A Title Does Not Give You Much of a Head Start
When I became Medical Staff President, I already understood responsibility. I had spent years as a surgeon making decisions where the consequences were real and immediate. I had also served in other leadership roles, including Chief of Surgery.
Still, leading physicians taught me something different.
Doctors are independent by nature. We are trained to make decisions, defend our reasoning, and take responsibility for patients. Those qualities are necessary in medicine. Put a group of physicians around a conference table, though, and you quickly discover that independent thinking can make leadership complicated.
A title may give you authority on paper.
It does not automatically give you trust.
That part has to be earned.
Physicians Usually Want the Reason Behind the Decision
One thing I learned quickly was that telling physicians what to do is rarely an effective leadership strategy.
Doctors ask questions.
Why are we changing this?
What problem are we trying to solve?
What evidence supports the decision?
How will this affect patient care?
I actually came to appreciate those questions, even when they made meetings longer.
If I could not explain why a decision made sense, maybe I needed to reconsider it.
There were times when I walked into a discussion believing I knew where we needed to go. After hearing from colleagues, I changed my mind.
Was that weakness?
I do not think so.
The responsibility was to make the best decision, not to protect my original position.
You Are Leading People Who Are Used to Leading
That is probably the biggest difference in medical staff leadership.
Every physician in the room has spent years being trained to take control of difficult situations.
A surgeon leads an operating room.
An emergency physician leads during a crisis.
Other specialists make important decisions within their own areas every day.
Then you bring everyone together and ask them to work toward one hospital-wide goal.
You cannot approach that group as though they are waiting for instructions.
They have experience.
They have opinions.
Sometimes they have very strong opinions.
The challenge is creating enough common ground that disagreement does not become division.
Disagreement Is Not Necessarily a Problem
Earlier in my career, I probably viewed disagreement as something that needed to be resolved quickly.
Leadership changed that.
Sometimes disagreement is useful.
If several experienced physicians look at the same issue differently, I want to understand why.
What are they seeing that I am not?
Are they protecting their department, or are they identifying a legitimate problem?
Am I listening carefully, or am I simply waiting for my turn to respond?
Those questions became important to me.
The goal is not to create a medical staff where everyone agrees.
I would probably be suspicious of a room full of physicians who agreed about everything.
The goal is to disagree without losing respect for one another.
The Unpopular Decision Still Has to Be Made
There are moments in leadership when discussion eventually has to end.
A decision has to be made.
That can be uncomfortable when you know some respected colleagues will disagree.
I have learned that you cannot lead by constantly asking, “Will everyone like this?”
Sometimes the better question is, “Can I explain this decision honestly and stand behind the reasoning?”
There is a tradeoff.
Move too quickly and people feel ignored.
Wait for complete agreement and nothing gets done.
Finding the right point between those two can be difficult.
I did not always know immediately where that point was.
Sometimes leadership means accepting that a thoughtful decision can still disappoint good people.
Private Conversations Often Matter More Than Meetings
Some of the most productive conversations I had as a leader did not happen in formal meetings.
They happened in hallways, offices, or after someone called and said, “Do you have a minute?”
A physician who says very little during a committee meeting may have a lot to say privately.
I learned to pay attention to that.
Sometimes there was frustration underneath an argument that had very little to do with the issue being discussed. Maybe someone felt their department was not being heard. Maybe a previous decision had damaged trust.
You cannot solve those problems with another policy.
Sometimes you have to sit down and listen.
Relationships Matter When Things Get Difficult
It is easy to work together when everything is going well.
Leadership becomes more revealing when there is conflict.
That is when the relationships you built earlier matter.
If colleagues know you respect them, a difficult conversation can remain productive.
If that trust does not exist, even a small disagreement can become personal.
I became more intentional about how I treated people when there was no immediate problem to solve.
Return the call.
Listen to the concern.
Give credit when someone has a good idea.
Those things sound small.
They build the foundation you depend on later.
You Cannot Forget the Patient
Hospital leadership can become consumed by meetings, policies, schedules, budgets, and administrative concerns.
Those things are real. They cannot simply be ignored.
But I found it useful to keep bringing conversations back to one question.
How does this affect patient care?
That question does not magically settle every disagreement.
It does change the tone.
Physicians may disagree about process, but most of us entered medicine for the same basic reason.
We want patients to receive good care.
When discussions became complicated, returning to that purpose often helped.
Leadership Made Me More Comfortable Saying I Was Wrong
This may have been one of the more useful lessons.
When you are responsible for leading other physicians, eventually you will make a decision you would handle differently in hindsight.
I certainly did.
The temptation is to defend it because changing your position can feel embarrassing.
I found the opposite usually worked better.
If I believed I had gotten something wrong, I tried to say so.
Physicians can recognize defensiveness pretty quickly.
They also recognize honesty.
I never expected colleagues to believe I had every answer.
I hoped they believed I would listen when evidence showed me I needed a different one.
Respect Lasts Longer Than Authority
Serving as Medical Staff President changed how I think about leadership.
Authority can get a meeting started.
It can establish a process.
It can sometimes settle a decision.
But authority alone cannot create cooperation.
That comes from respect.
Looking back, I do not measure leadership by how often people agreed with me. I think more about whether they felt heard, whether we could work through disagreements, and whether we kept the needs of patients somewhere near the center of the discussion.
Leading physicians taught me that you do not have to be the loudest person in the room.
You do have to be willing to listen, decide, explain yourself, admit when you are wrong, and come back the next day ready to work with the same people again.
That is less dramatic than most ideas about leadership.
In my experience, it is much closer to what the work actually requires.