Jessica Hohman

Physicians as Leaders

August 13, 2013

Last spring, I had the privilege of taking a new HMS class—“Physician as a Leader”—with a dozen of my classmates who are all beginning residency. 

When I signed up for the course, I was not exactly sure of what to expect.  Like many of the people in the course, I am interested in health systems innovation and leadership, and I was hopeful that I would learn skills that would prepare me to be a better leader in our rapidly changing health care environment. 

While I had spent most of my four years of medical school learning about the pathophysiology, diagnosis, and management of disease, I had learned comparatively little in our formal curriculum about what it takes to be a good leader and manager—critical skills in an increasingly team-oriented health care system. 

This course was unlike any other that I have taken during my time at HMS.  Our course leaders—Dr. Ellner, Dr. Dierks, Dr. Finkelstein, and Dr. Stout—brought their unique personal stories and enthusiasm for teaching about health care leadership to our discussions each day.

My classmates also brought their own rich leadership experiences and backgrounds. The class included a former Navy Seal, an entrepreneur that began a health IT start-up company, a PhD candidate, and a director of an NGO. We all spent four weeks examining the ways in which we can be better leaders and foster innovation to further improve care for patients.

Using a hybrid of the Harvard Business School case-based teaching model and traditional didactics, the class drew on the wealth of leaders in the Boston academic community. 

It is incredible how much there is to be learned from other industries where leadership and management are considered disciplines on their own that are worth studying and perfecting.

Over the course of the month, we not only covered a broad swath of leadership topics, but practiced important skills—from role-playing tough conversations with difficult team members to negotiating licensing agreements with private companies for commercializing new technology. 

The student-driven projects were one of the highlights of the course. Whether tackling how to better design our paging systems or how to improve team dynamics in primary care, it was amazing to see everyone put some of the leadership skills we had learned into practice at different health care organizations around Boston. 

My group examined whether trainees are currently being taught about health systems innovation and leadership and, furthermore, whether they see themselves as future clinicians systems innovators.

We found that most trainees have poor exposure to and understanding of systems innovation, but almost all—particularly as they progress in their level of training—wish they had been taught more about leadership and innovation in their formal curriculum. Most trainees believed that basic competency in this area is essential to delivering high-quality care.

The message was clear; trainees are likely to benefit from learning leadership techniques.

Establishing a clear vision. The power of a clearly articulated vision to both unite and motivate all team members behind an organization’s mission resonated throughout the class.

Whether working through business cases about JP Morgan or hearing from leaders of innovative organizations such as Southcentral Foundation and Atrius Health, it was clear to all of us how effective leaders often invest a substantial amount of time into developing and articulating the mission of their organizations. In turn, these missions serve as a powerful tool for motivating the entire team.

Creating models for innovation and change was one of my favorite aspects of the course.

How can health IT improve care and increase efficiency? What tools do we have to enable better processes? Are there models for continuous improvement and innovation from other industries that can be useful in health care?

In class, we spent time learning about the well-known Toyota Production Process (LEAN) as well as lesser-known models from other industries. IDEO, for instance, has a fascinating culture and design process that has produced innovative products such as Apple’s first mouse and the first portable defibrillator. It is interesting to think about how these ideas and processes could be applied in the health care setting.

Given the changing health care environment, all of us had enrolled in the class to learn about health systems innovation and to develop the core competencies needed to be a leader and innovator. We were not disappointed, as we walked away with tremendous conceptual learning and new skills to put into practice when we join clinical teams as interns on the wards.