Innovative Leadership Vital in Transformative Era of Healthcare
Monday, Nov. 30, 2015
Leadership styles that facilitate collaboration and team building are key factors to improving healthcare during this transformative era in medicine, according to one of the leading voices in medical education.
Speaking at Sunday's plenary session, Darrell G. Kirch, M.D., president and chief executive officer of the Association of American Medical Colleges (AAMC), in Washington, D.C., suggested that the challenges facing the U.S. healthcare system also represent significant opportunities for physicians to take the lead in providing better care for individuals and populations at a reasonable cost.
"We must accept the move away from fee-for-service to population-based medicine, embrace the need for the alignment of hospitals and doctors and keep patients at the center of our focus," he said.
To underscore the importance of patient-centered approaches, Dr. Kirch asked to see, by a show of hands, how many physicians were in the large audience at the Arie Crown Theater. He then asked, "how many of you plan to be patients one day?"
The question generated much laughter, but the information Dr. Kirch shared about the current state of healthcare was far more sobering. A shortage of doctors is imperiling healthcare access, he said, even as the Affordable Care Act has enabled more Americans to get health insurance than ever before. Funding for the National Institutes of Health and for residency training positions is stagnant amid an atmosphere of partisan gridlock in Washington.
"In the United States, we have the best biomedical science, the greatest store of intellectual talent and we're spending more money than anyone else," he said. "These are key resources, but right now they're tied up in dysfunctional ways of operating."
Despite the alarming statistics, Dr. Kirch, a former medical school dean and healthcare system chief executive officer, expressed optimism for the future, so long as physicians take the lead in changing the culture of medicine. He noted that many physicians today remain embedded in a traditional culture of autonomy, competition and individualism—a culture that often conflicts directly with the healthcare desires of today's patients.
"The traditional culture in healthcare and medical academia has been hierarchal," Dr. Kirch said. "We need to transcend this culture of rugged individualism and figure out how to be much more collaborative."
Selecting proper leaders is vital to the success of this process, he said. These new kinds of leaders will move away from committee-based models and harness the power of teams to bring out the maximum level of performance in the people around them.
"Historically we've selected leaders based on personal accomplishments as opposed to the ability to foster growth and form teams," he said. "It's wonderful if you've published dozens and dozens of research papers, but we need people with a talent for leadership too."
Dr. Kirch said that radiologists and other healthcare providers and their institutions must take the lead in developing cutting edge technology and migrate to payment models keyed less on the value of rescuing people and more on keeping them well. He also advised the physician community to fight the high rate of job-related burnout by building resilience through team support and a shared sense of purpose.
"The enemy here is inertia and inaction," he said.
Dr. Kirch said radiologists and other physicians can help address the inequalities of the day by remembering the ethical concerns that helped inspire them to seek a career in medicine.
"Don't look at racial and income and educational inequalities as political issues but as ethical ones," he said. "All of these inequalities are associated with health disparities, and as physicians we have an ethical obligation to do good for patients."
In closing, Dr. Kirch shared an image of artist Luke Fildes' painting, "The Doctor," an iconic 1891 work that shows a physician paying a house call to a sick child while the concerned father looks on. He contrasted that image of a simpler time with today's world of iPods, sophisticated scanners and large staffs.
"Can we retain that connection with the patient?" he asked, gesturing to the image. "That's our task as we move forward."