PERSPECTIVE: Physician leadership: 50 shades of great
Johny Van Aerde, MD, PhD
Over the past two plus years, I have had the opportunity to interview 50 health care leaders (mainly physicians) on behalf of the Canadian Society of Physician Leaders for its Leading the Way podcast series.1 These leaders are wrestling with the most significant upheaval in health care in many generations.
Although many of these brief interviews focused on how outstanding physicians have dealt with various phases of the COVID-19 pandemic, a number also provided valuable tips on the skills and attitudes needed to be an effective leader in any situation.
What was unsurprising was the degree to which those I interviewed were committed to caring, not only for their patients, but also for their colleagues and the health care system as a whole.
Although the focus of the interviews changed depending on where we were in the COVID-19 pandemic, that commitment was unwavering.
The series began with an interview with Dr. Gillian Kernaghan,2 then president and CEO of St. Joseph’s Health Care in London. It gave us a glimpse into the world of a physician leader amid what was then the new COVID-19 crisis. The 50th podcast was with Dr. Graham Dickson (PhD),3 who bluntly described the realities physicians and all of society face in dealing with a failing system. In many of the podcasts, you can hear an acknowledgement of the stress and burnout facing physicians and other health care providers working through the pandemic.
However, the style of leadership that rose to the forefront again and again was collaborative. Many acknowledged that, although a “command and control” approach may have seemed the obvious way to deal effectively with the pandemic, they spoke about the importance of working together with colleagues — supporting them and keeping them engaged.
It is difficult, and perhaps unfair, to single out individuals, but I must admit that my conversations with now CMA president Dr. Alika Lafontaine4 and Saskatchewan Health Authority’s Dr. Susan Shaw5 were particularly inspiring.
“If I’m commenting on the future of leadership within medicine, we all need to come to an understanding of where we are and whether or not the spaces we fill are the best way to leverage the power and influence that we have,” said Alika.
“Physician leadership is a keystone to health system transformation,” said Susan. “It’s really hard [but] it can be really worth it. Physician leadership is practising medicine at scale. It’s allowing you to bring your full self, all your clinical knowledge, all the curiosity that physicians have to that continuing journey of always being a learner, and always being a leader, to the next level.”
Although the vast majority of those I interviewed for the podcasts were physicians, two of the most satisfying interviews were with patient advocates, Sue Robins6 and Marni Panas.7 Sue was especially eloquent in describing how and why patients and caregivers need to be core members of the patient care team and how physicians need to really listen to what patients have to say, even if what they hear causes them discomfort. Marni highlighted the various forms of external and internal biases embedded in our health care system and in society, in general, how those biases continue to permeate our conversations until we become aware of them, and how we can then make those conversations and our actions safer.
Podcast interviews are snapshots in time, no more so than during trying times when the whole system and those within it are under stress. But if you listen to any of these interviews you will always hear optimism for the future and, in many cases, you will hear explicit statements about how important it is for physicians to help shape that future.