Rural Physician Leadership Curriculum

1. Rural Physician Leadership Curriculum West Virginia University Rural Family Medicine Residency Program

2. Rural Physician Leadership Curriculum Module 1 Leadership : Why, Where, What

3. Rural Physician Leadership Curriculum Description • Funded by HRSA Grant D22HP00306 • Objective 1 • Develop a competency based longitudinal curriculum in Rural Physician Leadership Konrad C. Nau, MD Principle Investigator Chair, Dept of Family Medicine-Eastern Division WVU Rural Family Medicine Residency Program

4. Rural Physician Leadership Curriculum Learning Objectives : Module 1 • Understand why leadership development is important for rural physicians • Review traditional leadership definitions • Operationally define leadership • Review four growth stages of leaders

5. Leadership : Why ? • USA = Effective Healthcare Leadership shortage area • Rural = Physician shortage area • Result - rural physicians have increased opportunity and impact for leadership early in their careers

6. Leadership : Why ? • Action Plan for the Future of Residency Education in Family Practice / AFMO/August 2002 • Organizational Competencies • “Require residents to master teamwork competencies such as leadership, building consensus, cooperation, and verbal, written, and electronic communication.”

7. Leadership : Why ? • Satisfaction with Leadership roles may be a primary factor in rural physician retention • Frustration with Leadership roles may be a primary factor in rural physician attrition

8. Leadership : Why ? • “The education of physicians is completely stacked against the development of leadership qualities needed in today’s complex medical environment.” Michael S. Woods, MD Applying Personal Leadership Principles to Health Care: The DEPO Principle , 2001, Tampa, Florida : ACPE, page 13.

9. Leadership : Why ? • “… the system developed to select and train us operates counter to engendering good personal leadership and interpersonal qualities… or perhaps we allowed those qualities to be ‘trained out of us’. ” Michael S. Woods, MD Applying Personal Leadership Principles to Health Care: The DEPO Principle , 2001, Tampa, Florida : ACPE, page 13.

10. Leadership : Why ? “so that” ATTRIBUTES RESULTS “Because of” D. Ulrich, et al. Results Based Leadership , Tampa, Florida : Harvard Business School Press, 1999.

11. Leadership : Why ? “so that” RESULTS ATTRIBUTES “Regardless of” Michael S. Woods, MD Applying Personal Leadership Principles to Health Care: The DEPO Principle , 2001, Tampa, Florida : ACPE, page 18.

12. Leadership : Where ? • Patient “bedside” • Office / Clinic • Hospital • Professional Organizations • Community

13. Leadership : Where ? • PATIENT BEDSIDE • Traditional focus of residency training • Face-to-face patient care • Encourages and rewards specific sets of physician behavior • NOT a focus of this curriculum

14. Leadership : Where ? • Office / Clinic • Recent focus of “Practice Management” • Physician as employer vs - Physician as employee

15. Leadership : Where ? • Hospital • Committees • Departments/Services • Medical Staff Officers • Interdisciplinary Patient Care Teams • Clinical Pathways

16. Leadership : Where ? • Professional Organizations • State/National AAFP • State/National Medical Societies • Academic Faculty Community/STFM

17. School Homeroom mom PTA School Board Church Committees Liturgy Counsels Leadership : Where ? • Rural Community

18. Sports Boosters Medical coverage Coaching Hobbies Clubs Events Leadership : Where ? • Rural Community

19. Politics Advocacy Campaigns Holding Office Public Health News media Health Department Emergency Medical Services Leadership : Where ? • Rural Community

20. Leadership : Where ? Doctor Organization Employee Patient Michael S. Woods, MD Applying Personal Leadership Principles to Health Care: The DEPO Principle , 2001, Tampa, Florida : ACPE, page 18.

21. Leadership : What ? • Definition: • Leadership is ……… ???????????????????????

22. Leadership : What ? • Definition: • Leadership is ……… • “After all these years…no one is able to articulate a comprehensive, absolute definition of leadership.” Carson F. Dye Leadership in Healthcare, Chicago: Health Administration Press, 2000. page 12.

23. Leadership : What ? • Definition: • Leadership is ……… • Contingent upon three primary variables • The leader • The followers • The situation Hughes, Ginnet, Curphy Leadership: Enhancing the Lesson of Experience 3rd ed. New York : Richard D. Irwin. 1998 .

24. Leadership : What ? • Definition: • Leadership is ……… • Adapting principles to circumstances George Patton Patton on Leadership , Alex Axelrod , Paramus,New Jersey : Prentice Hall Press, 1999 , page 31.

25. Leadership : What ? • Definition: • Leadership is ……… A process that focuses on making organizational changes, while management is concerned with control and results John Kotter A Force for Change:How Leadership Differs from Management, New York : The Free Press, 1990.

26. Leadership : What ? • Definition: • Leadership is ………NOT • Controlling people • Being boss • Holding on to territory • Pep talks James A. Autry Servant Leadership, Roseville,California: Prima Publishing 2001 , pages 20-21.

27. Leadership : What ? • Definition: • Leadership ……… • Does not simply happen. It can be taught, learned and developed. Rudolph W. Giuliani Leadership, New York : Hyperion , 2002, Page XII

28. Leadership : What ? • Definition: • Leadership ……… • Is a blend of characteristics , and while no individual possesses all of the needed talents that go into leadership, each man can develop a combination to make him a leader. Vincent Lombardi, SR What it Takes to Be #1, Vincent Lombardi, JR New York : McGraw Hill , 2001, Page 2.

29. Leadership : What ? • Definition: • Leadership is……… • Acting in a way that affects people more than other people’s acts affect people. • Competency-based Ralph Stogdill Stodgill’s Handbook of Leadership: A Survey of Theory And Research. New York : The Free Press, 1984.

30. Leadership : What ? • Definition: • Leadership is……… • “a social influence process in which the leader seeks the voluntary participation of subordinates in an effort to reach organizational goals.” R. Kreiter & A. Kinicki Organizational Behavior. New York : Richard D. Irwin, 1997.

31. Leadership : What ? • Definition: • Leadership is……… • Getting people to reach for common goals by helping them see aspects of the world differently , and creating a sustainable organization by developing leaders. Noel Tichy The Leadership Engine. New York : Harper Collins, 1997, page 42.

32. Leadership : What ? • Definition: • Leadership is……… • Attracting the voluntary commitment of followers, energizing them , and transforming the organization into a new entity with greater potential for survival, growth, and excellence. Burt Manus Visionary Leadership. San Francisco: Josey-Bass, 1992, page 10.

33. Leadership : What ? • Definition: • Leadership is……… • Inherent and learned skills • Skills are effectively linked with values • Values are ingrained beliefs that guide our behavior and thought Carson F. Dye Leadership in Healthcare, Chicago: Health Administration Press, 2000. page 15.

34. Stages in the Growth of Leadership Unconscious Competence Conscious Competence Conscious Incompetence Unconscious Incompetence Carson F. Dye Leadership in Healthcare, Chicago: Health Administration Press, 2000. page 18.

35. Stages in the Growth of Leadership • Stage 1: Unconscious Incompetence • “You don’t know that you don’t know” • think leadership is not your job • may be resistant to feedback • developmental needs • SKILLS TRAINING • FEEDBACK • SELF-AWARENESS

36. Stages in the Growth of Leadership • Stage 2 : Conscious Incompetence • “You know that you don’t know” • most important step toward learning • may lose your job before you realize • developmental needs • MENTOR / COACH • SINCERE DESIRE TO GROW / IMPROVE

37. Stages in the Growth of Leadership • Stage 3 : Conscious Competence • “You know that you know” • effective but not born or strong leaders • skills not totally natural yet • developmental needs • OPPORTUNITY TO PRACTICE SKILLS • EFFECTIVE FEEDBACK • CONTINUED LEARNING

38. Stages in the Growth of Leadership • Stage 4 : Unconscious Competence • “You don’t know that you know” • skills flow smoothly without force or hesitation • ultimate stage of leadership • seem to be “true naturals” at their trade • “born leader”

39. Stages in the Growth of Leadership You don’t know That you know You know That you know Unconscious Competence You know You don’t know Conscious Competence You don’t know You don’t know Conscious Incompetence Unconscious Incompetence Carson F. Dye Leadership in Healthcare, Chicago: Health Administration Press, 2000. page 18.

40. Leadership : Why, Where, What • Where • Patient Bedside , Office , Hospital • Professional Org. , Rural Community • Why • Need , Opportunity (especially rural) • Job Satisfaction / Retention

41. Leadership : Why, Where, What • What • Leadership is a social influence process using skills (inherited and learned) to seek voluntary participation of others to reach a common goal • Leadership Growth Stages progressively develop in consciousness and competency

42. Leadership : Why, Where, What • The Hope • By developing leadership skills in young physicians , our nation’s rural healthcare will enhance it’s • Survival • Growth • Excellence