Decisive Leadership: Transitioning Physicians Into Leadership Roles Baltimore Health Commissioner Sees the ER As a Valuable Training Ground for Physician Leaders
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THE TOP EXECUTIVES IN HEALTHCARE Decisive leadership: Transitioning physicians into leadership roles Baltimore Health Commissioner sees the ER as a valuable training ground for physician leaders A C-Suite Conversation with The Companies of MPI Leana Wen Health Commissioner, City of Baltimore One such physician who has fellow residents in the last two made the jump is Leana Wen, and a half years,” she says. MD, the Baltimore City Health l Commissioner, who leads a She supported the expansion of staff of 1,000 employees. Since a program called Safe Streets, being named to the role in which calls upon former felons December 2014, Wen has shown to intercede and help defuse a predilection for taking decisive tense situations in Baltimore. action, perhaps unsurprising as She also employs people who someone trained as an emergency are in recovery from addiction, room physician: others who are living with HIV, and still others who learned l She led the creation of Vision about lead poisoning from for Baltimore, which provides home visits from the health free eye exams and glasses department and now are to children in grades K-8 in all outreach workers themselves. Baltimore City public schools. “It is my obligation as a leader to he number of physicians She created a partnership with ensure a workplace of diversity, Tand nurses transforming into the schools, Johns Hopkins, equity and respect, and it’s my administrative leaders capable the glasses manufacturer privilege to work with those who of running major organizations is Warby Parker, and a national are using their lived experience growing rapidly. nonprofit, Vision to Learn, to to help lift up others in similar In the age of value-based make it happen. “That’s an circumstances,” Wen says. care, organizations are leaning on example of directly translating clinicians to lean in to leadership. policy into action,” she says. Decisive leadership is at a This opens new vistas for physicians premium these days. Writing in and nurses, but health systems and l Wen was a pioneer as a Forbes, leadership expert Sunnie insurers must do their homework. public-health leader in issuing Giles points out that the increasingly A physician who heads his or her a standing prescription for all complex world in which we live can own practice may have valuable Baltimore residents to obtain and be paralyzing for leaders. Those who leadership skills, but leading, administer naloxone, the antidote can adapt, like Wen, and use the say, a staff of 12 is different from that can save a person’s life in complexity as a positive catalyst for overseeing a $2 billion budget and the event of an opioid overdose. their team are poised for success. ensuring a board and a C-suite are in “Since then, residents have saved Decisive leaders should: sync with your vision. the lives of more than 2,500 Continued on next page... ©2018, MPI. All rights reserved. 1 l Accurately define the challenge – gathering as much information EXECUTIVE’S TOOLKIT: as possible in a short period Strategies for physicians moving of time from a number of reliable sources, being sure into leadership roles to gain a better holistic picture ooking back, Wen sees several lessons that can help her fellow from all sides of the issue doctors if they choose to become physician executives leading the Lentire enterprise: l Encourage constructive discourse surrounding the l “Be intentional as you consider your move. Working clinically gives challenge and possible you many leadership skills. Channel these skills into leading on a solutions and alternatives different level.” l Act quickly to set a l “Find multiple mentors from within and outside your organization who course of action can help guide you and problem-solve. Gain management experience.” l Support the execution of l And, finally: “Never forget why it is that you are here: to serve that action plan by breaking our most vulnerable individuals during their time of need.” down hurdles and providing additional direction as needed work, the Milton and Ruth Roemer 2. The second lesson is “assisting Award. Achievements have come those who are most vulnerable,” The emergency department as through steely determination for she says. The naloxone a leadership crucible Wen, who grew up as the child of prescription that has saved so Wen’s transition from physician Chinese political dissidents in a many people from opioid deaths is to leader had some elements of a rough Los Angeles neighborhood. one example of this, as is providing baptism by fire. She was greeted Nonetheless, she graduated from something as basic as glasses with a measles outbreak erupting at college at 18, became a Rhodes to children who are in need. the same time as several possible Scholar and studied at Oxford, and Ebola cases. Three months after 3. Finally, Wen says she learned the completed her medical training at she became health commissioner, importance of speaking up. “In the Brigham & Women’s Hospital and Freddie Gray, an unarmed ER setting, you can never wait to Massachusetts General Hospital African-American man, died in speak up,” she notes. “If there’s before becoming Director of police custody and riots ensued. something that you suspect is Patient-Centered Care Research In all, 13 pharmacies were burned wrong, you need to speak up right and an attending physician in the down or closed. “We had to figure now. And that directly translates Department of Emergency Medicine out how to get people food, and into the workplace. There are at George Washington University in how to get seniors their medications many issues we need to speak Washington, D.C. because their pharmacies were up on right now, including Wen sees three direct correlations closed,” Wen says. “We had to issues of discrimination and between her ER work and her figure out how to get people to harassment, health as a human leadership role now. dialysis, chemotherapy and other right, the cost of prescription life-saving treatments.” 1. “Working in the emergency drugs, and evidence-based, Leading her team, in collaboration department is all about doing science-based programs like with city, state, federal, and private what you can right now,” she teen pregnancy prevention.” sector partners, she figured it out says. “That bias to action is the quickly. So quickly that, a year same bias that is necessary Even for those not in public health later, the American Public Health in public health where there or policy-oriented roles, clinicians Association honored her with its are so many urgent matters can sometimes underestimate the highest award for local public that demand our attention.” Continued on next page... ©2018, MPI. All rights reserved. 2 power of their voice in the age of It’s no easy task to work through are women. She actively recruits patient-centered care. While it is these phases, especially without the from the communities the Health true that healthcare administrators proper guidance. The accelerated Department serves. often have years of mentoring and nature of these programs helps Commitment to diversity on-the-job training for executive roles, physicians gain in months and years is a powerful engine to create physicians can be prepared for new what may have been elusive in that organizations that are more opportunities through accelerated solitary mindset within which they profitable and thoughtful as they physician leadership training. were trained to operate. face the business world exter- This type of training allows nally, and catalysts for employee physicians to gain valuable skills and Diverse voices matter at the top engagement and leadership devel- insights into leadership principles As an immigrant, Wen opment internally. Leaders at the that challenge their core training. experienced vivid episodes that top of an organization should not By working through real world crystallized for her the importance of underestimate the power they scenarios, physicians can begin speaking up. have to recalibrate an organiza- applying these principles right Shortly after arriving in the tion’s perspective, because many away. In our experience, many U.S., Wen saw a neighbor die challenges remain, something notice impactful outcomes within from an asthma attack; his Wen knows personally. weeks with this type of leadership grandmother was too afraid to call “As a minority and a female, I development and support. an ambulance because of their have faced entrenched racism and The goal is to bring the family’s immigration status. And sexism,” she says. physician from thinking in terms the #MeToo groundswell in the last Some are mundane – patients of their solitary influence on the year refreshed Wen’s memory of requesting to see the “real” doctor, goal to shift them into leading an watching her mother come home or CEOs calling her by her first enterprise, which takes a much from a job at a video store sobbing name while addressing her male broader perspective. An accelerated because of an unnamed incident counterparts by their titles. Some physician leadership training uses that occurred with her physically are overt – “at one event, I was three phases: and verbally abusive boss. introduced as a ‘cute little thing’ “I have always thought from and openly questioned on how a l Coaching and mentoring that time, that if I’m ever in a female person of color can lead – which moves them from position of leadership where I can 1,000 people.” leading self to leading others do something about these things, How to overcome that? I need to speak up for her and “We must foster a culture of l Collaboration and change for so many women who have diversity, inclusion and equity,” Wen management – which transitions suffered in silence.” says.