Jerri Blackburn Kendall L. Stewart January 26, 2008

1. SOMC Physician LeadersThe SOMC Physician Leadership Development Process and Results of a Needs-Assessment Survey1A Presentation for SOMC Leaders Jerri Blackburn Kendall L. Stewart January 26, 2008 1Why do physician leaders exist?

2. Physicians are the foundations of our success. Physician leaders are the keys to Recruiting and retaining physicians, Increasing SOMC-physician alignment, Clarifying our expectations for physicians, Optimizing physician performance, and Dealing effectively with difficult physicians. Our foundation model has no chance of success without effective physician leaders showing the way. Physician only develop into effective leaders as they acquire the knowledge and skills critical to their success. Effective physician leaders possess natural talent for leadership, but talent and desire are insufficient by themselves. Arduous practice, painful failure, and life-long learning are the keys to mastery. Leadership is neither easy nor simple—except to clueless spectators on the sidelines. Leadership effectiveness begins with clear role expectations and a determination to produce and sustain organizational results. Why does this matter?

3. How did we assess our physician leaders’ perceived learning needs? • We conducted a simple needs-assessment survey • We used a Likert Scale with 5 being “strongly agree” and 1 being “strongly disagree.” • “I have all of the KNOWLEDGE and SKILLS I need to be an effective physician leader.” • “What physician leadership KNOWLEDGE do you need?” • “What physician leadership SKILLS do you need?” • “How do you prefer to acquire new physician leadership knowledge and skills?”

4. “I have all of the knowledge and skills I need to be an effective physician leader at SOMC.”1,2,3 15 is Strongly Agree 21 is Strongly Disagree 3N =35

5. How to build relationships (3) How to manage conflict (3) How to stay informed (2) How to deal with difficult people (2) How to master key health care business concepts (2) How to deal with disruptive physicians How to design and complete projects How to understand organizational concepts and implement them How the Executive Committee works How the Medical Staff works How to improve coding and collections How to supervise my physician colleagues more effectively How to develop better people skills How to have more patience How to understand SOMC’s structure and operations How to understand Medical Staff structure and operations How to develop and analyze the budget How to understand Medical Care Foundation operations How to better understand CMS funding and operations How to complete administrative duties more efficiently How to effectively recruit and retain physicians How to avoid legal risks as a physician leader How to understand the legal implications of physician-hospital relationships How to manage physicians better How to focus on the common ground to achieve our goals How to invite feedback How to build relationships How to deal with errors How to manage non compliance How to delegate How to communicate effectively How to improve office operations How to develop strategy How to be more organized How to build consensus How to understand and use organizational structure How to negotiate effectively What physician leadership KNOWLEDGE do you need?

6. What physician leadership SKILLS do you need? • Conflict management (10) • Communication (6) • Confrontation (4) • I don’t know (4) • Teamwork (3) • Relationship management (2) • Process improvement (2) • Supervision • Organizational • Time management • Legal • Computer • Patience • Negotiation • Facilitation • Crisis management • Problem solving

7. How do you prefer to acquire new physician leadership knowledge and skills?1 1Respondents chose multiple strategies.

8. Physicians who are Exceptional clinicians Passionate about organizational results Positive Enthusiastic Team players Even-tempered Supportive Hard-working and driven Eager to give others the credit Physicians who are Thick-skinned1 Patient and persistent Persuasive Forthright Trustworthy Persons of integrity Reliable Organized Effective communicators Eager to learn Eager to teach What are we looking for in physician leaders? 1Physicians really, really don’t like criticism. We are used to being loved.

9. We expect physician leaders to Attend meetings faithfully Prepare for meetings Show up on time Participate fully in meetings without dominating them Pull their weight Be accountable Ask the right questions Model the SOMC Standards of Behavior and confront their colleagues appropriately who do not We expect physician leaders to Be positive Be forthright Suggest options instead of whining about problems1 Take personal responsibility instead of blaming others Take a considered position and stick to it in the meeting and outside the meeting Become expert in one or more critical leadership skills Embrace the SOMC Rules of Engagement What are our expectations for physician leaders? 1Physicians often believe that leadership consists of identifying the problems and telling others what to do to fix them.

10. Inquire about my interest in physician leadership when I first join the staff. If I have some interest, invite me to serve on a committee. Invite me to discuss my interest in leadership with other physician leaders. Invite me to attend A Complete Course for Medical Staff Leaders. Give me selected books and articles to read. Invite me to pursue a voluntary physician leadership position at SOMC such as a committee chair or a member of the Medical Staff Executive Committee. Invite me to a new physician leader orientation session. Provide me with an SOMC Physician Leadership Manual. Create and update an annotated bibliography on physician leadership and make it available through our medical librarian. Remind me regularly that physician leaders exist to achieve and sustain exceptional organizational results. Invite me to attend local meetings on physician leadership. Invite me to attend national meetings in areas of my developing leadership expertise. Invite me to become a candidate for an available SOMC Medical Directorship. Clarify your expectations of me as a physician leader. Invite me to participate in the SOMC Leadership Development Institute (LDI) if my clinical schedule permits. Give me feedback about my performance. Invite me to participate in a facilitated 360-degree feedback process. Encourage me to pursue formal graduate work on my own if that interests me. What is the SOMC physician leadership development process?1 1This process is written from the physician’s perspective.

11. If you intend to become a more-effective physician leader, what are some next steps? • Embrace discomfort.1 • Identify, accept and express feelings—including your own. • Begin reading regularly about evidence-based physician leadership. • Attend local, regional and national meetings on physician leadership. • Arrange for facilitated 360-degree feedback about your perceived effectiveness as a physician leader. • When you face a leadership challenge, seek out an effective physician leader for individualized coaching. • When you have worked through an issue or make a mistake, figure out what you could have done better. • Document your own best-practice processes. • Share your learning with your colleagues. 1Bear in mind that we all show up every day wanting to do what we want to do, not wanting to do what we don’t want to do, wanting to be paid a lot more for it, and wanting to be told how wonderful we are—particularly when we are not.

12. Where can you learn more?1 • Stewart, Kendall L., “The Dark Side: Some Practical Guidelines for New Physician Executives,” 2005 (If you would like to receive a copy of this draft White Paper, please send me an email message.) • Stewart, Kendall L., et. al., A Portable Mentor for Organizational Leaders, SOMCPress, 2003 (If you have not already received your copy, please let me know.) • Michael E. Porter, PhD, MBA; Elizabeth Olmsted Teisberg, PhD, MEngr, MS, “How Physicians Can Change the Future of Health Care,” JAMA. 2007;297:1103-1111 (The book from which this is drawn is probably the health care book to read this year. If you would like to receive a summary, please send me an email message.) • McKenna MK, Gartland MP, Pugno PA, “Development of physician leadership competencies: perceptions of physician leaders, physician educators and medical students,” J Health Adm Educ. 2004 Summer;21(3):343-54. 1Please visit www.KendallLStewartMD.comto download related White Papers and presentations.

13. Are there other questions? www.somc.org SafetyQualityServiceRelationshipsPerformance 