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Why Doctors Make Lousy Leaders and Three Ways to Get Better Quickly

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Why do doctors make such lousy leaders? In this modern era of health care innovation and change, it is typically the physicians who have to be dragged kicking and screaming into the future rather than taking their natural leadership role in improving health care.

There are three built-in blind spots in our education that create our leadership handicap. Let me show them to you in this article and -- rather than leave you hanging -- give you three ways forward with some simple steps that will instantly improve your leadership skill set. In my work with over-stressed doctors, these leadership gaps are major contributors to the physician burnout epidemic, and addressing them can provide immediate stress relief.

1) Medicine's Dysfunctional Default Leadership Style

Our medical training is almost exclusively focused on our clinical skill set. We take a minimum of seven years in medical school and residency to learn and practice the ability to diagnose and treat. That knowledge base is nearly overwhelming all by itself, and it is unfortunately not sufficient once we are out in practice.

Once we graduate we quickly recognize that the act of seeing patients and delivering our treatment plan is dependent on a whole team of people. We are meant to be an effective team leader right out of the gate, but were never taught the basic leadership skills to play this role.

We automatically adopt a dysfunctional leadership style based on "giving orders."

The clinical actions of diagnosis and treatment are simply adopted as our default leadership tool set for all other areas of our practice. When faced with any practice challenge, we assume we must be the one who comes up with the answers (diagnose) and then tell everyone on the team what to do (treat).

We become "top-down" leaders naturally and automatically.

This default top-down style -- the same one used in the military -- has its consequences. It turns your team into sheep. It will seem to you like they have lost the ability to make independent decisions. Everything they perceive as a problem -- from the front desk to the billing office -- is brought to you for a solution.

Have you ever felt overwhelmed by people asking you non-clinical questions about scheduling, billing and such? The top-down leadership paradigm produces that naturally. They all look to you for answers because you are the apex of the top-down pyramid. It does not have to be that way.

What You Can Do Differently

Understand there are multiple areas of your practice where you are not the expert, and start to use the whole team's expertise to address the problems you are facing.

After all, you are in the room with the patient, doing your best to solve the clinical issues while the rest of your staff spends their day actually working in your scheduling and billing systems. They are the experts in what is going on in those areas... not you.

The key is to ask more questions -- and give fewer orders.

Try becoming more of a facilitator, not "the boss" or source of all the answers. Ask your people what they suggest as the solutions to the problems they discover. You might even tell them to only bring you a problem if they bring their thoughts on a solution at the same time.

Have regular meetings where you work "on" the practice and deal with these issues as a collaborative team, rather than spending all your time working "in" your practice. This is the key to a much more effective leadership style. You begin leveraging the skills and experience of your entire team.

When you work together to systemize and delegate, you won't feel like you are doing all the work, and your team will feel honored and more involved. A better practice experience for you, your staff and your patients will result.

2) No Leadership Training and a Nonsensical Business Model

When did you ever receive training on leadership skills? Didn't happen in my residency. It is foreign territory for most of us. Physicians as a group tend to see leadership, facilitation, team-building and the meetings required to coordinate the actions of a team as necessary evils we would like someone else to address.

I have heard this over and over. "I just want to be left alone and see patients." That is because you were only trained to perform that activity. The subjects of leadership and organizational development are absent in our medical training, and yet become crucial to our success out in practice.

Then there is our business model -- which often makes no sense at all.

Imagine the CEO of a automobile manufacturer who is simultaneously the only person who can put the doors on the cars in the assembly line. The boss is the biggest bottleneck in the system. Who would design a business like that? Welcome to the world of medicine. You are the leader and the piece worker on the line at the same time.

You have the complete skill set to do your work on the line: seeing patients behind a closed door in the office. Unfortunately your team leadership skill set is ignored at the same time that it is required to fill the other major role you play in the practice.

The key is to respect, understand and begin acquiring collaborative leadership skills. Understanding how to lead effectively will make your life easier, and your team and patients happier and healthier.

A great place to start is with some of the leadership classic books like:

  • First Break All the Rules
  • The E-Myth
  • The Five Dysfunctions of a Team
  • 7 Habits of Highly Effective People
  • The Leadership Challenge
  • What Got You Here, Won't Get You There

Any of these books will give you multiple instantly effective tools you can use with your teams.
(Please put your favorite leadership book in the comments -- thanks.)

3) We Demonize Managers/Administrators and Become Part of the Problem

If I say "medical director" to you, what are the first words that come into your head? I will wager they were not positive ones.

This common knee-jerk reaction has important negative consequences for everyone.

Physicians as a group tend to see anyone in a management role as "the enemy." If these people would just do their jobs, we could finally left alone to "just see patients." These are the "bean-counters" and "pencil-pushers."

It gets even worse if that same manager, medical director or administrator is also a physician. For those of our brothers and sisters who have stepped into administrative roles, we tend to see them as failures, traitors -- "they've gone over to the dark side," or worse.

We demonize managers/administrators at our own risk.

These organizational leaders are charged with managing and improving the function of the larger systems that play such a big role in your practice. We can fight them and become part of the problem. We have all seen and done this -- bringing them only problems and complaints. Our interactions can become hostile venting sessions and nothing gets accomplished.

Or we can take responsibility to become part of the solution.

As a team leader in the front lines of patient care, you can make a difference by working to influence and support these managers and administrators. You and your team have valuable experience to share with those who are charged with running and improving these larger systems. This physician leadership role at the larger system level is even more important now as hospital-based physician networks are rapidly forming across the nation from what used to be independent practices.

  • What are your suggestions for improvement in these larger systems?
  • Who needs to know and how can you help them implement the changes you recommend?

We can each play a role in helping these larger systems become more functional, but not if we retreat to our exam rooms and simply complain.

In my experience, any efforts doctors put into their own physician leadership development pays immediate dividends.

Putting some effort into:

  • Studying collaborative leadership
  • Leveraging your team with your new physician leadership skills
  • Playing a role in improving the larger systems

These are ways to quickly improve the practice experience for you and your staff and the quality of care you and your team provide to your patients.

Please leave a comment and share your favorite leadership tool/tip. What is working for you and your team?

Dike Drummond, M.D., is a family physician, executive coach and creator of the 1 Minute Stress Relief Program for Doctors Online Training. He provides stress management, burnout prevention and leadership development services to physicians and other healthcare professionals through his website, The Happy MD.

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