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The 10 deadly flaws of physician managers
(in no particular order):
Insensitivity and arrogance
Inability to choose staff
Over-managing (inability to delegate)
Inability to adapt to a boss
Fighting the wrong battles
Being seen as untrustworthy (having questionable motives)
Failing to develop a strategic vision
Being overwhelmed by the job
Lacking specific skills or knowledge
Lacking commitment to the job[1]
Under many of these deadly flaws is the unifying flaw of our inability to accept criticism. If we seek to lead within our institutions, profession or in broader spheres then we need to learn how to give and receive feedback constructively. Physician as Manager cannot be unlinked from Physician as Communicator or Collaborator. - see collaborator and communicator modules
The finding that “the preponderance of evidence suggests that physicians have a limited ability to accurately self-assess” [5] has concerning implications for practice and likely indicates the death nell for physicians in management and or leadership positions.
The skills of personal reflection and openness to the perspectives of others can be sustaining, protective against burn-out [4] and the skills necessary for an effective transition to management.
What do we do in medicine that can be made explicit and developed / transferred to a management context?
Physicians have experience confronting problems in the medical context in order to become effective leaders and managers it is necessary to apply these skills in a new context and to develop “the ability to truly understand the problems that confronted them, the resources to proactively address these problems, and a sense of meaning that transcended both the individual and the problem.” [3]
O’Neil goes on to identify 5 key competencies that we must develop to aid us in this task:
Self-knowledge
Strategic action
Communication
Creativity
Managing change[3]
It then makes great sense to seek out opportunities to build your skills and have management experience during the course of your residency training.
take courses and develop skills and comfort outside of clinical world
find mentors and coaches with management experience and skills to share
read books and literature from the world of leadership, organizational behaviour, business and management
reflect on your leadership and management experience and opportunities and work to improve, seek feedback and guidance [2]
Continuous quality improvement questions for physician leaders might include:
What worked and what did not?
Why did this happen?
What lessons can be extracted from success and failure?
What can be done differently? [3]
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1. Clair, JA, McCall, MWJr. Why physician managers fail - part one. Physician Executive.1990;May-June:6+. Clair, JA, McCall, MWJr. Why physician managers fail - part two. Physician Executive.1990;July-August:8+. accessed: September 9, 2011.
2. Clair, JA, and McCall MWJr. In transit from physician to manager - part 1. Physician Executive. 1992;March-April:3+. Accessed September 9, 2011. Clair, JA, and McCall MWJr. In transit from physician to manager - part 2. Physician Executive. 1992;May-June:15+. Accessed September 9, 2011.
3. O’Neil E. Leading to well-being - The 5 key elements of healthy leadership. West J Med 2001;174:34-36.
4. Rabow M. Doctoring to Heal Fostering well-being among physicians through personal reflection. West J Med 2001;174:66-69.
5. Davis D, Mazmanian P, Fordis M, Van Harrison R, Thorpe K, Perrier L. Accuracy of Physician Self-assessment Compared With Observed Measures of Competence - A Systematic Review. JAMA. 2006;296:1094-1102.