AAPL Annual Leadership Conference Day One: Journeys

For many, the great American journey westward began in Chicago on Route 66.

Dr. Peter Angood, president and CEO of the American Association for Physician Leadership opened AAPL’s Annual Leadership Conference this week by acknowledging that the journey toward more widespread acceptance of the value of physician leadership also goes through Chicago, where more than 600 had gathered.

On day one of the conference, that journey took many paths: setting the stage for excellence, discussions surrounding diversity, equity, and inclusion and the challenges faced specifically by women, and a significant step toward officially creating the medical subspecialty of Healthcare Administration Leadership and Management (HALM).

The conference’s opening keynote address, presented by Antonia J. Hock, founder and CEO of Antonia J.A. Hock & Associates, who defined four styles of physician leaders:

• The Intellect: Somebody who prizes their intellectual knowledge and capabilities over all other soft skills and social norms.

• The Actionist: Somebody who focuses on activity, near term outcomes, and current state metrics and tactical execution.

• The Advocate: Somebody who consistently champions programs and ideas that are only and always patient-centric, to the exclusion of everything else.

• The Innovator: Somebody who balances the need for pragmatism and execution against the need to grow and evolve and they stay open to new ideas, and they also understand that innovation can come from anywhere and anyone.

Hock focused on the need for physicians to proactively address their own mindsets, and she encouraged adopting the leadership style of the innovator.

“The innovator understands that the team is essential. Because they are egalitarian, they see everyone's contribution, and they see the team as the essential component of success. TEAM is first in their language and behavior,” she said. “Because they understand that the team is so critical, they are focused on culture and environment where progress and humanity can thrive.”

Hock presented a “top ten” list of key factors in the Innovator’s mind set:

1. Focuses on a “can-do” attitude. Philosophically, this is a person with a positive, solution-oriented point of view. No matter how challenging a scenario, this person can be counted on to be focused on finding options or solutions.

2. Cultivates ideas and input from all sources, every day.

3. Lifts up others with kindness and consideration because creating psychological safety allows for people to do their best work.

4. Inspires others by setting an example of execution excellence while actively sharing a vision for the future. Never leads with ego or pulls rank because they have other tools to create results.

5. Makes work fun by actively noticing positive contributions and providing opportunities for camaraderie, fellowship, humor, and personal wellness.

6. Never has a really bad day in front of the team, does not actively blame others in public, and does not complain or create negative environments by seeing problems and issues without solutions or ideas.

7. Inspires Passionate Advocates … they build an organization and/or team that loves their specific healthcare practice or institution, so employees feel invested in the business at a core human level. This is not a paycheck.

8. Empowers individuals to lead with their heart for service, their intuition, and humanity. This should be paired with clinical skill/vocational excellence. Actively recognizes contributions every day and says “thank you” more than anyone else.

9. Fosters respect and understands the chain of command but removes the feeling of “hierarchy” in the culture, so that everyone feels valued and motivated to contribute.

10. Puts the “desire to serve” into every process, collaboration, and operational discussion.

Hock tied healthcare to hospitality by sharing a key element of success for both: happy employees/team members will lead to happy customers/patients.

That led into a session of shared experiences of physicians who have become chief medical officers in their hospitals and health systems. This panel discussion was moderated by Mark Olszyk, MD, MBA, CPE, author of The Chief Medical Officer’s Essential Guidebook.

Speakers in the session included Rex Hoffman, MD, a radiation oncologist by training, chief medical officer at Providence Holy Cross Medical Center; Jason M. Golbin, DO, chief medical officer and executive vice president at Catholic Health; Reka Danko, MD, chief medical officer of Saint Mary’s Regional Medical Center; Steven Brass, MD, executive vice president and chief medical executive for Harris Health System; Lee Scheinbart, MD, chief health affairs officer and assistant professor of Leadership Development at the Burrell College of Osteopathic Medicine; and Elizabeth J. Warner, MD, chief medical officer of Cherry Health and president of Warner Well Being.

The stories they shared exemplified the challenges of being a physician and a “suit” (healthcare administrator). And they also showed how, through learning empathy, communication, and consensus building skills, those challenges can be overcome for the betterment of the organization and patients.

The DEI Path Toward Physician Leadership

A lunch keynote presented a serious and humorous look at the challenges presented by creating cultures that support Diversity, Equity, and Inclusion (DEI). Speaker, Tracy Spears, tied her upbringing from a trailer park in Oklahoma to the challenges faced by physician leaders as they overcome both conscious and unconscious biases.

In a unique and funny self-effacing style, she articulated the six types of unconscious bias:

• Affinity bias: A preference for people who are most like us.

• Halo effect: Favoring a person because you like them personally.

• Perception bias: Forming assumptions about certain types and groups.

• Confirmation bias: Seeking information that confirms pre-existing beliefs.

• Group Think: Trying to fit into a group by modeling their opinions. 

• Regency Bias: Outcomes that have happened recently carry more weight.

Complementing this discussion, a panel that included Grace Terrell, MD, author of Strategies for Recognizing and Eliminating Gender Bias for Healthcare Leaders, discussed the slights that befall women in healthcare. One example involved how to avoid seniority losses for women who take a year off to have a child. Step one: stop calling it “a year off.”

“Difficult Physicians and Difficult Patients”

Physicians also jump to conclusions about their patients, especially in the emergency department, where people can become particularly unsettled and impatient.

Emergency medicine physician Joan Naidorf, DO, led a discussion of what makes physicians, and patients, difficult. She is the author of Changing How We Think About Difficult Patients, and she discussed the value of seeing scenarios from the patients’ perspectives.

Why do this? Because without this approach, “We get terrible results: missed diagnoses, patient complaints, bad reviews, board of medicine inquiries, and malpractice suits. We feel terrible, we feel burned out, we want to change jobs, and some even want to leave medicine” said Naidorf.

The day ended with a look at a huge new step in the journey of physician leadership. A panel moderated by Angood discussed the recent fellowship program accreditation for training in HALM and board-certification in HALM by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS).

The panel included Suzanne R. White, MD, chair of HALM Taskforce, American Board of Emergency Medicine; Richard Hawkins, MD, president, and chief executive officer, American Board of Medical Specialties; and Kevin Weiss, MD, chief sponsoring institutions and clinical learning environments officer, Accreditation Council for Graduate Medical Education.

The move holds great potential for establishing physician leadership as a bona-fide medical subspecialty.

And it was a fitting end to day one of the journey that is the AAPL annual meeting.