What it takes to lead

An MBA may or may not be needed, depending on whom you ask.

You don't need to get an MBA to be a leader, according to Brian J. Harte, MD, FACP, president of South Pointe Hospital in Warrensville Heights, Ohio, part of the Cleveland Clinic Health System.

“Your time and money is better spent developing skills and experience on site, with a modest amount of complementary curriculum,” said Dr. Harte, during the session “Leading and Managing Change” at Internal Medicine 2013.

Edmondo J Robinson MD FACP Photo by Kevin Berne
Edmondo J. Robinson, MD, FACP. Photo by Kevin Berne.

Not so fast, said co-speaker Edmondo J. Robinson, MD, FACP, associate chief medical officer of Christiana Care Health System in Wilmington, Del.

“You want to fast-track your leadership, not spend 25 years as a clinician until someone notices you've done good work and gives you a leadership opportunity. You want to use [the MBA] as a signal of business competency and acumen,” said Dr. Robinson. “Physicians like credentials.”

The problem, countered Dr. Harte, is that much of the MBA curriculum is overkill, teaching skills that could be delegated to team members in real life. “You don't have to be the operator of every part of the business; your role as leader is to keep everyone focused on patients and quality,” he said.

Physicians who anticipate they may someday move from medical practice to another field, however, may be wise to get an advanced business degree, Dr. Harte acknowledged.

The debate wasn't merely academic, so to speak. Dr. Robinson himself got an MBA more than a decade ago and said his education was invaluable in teaching him how to manage people, as well as how to affect change at a system-wide level.

Eventually the speakers found common ground in their friendly debate. “Neither of us believes all [the skills needed for leadership] can be acquired solely by living in the trenches day in and day out,” Dr. Harte said, noting that professional organizations like ACP offer many opportunities for education.

Some of those leadership skills include having self- awareness; being visionary and communicating one's vision; and being able to energize staff, mentor individuals and teams, and listen and give feedback. The abilities to build consensus, make decisions, and stimulate creativity and adaptability are also important, Dr. Robinson said.

There is also emotional intelligence, which is part of self-awareness and deserves elaboration, Dr. Robinson added. “This means being able to recognize your personal strengths and weaknesses, having sensitivity toward others, recognizing emotional cues, being an open communicator, and being able to handle conflict and tense situations effectively,” he said.

Many internists start with some of the raw material required for leadership: problem-solving abilities, training in using a broad scope, a passion for lifelong learning, strong interpersonal and communication skills, and a sense of ethical and social responsibility, Dr. Robinson said.

However, leadership involves other aspects that may not come as easily for physicians, he added. Physicians tend to be action-oriented and prefer immediate gratification, while leaders are strategic planners who accept delayed gratification. Physicians are focused on autonomy, professional identity and credentials, while leaders focus on teams, organizational culture and results. Many physicians also see finances as a hindrance to doing their jobs, while leaders embrace fiscal realities, Dr. Robinson said.

Acquiring the right skills for leadership has become more important in a health care landscape that's gotten increasingly complex, Dr. Harte said.

“Physicians play a critical role in moving health care forward,” said Dr. Harte. “Whether learned formally or informally, business skills are a necessary complement to clinical skills.”