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Doctors Are Leaders, but Are They Good at It?

Despite it not being a focus of their training, the best doctors are also great leaders.

Being a Physician Sure Is a Big Responsibility

We go to them for advice and peace of mind. We rely on them in times of crisis. Doctors are viewed as healers, but they are also looked up to as leaders who have knowledge and resources that can enrich their communities.

As a current family medicine resident, I am in the middle of a years-long journey populated with all sorts of unique mentors. Some have been phenomenal; I could never possibly forget their lessons. Others have been… well, not so phenomenal.

For better or worse, there is a clear pecking order in medicine, and you’re expected to be a leader right after you graduate from medical school. 

This can feel gratifying to new residents, but few are prepared to step into that privileged role. The truth is that basically none of the years of training required of doctors is focused on leadership. So, there is a constant influx of young doctors labeled as leaders, and most do not have the slightest idea about effectively functioning in a position of authority. Many learn. And even though an enormous amount don’t, they will still be thrust into those roles whether equipped for them or not.

That’s bad because inept leadership can be disastrous. Also, literally, lives are at stake.

Medicine’s Ladder/Power Structure

When you’re a medical student, you stay out of the way and do what you’re told.

Then you graduate and have a shiny new MD after your name. Except nobody you work with cares, and you quickly learn you’re on the ladder’s bottom rung. The first year of residency is called intern year. As an intern, you still do what you’re told, and you’re told to do A LOT.

Oh, and also, you get to mentor the students, which is funny because you used to be one yourself like a week ago.

Every year, you’re in charge of more and more people. The second-years lead the interns and the students, the third-years lead the second-years, the interns, and the students. You get the idea.

When you graduate residency, you can become a fellow, answering to your attending physician while supervising all levels of residents and students. Or you can be a full-fledged physician. Either way, now your MD is finally allowed to be impressive. If you so choose, you can become an attending physician and guide yet more residents and students. Or you can go out on your own and leave the world of medical education.

Is your role as a leader finally fulfilled? Nope.

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Leadership Goes Beyond the Pecking Order

Good leaders get people to follow them. As a family medicine resident, much of my job revolves around educating my patients and fostering healthy habits and prevention.

To be an effective doctor, I must find a way to get my patients to listen to me and follow my instructions. I need their trust. Communication skills, accountability, and emotional intelligence go a long way toward that, and those are all traits of good leaders.

All other medical specialties have similar elements that benefit from those attributes. For instance, even if they don’t often see patients face-to-face, pathologists are often crucial members of diverse medical teams.

Obviously, learning about leadership is a must. But how? Besides turning to Amazon for as many audiobooks on the subject I can listen to on the way to and from work, I’ve found the best way to learn is from mentors in the profession. And don’t just take my word for it. Even Tony Robbins agrees!

I met one of my most influential attending physicians as a student. He was a brilliant internist who I swear would have been a famous stand-up comedian had he not entered medicine. Nobody was safe from his wit, which he used both as an icebreaker with patients and as a tool to bring his team together. During that particular rotation, I never felt like the lowly student who occupied the lowest rung of the proverbial ladder.

My attending didn’t see students in front of him. He saw future doctors. Future leaders. And he treated us as such. As a result, even though everyone thought they had all worked their hardest before, we all managed to squeeze out a little bit more under him.

In short, he was one of the best leaders I have ever worked with.

The Future = More Classes?! Yup.

Since medicine is constantly evolving, so must its curriculum. The goal of medical school has always been to create good doctors. Since the best ones are accomplished leaders as well, it only makes sense that medical schools should teach leadership skills.

For many, being a resident physician is their first job. Think about that for a minute. Their (albeit expansive) training is relatively narrow in its scope; it’s based on countless hours of study, clinical practice, and test taking. Then it’s complete. They graduate and are immediately expected to be leaders. Who have they learned from though? Often it’s people like them: fledgling residents with no formal instruction in mentorship.

What’s the solution? Well, it’s complicated. Leadership courses on their own might not be effective for everyone. However, it should not be something that we can expect to be picked up after a semester of intense studying. But introducing leadership as a concept all physicians will encounter is vital. It should always be there in the background as something we’re working on via multiple avenues. We aren’t learning to interpret EKGs or lab values here.

Leadership is a skill that requires careful cultivation and attentive nurturing. Sure, adding yet ANOTHER subject to the laundry list of courses that defines medical school is daunting. However, it’s necessary – doing so will create a new, more well-rounded and more influential generation of young doctors.

The Key Three (Takeaways)

1. Whether they’re prepared or not and whether they like it or not, physicians are leaders.

2. The better the leader, the better the doctor.

3. Leadership training should be integrated into the medical school curriculum.

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