing the observed outcomes of a strategically developed leadership pipeline. The case study highlights the resources required to put in place and operate clinical leadership pipelines—pipelines for preparing, hiring, supporting, and managing clinical leaders—based on one large healthcare system.

Design and Program Elements of a Clinical Leadership Program

Healthcare delivery in the United States is an ever-evolving field that is changing across multiple economic and cultural levels. Healthcare delivery systems are being affected not just by emerging technological capabilities but by ongoing changes in the structure and role of health systems themselves, as well as in the diversity of the communities they service. The older model of physician-provider is likewise evolving, and today's clinician requires the skill set necessary to navigate this new healthcare delivery environment. This chapter describes the development and implementation of a clinical leadership MBA curriculum designed to provide physician-leaders with a strategic perspective on healthcare decision making that encompasses a broad range of structural, technological, financial, cultural, and ethical considerations.

Developing Healthcare Leaders for the Future

Irrespective of the healthcare delivery mechanisms that have endured to this day, consumers expect value in their healthcare, which implies high quality, reasonable cost, and an excellent patient experience. Physicians will need to not only participate in effecting this change, but also lead it, or risk losing credibility as a patient's most critical healthcare advocate. In anticipation of these needs, Lancaster General Health (LG Health) embarked on a unique, decade-long physician leadership development journey that culminated in the graduation of 21 physicians and administrators from St. Joseph's Haub School of Business Executive MBA program. Collectively, the group constitutes a priceless network of professionals who are helping to lead healthcare change in their community.

A Capstone Course Linking Business Knowledge and Strategic Initiative

This chapter describes the capstone course in which students act as internal consultants and apply the knowledge they acquired from previous courses in the MBA curriculum (e.g., strategic thinking, competitive analysis, statistics, forecasting, financial analysis). Students form teams of complementary backgrounds and expertise (e.g., president physician services, director of nursing, community medicine physician, rheumatologist) to develop and write a strategic plan, demonstrating a comprehensive understanding of business knowledge and the competitive environment. Uniquely, in this capstone, the instructors collaborated with top management of Lancaster General Health (LG Health) to identify a set of strategic priorities focused on five issues: standardization, innovation, competition, growth/scale, and interaction with the University of Pennsylvania. Each of these became a project assigned to a team of students who concluded the course and the MBA program with a presentation of their strategic recommendations to top management of LG Health.

Developing Clinical Leaders

Complex 21st century healthcare systems require leaders capable of making strategic decisions grounded on sound medical and healthcare knowledge and practices. Traditionally, these two domains have been viewed through a binary lens. In the 21st century, these domains are best viewed through a unitary lens. Consequently, several medical and business schools have developed joint programs to train physician leaders who receive both medical (MD) and master of business administration (MBA) degrees. St. Joseph's University in partnership with Lancaster General Health (LG Health) system developed an Executive MBA program for aspiring healthcare system leaders who previously trained for only one domain. This chapter examines the impact of the Executive MBA on clinical leaders and the organization they serve.

Advancing Healthcare Leadership

As healthcare systems evolve and physicians face more administrative and regulatory burdens, it is imperative for them to build leadership competencies. In fact, there is a need for a pipeline to be created of emerging clinical leaders who have already mastered competencies and skills required of successful leaders. The heroic style of paternalistic leadership is less successful in an era of system complexity, quality control, and personnel diversity. A more preferable leadership style is that of shared leadership where a vision is created towards which team members are intrinsically driven to achieve. These factors have cumulatively contributed to the increasing cognizance that more training programs are needed to make comprehensive leadership development widely accessible to a greater number of potential clinical leaders. This chapter explores physicians and agents of change.

Reconceptualizing Medical Curriculum Design in Strategic Clinical Leadership Training for the 21st Century Physician

This chapter provides an insight into the value of tacit knowledge and how this contributes directly to the concept of human factors in the context of multi-disciplinary teamwork. In considering the notion of implicit or intuitive knowledge and how this can be taught in practice, the authors draw on the field of creative praxis as a means of harnessing knowledge from other (often under-acknowledged) signature pedagogies of direct relevance to medical practice. The authors focus on the significance of situational awareness and context of medical and healthcare provision as a means of driving debate around the value of affective domain learning and its role in 21st century physician practice. These are bracketed under the category of non-technical skill acquisition, which is linked heavily, in the published literature to date, with holistically positive patient outcomes.

Team Building and Function in a Physician Leadership Program

Among the critical skills to be developed in a physician leadership program are teamwork and collaboration. The team approach to the design, execution, and implementation of healthcare programs should be stressed. To encourage this approach in our physician leadership program, the authors use team structure as an essential component of classroom structure to encourage completion of real-world projects and assignments relevant outside of the classroom environment. This chapter demonstrates how teams were formed and evaluated in courses involving the marketing of healthcare systems services and healthcare system mergers and acquisitions. This chapter also describes components in the development and implementation of a clinical leadership MBA curriculum designed to provide physician-leaders with a strategic perspective on healthcare decision making that encompasses a broad range of structural, technological, financial, cultural, and ethical considerations.