The need for physician engagement and leadership is greater than ever. When physicians are engaged in monitoring organizational performance, better outcomes from clinical and financial measures occur, and quality of service improves.1 In 2015, this fact was reconfirmed: the CEOs of the top five health organizations in the United States are physicians.2

 

However, while the need for physician leaders is apparent and growing, not enough doctors are poised to engage and succeed in leadership roles. Besides deficiencies in training and skills, financial and status disincentives further contribute to physicians’ reluctance and ambivalence about assuming formal leadership roles. Top

 

Inspired Physician Leadership: Creating Influence and Impact is intended to help physicians transition into leadership roles. The authors extrapolate knowledge from the world of leadership into the world of physicians, based on their long experience as academicians and executive coaches. It is a book for established physician and non-physician leaders, for academicians and teachers interested in leadership in general and in physician leadership specifically. It is not meant for emerging physician leaders who are looking for their first textbook. Top

 

The book is unique because it is solidly based on evidence and because some chapters focus on specific difficulties doctors encounter when transitioning from clinician to leader. Each chapter gives at least one real-life example of a physician facing a problem related to the chapter topic. The book is strong in providing evidence for why physicians, with their training, mental models, and assumptions, are at risk of failing when tackling those topics. The book is less strong in the practicalities, in how to apply the evidence and theories in day-to-day life.

 

Physicians demand a blend of evidence and pragmatism, and Inspired Physician Leadership is guided by those core tenets. Physicians deal with evidence. To gain credibility with doctors, Stoner and Stoner ground the book in sound research, accepted theories, and best practices. Because physicians have little time, the delivery of that knowledge is meant to be practical, realistic, and approachable. The book provides plenty of good, solid evidence, but falls somewhat short on pragmatism in some chapters. Top

 

The authors first introduce the challenges of transitioning from clinician to physician leader and the mind switches that go with that transition: from doer and respected independent performer to interdependent leader; from expert with technical skills to leader with interpersonal skills; from reactor or resistor to change leader; from social embeddedness that includes personal pride, interpersonal prestige, and status to losing part of that identity. Because doctors are intelligent and action-oriented, they are often impatient, inflexible, and perfectionist. As a result, their underdeveloped listening skills, quick comprehension of issues, and decisiveness do not set the average clinician up for success as a leader. Top

 

The chapter on tone deals with self-awareness and self-management, one’s related emotional intelligence, and how these elements connect with the construct of trust. Models of trust-building could have been explored more widely, and the link with credibility and respect could have been made more clearly. The chapter includes a good sample of references to literature on emotional intelligence and authentic leadership. Top

 

Dialogue and communication dives somewhat deeper into the concepts of engaged listening and inquiry. However, the dynamics of dialogue could have been explored much more and applications with examples are missing. The barriers to good dialogue, and how to watch out for them, are well elaborated. Overall, this chapter has useful elements, while other important features of communication and its practice are missing.

 

The chapter on teamwork and collaboration includes helpful sections on the dynamics of team development, what is needed to build a successful team, how to hold effective meetings, team communication, trust, and conflict. This chapter includes lots of evidence and references on many aspects of teams. Top

 

The conflict chapter provides insight into the origin, management, and resolution of conflict. It, too, offers plenty of evidence and research, but provides little practical advice. Like all the chapters in this book, this one explains how physicians, in general, perform in this particular domain.

 

The chapters on negotiation and motivation seem to be more suitable for the organizational non-physician leader than for physicians. Of interest is the research evidence on what motivates physicians: the impact of their work, the feeling of accomplishment on completing a difficult and challenging task, recognition, autonomy, respectful collegial interactions, compensation, and, most important, identity as part of societal status. The chapter does not do well in addressing the factors, other than motivation, that would help the leader change behaviour in either self or others. Top

 

The book finishes with a chapter on change management, which touches on the very basics. It is insufficient for those who want to influence and accomplish change in an organization.

 

In short, this book is worth owning because it contains a lot of evidence-based knowledge on leadership in general. More specifically, it helps us understand why physicians are at high risk of failing when transitioning from the mindset of clinician to that of leader.

 

References

1.Goodall, AH. Physician leaders and hospital performance: is there an association? Soc Sci Med 2011; 73(4):535–9.

2.Comarow A. The honor role of best hospitals 2015–16. U.S. News 2015;July 21. Available: http://tinyurl.com/peooft6 (accessed 12 Oct. 2015).

 

Author

Johny Van Aerde, MD, MA, PhD, FRCPC, is past president of the Canadian Society of Physician Leaders and editor of the Canadian Journal of Physician Leadership.

 

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