includes downloadable online tools medical staff...

R. Dean White, DDS, MSReviewed by

Jonathan H. Burroughs, MD, MBA, FACPE, CMSL

MedicalStaff

EssentialsLeadership

A Guide to developinG leAdership skills And recruitinG the next GenerAtion

INCLUDESDOWNLOADABLE

ONLINE TOOLS

MedicalStaff

EssentialsLeadership

A Guide to developinG leAdership skills And recruitinG the next GenerAtion

R. Dean White, DDS, MSReviewed by

Jonathan H. Burroughs, MD, MBA, FACPE, CMSL

Medical Staff Leadership Essentials: A Guide to Developing Leadership Skills and Recruiting the

Next Generation is published by HCPro, Inc.

Copyright © 2011 HCPro, Inc.

All rights reserved. Printed in the United States of America. 5 4 3 2 1

Download the additional materials of this book with the purchase of this product.

ISBN: 978-1-60146-861-1

No part of this publication may be reproduced, in any form or by any means, without prior written

consent of HCPro, Inc., or the Copyright Clearance Center (978/750-8400). Please notify us

immediately if you have received an unauthorized copy.

HCPro, Inc., provides information resources for the healthcare industry. HCPro, Inc., is not affiliated

in any way with The Joint Commission, which owns the JCAHO and Joint Commission trademarks.

R. Dean White, DDS, MS, Author Mike Mirabello, Senior Graphic Artist

Jonathan H. Burroughs, MD, MBA, Matt Sharpe, Production Supervisor

FACPE, CMSL, Reviewer Shane Katz, Art Director

Elizabeth Jones, Associate Editor Jean St. Pierre, Senior Director of Operations

Erin Callahan, Associate Group Publisher

Advice given is general. Readers should consult professional counsel for specific legal, ethical, or

clinical questions.

Arrangements can be made for quantity discounts. For more information, contact:

HCPro, Inc.

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05/2011

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iiiMedical Staff Leadership Essentials © 2011 HCPro, Inc.

About the Authors ............................................................................vii

Introduction .......................................................................................ix

Chapter 1: Principles of Leadership ................................................... 1

Four Cornerstones of Leadership ................................................................................................. 3

References .................................................................................................................................... 12

Chapter 2: Foundational Leadership Skills That Can Be Learned ......13

Learning Leadership .................................................................................................................... 14

Emotional Intelligence ................................................................................................................. 15

The Art of Listening ..................................................................................................................... 21

It Takes a Village ........................................................................................................................... 24

The Wisdom of Crowds ............................................................................................................... 25

Conflict Resolution ....................................................................................................................... 26

References .................................................................................................................................... 28

Table of Contents

iv Medical Staff Leadership Essentials© 2011 HCPro, Inc.

Table of Contents

Chapter 3: Roles and Responsibilities of Medical Staff Leaders .......29

Medical Staff Leadership Roles .................................................................................................. 30

Job Performance Evaluations ..................................................................................................... 58

How to Run an Effective Meeting ............................................................................................... 66

Conflicts of Interest and Disclosure Policies ............................................................................. 76

Chapter 4: Identifying and Recruiting Medical Staff Leaders ...........81

How Recent Trends Affect Leadership Recruitment ................................................................ 81

Developing a Recruitment Plan .................................................................................................. 84

Changing Physicians’ Mind-Sets ................................................................................................. 96

Incorporate Mentoring into Your Recruitment Process ............................................................ 98

What Should You Tell Potential Leaders About the Burdens, Challenges, and Risks of Assuming a Leadership Role? ............................................................................... 99

What Are Adequate Rewards to Entice Medical Staff Members Into Leadership Roles? ............................................................................................................... 103

Conclusion ...................................................................................................................................113

References ...................................................................................................................................114

Chapter 5: Educating Medical Staff Leaders ................................... 115

Leadership Development Training ............................................................................................116

Implementing a Training Program ............................................................................................ 121

Three-Phase Training ................................................................................................................. 123

Mentoring Versus Coaching ...................................................................................................... 137

Medical Staff Advisors ............................................................................................................... 142

Conclusion .................................................................................................................................. 146

vMedical Staff Leadership Essentials © 2011 HCPro, Inc.

Table of Contents

Chapter 6: Nominating and Selecting Medical Staff Leaders .........147

Leadership Selection Criteria ................................................................................................... 148

Nominating Process ................................................................................................................... 152

Chapter 7: Succession Planning and Leadership Retention .............157

Identify Roles That Require Succession Planning ................................................................... 158

Identify Who Is Responsible for Succession Planning ............................................................ 159

Adopt a Systematic Process to Ensure Future Leadership .................................................... 165

Retain Medical Staff Leaders .................................................................................................... 167

Making Physician Leadership Positions Visible ....................................................................... 168

Chapter 8: Understanding the Medical Staff Culture to Meet Future Challenges .............................................………………..171

Don’t Repeat the Past ................................................................................................................ 172

Understanding Polarities ............................................................................................................174

Size Makes a Difference ............................................................................................................ 180

References .................................................................................................................................. 181

Chapter 9: Reflections and Resources .............................................183

Chapter 10: From the Field: Medical Staff Leaders Share Their Thoughts on What It Means to Lead ......................................189

Gary Jones, MD, FCCP .............................................................................................................. 189

James R. Hupp, DMD, MD, JD, FACS....................................................................................... 192

David Frost, DDS, MS, FACD .................................................................................................... 194

Robert Cluck, MD ....................................................................................................................... 196

viiMedical Staff Leadership Essentials © 2011 HCPro, Inc.

R. Dean White, DDS, MS

R. Dean White, DDS, MS, has been involved in medical staff leadership and govern

ance for the past 35 years. He has served on almost every medical staff committee

either as a leader or as a member. He chaired the performance improvement committee

and the quality improvement committee and served as chief of the medical staff in

1999 and 2000 at Texas Health Harris Methodist Hospital HEB in the Dallas/Fort Worth

Metroplex; he served on the board of trustees for the hospital for six years. He recently

retired from his position as the medical staff advisor for Texas Health Harris Methodist

Hospital HEB. In this role, he was responsible for medical staff orientations, leadership

development, coaching and mentoring, behavioral event peer review, and the physician

health committee. He championed and helped implement the medical staff code of

conduct in 2003.

White presents at seminars frequently and consults with medical staffs, their leader

ship, and medical staff professionals on state and national levels. He serves on

faculties for maintaining proper boundaries and prescribing controlled substances

cosponsored by the Santé Center for Healing and Southwestern Medical School.

About the Authors

viii Medical Staff Leadership Essentials© 2011 HCPro, Inc.

About the Authors

He is the coauthor of A Practical Guide to Managing Disruptive and Impaired

Physicians (HCPro, 2010) and has been a speaker for The Greeley Medical Staff

Institute on several occasions on topics such as managing disruptive behavior and

impairment, leadership principles for physicians, ethics in a changed workplace, and

empathy training for physicians.

White practiced oral and maxillofacial surgery from 1974 to 2002 in the Dallas/Fort

Worth Metroplex. He received his dental degree and oral and maxillofacial surgery

training and a master of science degree from the University of Texas Dental Branch in

Houston. He is a past president of the Texas and Southwest Societies of Oral and

Maxillofacial Surgery and is a past president of the American Board of Oral and

Maxillofacial Surgery. He can be reached at DeanWhiteConsulting.com.

Jonathan H. Burroughs, MD, MBA, FACPE, CMSL, Reviewer

Jonathan H. Burroughs, MD, MBA, FACPE, CMSL, is a senior consultant with

The Greeley Company, a division of HCPro, Inc., in Danvers, MA. He works with

medical staffs and boards throughout the United States in the areas of governance,

credential ing, privileging, peer review and performance improvement, medical staff

develop ment planning, strategic planning, and physician performance and behavior

management. He is one of The Greeley Company’s leading national speakers and

currently serves on the national faculty of the American College of Physician

Executives, where he has been consistently rated as one of its top speakers and

educators during the past five years.

ixMedical Staff Leadership Essentials © 2011 HCPro, Inc.

Physicians often enter medical school not knowing what practicing medicine entails or

the demands that accompany it. Physicians often enter leadership positions much in

the same way. Leaders are often thrown into their positions—sometimes unwillingly

or unknowingly—with little training or direction. Some simply hunker down and do

their best until their term is over and then walk away hoping never to be elected or

appointed again. For other physicians, being elected or appointed into a leadership

position is an opportunity for learning and career development. This book is for both

types of physicians and everyone in between.

Whether you are a new or veteran leader, leadership skills are important in any rela

tionship, whether it is personal or professional. Leaders must not only lead but they

must also govern, recruit, and educate. They must also be forward thinking and serve

as mentors and coaches. They must be able to arbitrate, negotiate, mediate, facilitate,

advocate, and, most importantly, listen. All these skills are necessary whether you

have just been elected to a medical staff office or have just been hired as a physician

executive for your hospital or organization. The benefits of leadership training and

experience is lifelong and life changing.

Introduction

x Medical Staff Leadership Essentials© 2011 HCPro, Inc.

Introduction

This book will help physicians build their careers from a foundation of contemporary

leadership concepts derived from the business world. As healthcare evolves, many

of the elected leaders of today will become the physician executives of tomorrow.

Foundational principles include active listening, advocacy, emotional intelligence,

communication techniques, diversity, understanding generational differences, manag

ing polarities, and leading and managing leaders.

In addition to covering the foundational principles, this book will also explain the

specific skills needed for leading and managing physicians, as well as strategies for

identifying, training, and retaining leaders. We will also discuss the critical difference

between leadership and governance and the skills required for each.

To help new and veteran leaders alike better understand their positions, this book in

cludes specific medical staff leaders’ job descriptions. These descriptions outline each

position’s role in and the everchanging dynamic of hospitalmedical staff collaboration.

Medical staff leaders today and in the future will not be able to get away with hunker

ing down and waiting for their terms to be over. Future leaders will most likely be

younger than their predecessors, and they will likely be employed or contracted rather

than independent physicians. Whether you have or are seeking a medical staff leader

ship or physician executive position within a hospital or the leader of a medical group

that is contracted with a hospital or system, this book will provide you with valuable

insight into the world of leadership and management.

DownloaD your MaTErIals now

All figures in this book are available online at the website listed below.

Thank you for purchasing this product!

Website available upon purchase of this book.

1Medical Staff Leadership Essentials © 2011 HCPro, Inc.

The boss drives people; the leader coaches them. The boss depends on authority;

the leader on good will. The boss inspires fear; the leader inspires enthusiasm.

The boss says “I”; the leader says “We.” The boss fixes the blame for the breakdown;

the leader fixes the breakdown. The boss says “Go”; the leader says “Let’s go!”

—H. Gordon Selfridge, CEO of Marshall Field’s

department stores (now Macy’s) in the late 19th century

There is a vast difference between governance and leadership. Medicine in

general, and medical staffs and hospitals in particular, desperately need both.

Let’s start with a couple of definitions from the Oxford University Press

Dictionary, 2010:

Govern: to control or influence somebody/something or how something happens,

functions, etc.

Lead: to go with or in front of a person or an animal to show the way or to make them

go in the right direction.

Principles of Leadership

CHAPTER 1

Chapter 1

2 Medical Staff Leadership Essentials© 2011 HCPro, Inc.

John Ashcroft, former attorney general of the United States, maybe stated it best:

“I have come to understand that leadership is different from governance. Some people

confuse the two. Governance is the process whereby minimums are established.

Governance operates on the basis of mandates, impositions, and (sometimes) punish

ment. Leadership operates on the basis of models. The outcome of governance is a floor;

the outcome of leadership is people operating at their highest and their best.”

Stated another way, governance is management. According to George Barna’s Master

Leaders: Revealing Conversations with 30 Leadership Greats (Tyndale House Publishing,

2009), Ashcroft also once stated: “Leadership is the identification of noble goals and

objectives, and it is the pursuit of those noble goals and objectives with such intensity

that others are drawn into the process.”

Physicians possess, for the most part, superior intelligence, excel in deductive and

inductive reasoning, have good interpersonal skills, and remain objective to a fault.

All except a few are capable of being physician leaders, but most are not willing to

spend the time and effort to excel at this endeavor or they are not capable of putting

others’ interests or the interests of the group above their own. Managing is as challeng

ing as governing, but both are easier than leading. Leading is personal, and managing

and governing are positional. But the literature shows that some people are capable of

becoming leaders of their peers with enough passion, practice, and performance. There

are many leaders in organizations who do not have titles or elected offices; rather, they

are unofficial leaders that people turn to because they can get the job done. There is

no other venue where this is truer than in medicine.



Four Cornerstones of Leadership

This chapter describes and defines the following four cornerstones of

physician leadership:

• Honesty and credibility

• Trust and transparency

• A positive vision

• A passion for quality

All these qualities are learned, for the most part, early in life from our most important

mentors: our parents. Many are learned from our teachers, coaches, and peers as we

develop. They can be learned later in life, but with more effort if an individual did not

have models earlier in life. All these qualities, along with the skills mentioned in the

introduction of this book and enumerated in Chapter 2 (emotional intelligence, active

listening, conflict resolution, group communication, and the wisdom of diversity), can

be learned and woven together to make a strong fabric of leadership. “Governors” are

easier to come by and are somewhat more generic; leaders are a rarity, but both groups

can be identified, recruited, trained, and retained. The goal of this book is to enable the

physician to begin the journey into leadership.

Honesty and credibilityThe most important cornerstones of leadership are honesty and its cousin, credibility.

One builds on the other. An excellent physician is an honest physician. If a patient

cannot depend on the honesty of his or her physician, then a relationship never forms.

Chapter 1


James Kouzes and Barry Posner have done extensive research over a 30year period

with over 1 million surveys pertaining to leadership and its principles (The Truth

About Leadership, JoseyBass Press, 2010). The No. 1 attribute people look for in a

leader is honesty.

Honesty can be defined in many ways. It is what you do when no one else is looking.

It means telling the truth and applying moral, ethical, and consistent standards to

all people and circumstances. It means playing golf by the rules. A leader has to be

honest first with him or herself, which is why selfawareness is critical if one wants

to become a leader. A leader must be aware of his or her own strengths and weaknesses.

If a leader is unaware, he or she will unlikely be able to lead others with different

strengths and weaknesses to a place they didn’t know they wanted to go.

Credentialing experts hold the principles of honesty and credibility sacred; if a physi

cian falsifies anything on his or her application, the application is stopped in its tracks.

Literature confirms that if a physician has had issues with professional conduct and

ethics in training, he or she is more apt to have the same lapses later in his or her

professional career1. Once a physician leader or physician executive has misrepresented

the truth, his or her credibility is forever tarnished. Once doubt has entered the equation,

it is almost impossible to trust this physician, regardless of the circumstances. Credibility,

simply stated, means that you say what you mean and do what you say you will do.

Kouzes and Posner asked their respondents to rate their immediate managers—not

their CEOs—on the extent they exhibited credibilityenhancing behaviors:

In these studies, we find that when people say their immediate manager exhibits high

credibility, they’re significantly more likely to be proud to tell others they are part of the



organization, feel a strong sense of team spirit, see their own personal values as consistent with

those of the organization, and have a sense of ownership of the organization. A culture of

leadership excellence and integrity is created when people at all levels genuinely expect each

other to be credible, and they hold each other accountable for the actions that build and

sustain credibility. Credibility will determine whether others want to follow you or not.

In other words, you cannot have a poor clinician lead your medical staff to better

clinical outcomes; you cannot have a disruptive physician be the champion of the

medical staff code of conduct; and you cannot expect a marginal physician executive

to recruit excellent physicians for your medical staff or organization. Honesty and

credibility are irrefutable for the physician leader.

Trust and transparencyTrust is critical to all relationships. Trust involves taking a risk in another person,

and you, the leader, must be willing and able to trust those you propose to lead.

In addition, you must be able to show others that you can be trusted, which again

is based on honesty and integrity. You must perform predictably and consistently.

If others trust you, then your actions and words will have an effect, and others will

be more likely to follow you. Trust and transparency take time, and for the most

part, one example of trust builds on another until your peers, colleagues, employees,

nurses, and administrators begin to trust you and your actions. Trust must be earned

by actions, not words.

Physician leaders, regardless of who they answer to, do not build trust by disparaging

others. You never look bigger by making other people look small. Some personalities are

just easier to trust than others, and most of us want to see how a person acts and reacts

in certain circumstances before we are willing to trust him or her. Abraham Lincoln

Chapter 1


once said, “Almost anybody can withstand adversity; but to test a man’s character, give

him power.” Power that is wielded from a position (e.g., chief of staff, vice president of

medical affairs, chief medical officer, etc.) will not engender trust.

John Townsend, author of Leadership Beyond Reason: How Great Values Succeed by

Harnessing the Power of Their Values, Feelings, and Intuition (Thomas Nelson, 2009),

makes a great observation about trust and transparency when he writes: “At the end of

the day, [leaders] take accountability for their successes and failures. They have zero

tolerance for blaming others and zero tolerance for excuses. They are harder on

themselves than others.”

Daniel Goleman, author of Primal Leadership: Realizing the Power of Emotional In

telligence (Harvard Business School Press, 2002), makes this statement about trans

parency: “Transparency—an authentic openness to others about one’s feelings, beliefs,

and actions—allows integrity, or the sense that a leader can be trusted. At a primal

level, integrity hinges on impulse control, keeping us from acting in ways that we

might regret. Integrity also means that a leader lives his values.”

Another critical facet of trust is being able to communicate clearly. Others will interpret

your statements, promises, and intentions. It is up to you, the leader, to do this clearly.

Ambiguity, evasiveness, and halftruths will not build trust. Body language, eye con

tact, the volume of your voice, and the cadence of your speech all play an important

role in this communication. The physician leader who looks at his or her shoes while

saying, “I have your back” is probably not the one you want to trust.

Jeswald Salacuse, author of Leading Leaders: How to Manage Smart, Talented, Rich and

Powerful People (AMACOM, 2006), makes this very valid point: “Don’t confuse trust



with friendship. Creating a friendly relationship with people you lead doesn’t

automatically mean that they will trust you (or that you should trust them).”

Full disclosure builds trust and transparency. Mark Twain once said, “If you tell the

truth, you don’t have to remember anything.” There are times, of course, when full

disclosure is not advisable or possible, but what you choose to disclose must be

accurate and truthful.

The importance of having a positive visionLike the others, there are two parts of this cornerstone. One is being positive and one

is being forward looking. No one wants to follow someone who has a negative vision.

The future of healthcare is certainly unclear, but regardless of the mandates, restric tions,

incentives, and proposed penalties, physicians will still be taking care of pa tients. This

is where the physician leader should spend his or her time and effort. Leading others to

improve patient care and outcomes should be our primary goal (the last chapter expands

on these thoughts). All of us have been around negative individ uals or groups. Negativity

sucks the oxygen out of the room. A physician executive who makes excuses for the

mediocrity of the medical staff members he or she recruited and continues to state,

“That’s just the way it is” might be an adequate manager but is not a leader.

Kouzes and Posner elaborate on this thought: “Those who learn to be optimistic about

life are far more likely to be successful than those who view the current events through

the lens of a pessimist.” This means that an individual’s overall outlook on life can

affect the overall success of the group that he or she leads.

Forwardthinking leaders are always reading, researching, attending continuing

medical education courses, and visiting with colleagues to learn how to improve

Chapter 1


current outcomes. The aspiring physician leader must spend some time in the future.

This activity must be planned, so set aside time for it. Eric Shinseki, United States

Secretary of Veterans Affairs, underlines this point by stating, “If you hate change, you

are really going to hate being irrelevant.”

Like it or not, healthcare is changing. Whether you are the chief of the medical staff,

chair of the credentials committee, or the vice president of medical affairs, you need

to be a student of the future. Spend time thinking about how you can lead your organ

iza tion or medical staff into a future where payment structures will be different,

accredit ing requirements will be stricter, and patients are more aware of their health

care choices.

Michael Hyatt, CEO of Thomas Nelson, a Nashvillebased publishing company, posted

the following on his blog (www.michaelhyatt.com) in December 2009: “Vision is the

lifeblood of any organization. It is what keeps it moving forward. It provides meaning

to the daytoday challenges and setbacks that make up the rumble and tumble of real

life. This is where great leadership makes all the difference. Leadership is more than

influence. It is about reminding people of what we are trying to build and why it

matters. It is about painting a picture of a better future. It comes down to pointing the

way and saying ‘C’mon, we can do this!’ ”

Kouzes’ and Posner’s research again emphasizes the importance of a forwardlooking

leader. Honesty is the single most important quality that people recognize in a leader.

Seventy percent of their respondents placed having a positive, forwardlooking vision

second on the list. Interestingly enough, when Kouzes and Posner asked what people

wanted most in a colleague, honesty was again first, but forward thinking was not even

in the top 10. This underlines the difference between leaders and colleagues.



Ninety percent of the older respondents, with more work experience and higher

positions in the organization, rated having a positive vision much higher on the list

than those who were younger with less experience.

Reacting to the results of customer satisfaction surveys (e.g., Press Ganey) has become

the leadership principle du jour. Survey results may help with your vision and your

forward thinking, but you can easily be trapped into reacting to the negative comments

and forget to stay on course. It is critically important to not equate satisfaction levels

garnered from surveys with customer loyalty. Most survey instruments lump every

thing that is positive into one category, leading hospitals to postulate that the com

bined percentage of pa tients are satisfied; however, that is not necessarily the case and

does not necessarily mean that patients would return to your facility for care. Surveys

are a lot like poli tical polls: sample size, demographics, timing, and how the questions

are worded may skew the results. Surveys are a great adjunct to decisionmaking and

planning, but in many institutions, they have become the compass. Keep in mind that

surveys do not contribute to a future vision; they simply tell you how patients felt in

the past.

Passion for qualityPhysician leaders should feel passionate about quality—not just the quality of their

clinical outcomes, but also in the organization’s outcomes. A true physician leader

strives for excellence in his or her own specialty, as well as others. The real test is when

the orthopedic surgeon pushes the podiatric staff toward excellent outcomes, or the

vascular surgeon helps the interventional radiologists improve HCAHPS (Hospital

Consumer Assessment of Hospital Providers and Systems) survey scores. Leadership

goes beyond advocacy. The key is to get other physicians to do the right thing.

Chapter 1


Salacuse states, “First, leadership is not a matter of position but one of relationships.

To be a leader, you need followers, and followers choose to follow a particular leader

because of their relationship with him or her. Second, oneonone personal encounters

are vital to building the relationships needed to lead leaders. People will follow you

because they believe it is in their best interest to do so. Your job as a leader is to

convince them that their interests lie with you.”

A 2007 white paper by J. L. Reinertsen and A. G. Gosfield, et al., “Engaging Physicians

in a Shared Quality Agenda,” from the Institute of Healthcare Improvement, describes

the critical relationship of physician quality and leadership:

A critical fact about hospitals is that very little happens in the health care system without

a physician’s order. By virtue of physicians’ plenary legal authority, which is broader

than that of any other actor on the health care scene, almost all actions in health

care are derivative of their decisions and recommendations.

Gary Jones, MD, FCCP, who specializes in pulmonary medicine and critical care medi

cine at Texas Health Methodist HEB Hospital in Bedford, TX, personifies this passion

for quality. He has been a champion for quality and improved patient outcomes his

entire career. He is not a big fan of topdown mandates. He decided, on his own, to

improve outcomes in the ICU.

He began his personal journey to improve and shorten ventilator times. Using

evidencebased medicine from the Society of Critical Care Medicine (www.sccm.org),

he developed an order set and took it to other pulmonologists, cardiologists, nephrol

ogists, and neurologists for their input and changes. He then took it to the ICU

nurses for input, and then to the pharmacy, respiratory therapists, and back to the



pulmonologists. This was all done outside the hospital committee structure. After he

had personally shepherded his order set through the communities of interest, he took it

to the hospital for approval.

His reputation for excellence and his passion for doing the right thing was all he

needed to get the buyin to move forward. Over the years, he has followed this same

model to improve the rate of ventilatoracquired pneumonias, psychosisrelated

sedation, and poor outcomes from outofhospital cardiac arrests. His individual

passion for quality has translated into several benefits. The order sets gave the nurses

as much responsibility as they were willing to handle, which led to an average length

of employment in the ICU of 18 years. More independence led to better outcomes.

What does that mean for a budding leader? It means that quality is personal.

Thanks to Jones’ leadership, the ventilator times decreased from seven days to two and

a half days; ventilatoracquired pneumonias decreased to less than 1%; and ICU seda

tion psychosis is basically a complication of the past. In addition, the average length of

stay after extubation in the ICU decreased from three and a half days to eight hours.

There is now a 50% success rate, determined by functionality, for out of hospital

cardiac arrests secondary to implementing a therapeutic hypothermia protocol.

It does not take a whole cadre of physician leaders to make a significant difference. Daniel

Goleman, Richard Boyatzis, and Annie McKee, authors of Primal Leadership: Learning to

Lead with Emotional Intelligence (HBP, 2004), say it best: “Throughout history and in

cultures everywhere, the leader in any human group has been the one to whom others

look for assurance and clarity when facing uncertainty or threats, or when there is a job

to be done.”

Chapter 1


Medicine today is facing uncertainty and threats, and there is a job to be done. We

should strive to celebrate excellent physicians, and we should try to provide a fertile

climate and culture for these physicians to continue to improve the quality and safety

of patient care. If you take away their ability to individually make a difference, then

you may put out the fire of their passion.

References

1. M.A. Papadakis, A. Teherani, et al., “Disciplinary Action by Medical Boards and Prior Behavior in

Medical School,” NEJM 353 (2005): 25.

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