- Carefully analyze the problem or situation
- Set clear objectives
- Consider all the alternatives
- Determine the consequences of those alternatives
- Determine the trade-offs between them
- Discuss the uncertainties that exist
- Weigh your risk tolerance
- Link your decision to other decisions being made and determine, if together, they will affect the future and in what way
Under the enormous pressures that face health care institutions, it is easy for physician leaders to be swayed by the many factions at play. Groupthink develops, individual perceptions define individual realities, and leaders succumb to the biases we know impact all decision-making. Providing clients with a model helps them guide teams, and themselves, through a careful, thoughtful, decision-making process. Alfred P. Sloan Jr., the CEO of General Motors in the 1920’s, once said,
My colleagues, I take it we are all in complete agreement on the decision here…Then I propose we postpone further discussion of this matter until our next meeting to give ourselves time to develop disagreement and perhaps gain some understanding of what the decision is all about.
Conclusions
Physician leaders are not unlike other subject matter experts that become leaders. Health care however, is unlike any other industry. Coaching physician leaders to excel in the business, while protecting the mission and their passion for caring for patients, is a challenge. Transformative change is desperately needed in health care, but it will be a wild ride through an upside down world to achieve it. Coaching is a wonderful tool to help provide physicians leaders with the support, guidance, and learning they need to keep them steady along the way.
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[i] Chilingerian, Jon. “A Curriculum for 21st Century Physician Leadership Programs.”Www.physicianfoundation.org, 1 Sept. 2016, physiciansfoundation.org/research-insights/building-a-21st-century-physician-leadership-curriculum/.
[ii] Gittell, Jody Hoffer. “Coordinating Mechanisms in Care Provider Groups: Relational Coordination as a Mediator and Input Uncertainty as a Moderator of Performance Effects.” Management Science, INFORMS, Nov. 2002, dl.acm.org/citation.cfm?id=968536.
[iii] Hammond J, Keeney R, Raiffa H. (2015) Smart Choices: A Practical Guide for Making Better Decisions. Harvard Business Review Press
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Margaret Cary, MD MBA MPH PCC
March 20, 2018 at 1:32 pm
Sally – this is a brilliant article. You deftly capture the challenges we have as physicians in moving from clinician, diagnose-and-treat roles into management and leadership roles. You include systems thinking and also offer suggestions for coaching clients, and coaches working with physicians. Thank you for a wise and practical piece.
Alexander Ku
July 11, 2018 at 2:50 pm
Great article Sally. I am an operations leaders working closely with physician leaders in a co-management environment. I am also a certify executive coach. How would you bring awareness to physician leaders that would encourage them to pursue leadership training that covers many of the topics outlined in your article?