Physician Leadership In Crisis And Recovery

During the past several months, all generations of the world’s citizens have witnessed, or experienced, what will be recognized in history as a truly monumental period of global adaptation.

We all have stories about life in the yet-to-be-determined new world order. Many of us are losing patients; some of us will become infected ourselves. Many of our peers have demonstrated profound leadership by leaning into the front lines of care; unfortunately, some have succumbed to the virus in the process.

Let’s take a moment to pause and remember the innumerable healthcare providers from all disciplines who place their lives at risk every day in order to help those in need during these times of overwhelming demand.

If you are one of those healthcare providers, we thank you for your contributions, and we thank your colleagues for theirs. May all those whom we have lost be remembered for their bravery. We extend our sincere appreciation to everyone for their sacrifice!

Times Of Adversity

“The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, a sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern. Beautiful people do not just happen.”

— Elizabeth Kubler-Ross, author of On Grief and Grieving

As physician leaders, we routinely face adversity, but we also see examples of leadership amid adversity. The core nature of who we are as physicians, how we were trained, and how we practice our skills helps provide us with the resilience to weather adversity.

Resilience And Persistence

“Resilient people do not let adversity define them. They find resilience by moving towards a goal beyond themselves, transcending pain and grief by perceiving bad times as a temporary state of affairs. ... It’s possible to strengthen your inner self and your belief in yourself, to define yourself as capable and competent. It’s possible to fortify your psyche. It’s possible to develop a sense of mastery.”

— Hara Estroff Marano, in her May 2003 Psychology Today article, “The Art of Resilience”

As is apparent by the ramifications of COVID-19, our healthcare industry must continue to evolve at an ever-increasing pace despite ongoing adversity. It is imperative that we, as physician leaders, continue to develop the resilience necessary to manage that adversity and achieve necessary results at all levels.

During World War II, recognizing the challenge of England’s ongoing fight with Germany, Winston Churchill tried to lift the spirits of the British people through a metaphor for persistence: “The nose of the bulldog is slanted backwards so he can continue to breathe without letting go.”

Churchill is also recognized for “We shall not fail or falter; we shall not weaken or tire. Neither the sudden shock of battle, nor the long-drawn trials of vigilance and exertion will wear us down. Give us the tools, and we will finish the job.”

The fact that we persevered through years upon years of education to enter a career that requires persistence and resilience is a testament to our commitment. As physician leaders, however, we must continue to develop the complex skills of resilience and persistence — not only for us as individuals, but also for our patients and the organizations in which we work.

All physicians are viewed as leaders at some level, and often the presumption is that we have the innate ability to manage adversity effectively. That is not always the case, however, and it underscores my point about the need for each of us to consider how better to evaluate our current degree of resilience and how to expand it. Our persistence in improving resilience will lead not only to a better end result for our patients, but also to benefits for us, our families, and our communities.

The Culture Of Healthcare

“The culture in healthcare is intricate and complex. And we know that all healthcare is ultimately local. The recent responses to COVID-19 has underscored the commitment and loyalty of our healthcare culture to providing the best of healthcare delivery to all patients in spite of the most challenging of circumstances — circumstances that often placed physicians, nurses, and other allied health providers at risk without adequate resources.”

— Anonymous Physician Leader

The COVID-19 pandemic is providing all of us with opportunities to learn and grow from the stories we hear about overcoming adversity — stories from patients, families, and other providers.

The pride we can all feel in the way our diverse healthcare workforces have come together is overwhelming, and it has become a foundational element within our healthcare culture. We have been challenged, and we have risen to the occasion in the most professional of self-sacrificing ways — at times with the ultimate sacrifice.

Physician leadership has helped drive this cultural shift.

Our society clearly benefits from the focus and skills of physicians who serve as leaders. Reflect for a moment on how strongly society has relied on physician leadership in the past several months as we navigated this public health crisis of coronavirus. Physicians were at the top echelon of influence regarding our country’s initial response, and we have continued to be at the top-tier of all health systems as each system responds. Physician leadership is critical for effective healthcare!

This is a prime opportunity for physician leaders to help initiate the changes necessary to improve our healthcare systems in the ways we so desperately desire. We must all work toward creating larger-scale change by demonstrating resilience and persistence when it comes to improving the next generation of outcomes for patient care, as well as the next generation outcomes for higher quality, safer more efficient systems of care.

A refreshed culture of optimism for healthcare is possible in the coming weeks and months … even as COVID-19 persists.

It is my personal commitment to physician leadership that motivates me to improve my own persistence and resilience. I do this by seeking a variety of athletic challenges, which to me represent adversity. I encourage you to find your own symbolic challenges and use persistence to develop your resilience. The culture you help create around yourself will ultimately benefit the culture around others as well.

Leading Change

Leading and creating change is our association’s overall intent. AAPL focuses on maximizing the potential of physician-led, interprofessional leadership to help create personal and organizational transformation that benefits patient outcomes, improves workforce wellness, and refines the delivery of healthcare internationally.

We must all continue to seek deeper levels of professional development and to recognize ways we can each generate positive cultural influence at all levels. As physician leaders, let us become more engaged, stay engaged, and help others to become engaged. Creating a broader level of positive change in healthcare — and society — is within our reach.

Our patients will appreciate the outcome.

NOTE: Portions of this column are adapted from the March/April 2016 PLJ CEO column.