Presentation delivered by Tony S. Reed, Chief Medical Officer, Temple University Hospital at the marcus evans National Healthcare CMO Summit held in Texas.

1. Building Physician-Leaders:
Selecting, Grooming and Engaging
Physicians to Lead Change
Tony S. Reed, MD, MBA, MPhil, CPE
Chief Medical Officer
Temple University Hospital
September 20, 2019
1

2. • By the end of this talk, you will be able to…
– Define why the concept of physician-leadership matters
– Identify key antecedents to effective leadership
– Describe essential training all physician-leaders should be given
– Demonstrate how to develop and maintain physician-leader engagement
• We’ll use storytelling to accomplish these goals
Objectives
2

3. Invokes memories
Makes it relatable
Adds the humanistic touch
Keeps you from getting too bored
Storytelling…
3
Boje, D. M., Rosile, G. A., Saylors, J., & Saylors, R. (2015). Using storytelling theatrics for leadership training. Advances in Developing Human
Resources, 17(3), 348-362. doi:10.1177/1523422315587899
Silverman, E. (2017). Sharing and healing through storytelling in medicine. JAMA Internal Medicine, 177(10), 1409-1410.
doi:10.1001/jamainternmed.2017.2996

4. Goals
4
“People with goals succeed because they know where they’re going.”
– Earl Nightingale, Author/Radio Host
“Goals are dreams with deadlines.”
– Diana Scharf, Author

5. • Align organization to a common set of guiding principles
• Encourage energy and focus to move in a single direction
• Garnish engagement from every contributor
• Create a platform to interface with other entities
• Provide consistency of messaging to internal and external stakeholders
• Built around a concise framework
• Developed with a vision
• Constructed as SMART (specific, measurable, attainable, relevant, timely)
goals
Goals

6. • Through clinical leadership, physicians provide the single greatest
influence on safety, quality, and cost in healthcare
• Their role as clinical leaders often leads to administrative titles – but
not always to administrative leadership training
• Physicians overcome the training deficit by using their innate
personality preferences and autonomous clinical training as a guide
Physician-Leadership
6
Aranda, R., & Tilton, S. (2013). Myers-Briggs personality preferences may enhance physician leadership success in non-clinical jobs. Physician
Executive Journal, 39(3), 14-20. Retrieved from https://www.physicianleaders.org/publications/journal
Nigam, A., & Gao, M. (2017). The future of clinical leadership: The critical role of front-line doctors. BMJ Leader, 1(4), 33-35. doi:10.1136/leader-
2017-000021
Quinn, J. F., & Perelli, S. (2016). First and foremost, physicians: The clinical versus leadership identities of physician leaders. Journal of Health
Organization and Management, 30(4), 711-728. doi:10.1108/JHOM-05-2015-0079
Xirasagar, S., Samuels, M. E., & Stoskopf, C. H. (2005). Physician leadership styles and effectiveness: An empirical study. Medical Care Research
and Review, 62(6), 720-740. doi:10.1177/1077558705281063

7. • It works a significant portion of time
– Physicians’ personality preferences differ proportionally to general society
– However, they match exactly with the distribution of preferences present among
organizational leaders across all industries
• But it’s not a guaranteed success
– Extraversion vs Introversion
• Charisma vs Proactivity
• Leader-Member Exchange Quality and Empowerment
– Command and Control vs Distributed Leadership
Physician-Leadership
7
Aranda, R., & Tilton, S. (2013). Myers-Briggs personality preferences may enhance physician leadership success in non-clinical jobs. Physician
Executive Journal, 39(3), 14-20. Retrieved from https://www.physicianleaders.org/publications/journal

8. • Ann G.
– Surgeon
– Seasoned veteran at a high-tech, high socioeconomic burden academic center
– Highly respected in her institution, city, state, and country for her dedication and
clinical skills
– Revered, respected, and perhaps feared
• Administrative leadership through commitment, time-served, and
clinical prowess
Now It’s Time for a Story
8

9. • Cognitive flexibility
• Charisma and Enthusiasm
• Integrity and Trust
• Emotional Intelligence
• Psychological empowerment
• ACCOUNTABILITY
– Execution
– Sustainment
• Able to build and communicate a vision that
encompasses the reason for change
• Believes in and sells the vision
• Has a clear roadmap to the future state and
recites it relentlessly
• Influences through words and deeds
• “Reads” the actions and emotions of followers
and adapts to engage them
• Holds herself and others accountable for the
change action
9
Elements of a Change Leader
Northouse, P. G. (2016). Leadership: Theory and practice (Seventh ed.). Washington, DC: SAGE.
Stilwell, R., Pasmore, W. A., & Shon, D. (2016). Change leader behavioral inventory Development
and validation of an assessment instrument. The Journal of Applied Behavioral Science,
52(4), 373-395. doi:10.1177/0021886316663406

10. Not all periods are those of rapid change
Sustaining change takes a different approach
Evolutionary change adds a whole new dimension
Adapting to the Times
10

11. • Empowerment at all levels
• Team-based approaches to care
• Leadership training for physicians
• Effective communication pathways
• Physicians meaningfully engaged in key leadership positions
Healthcare Organizations that Perform Best
11
Alloubani, A. M., Almatari, M., & Almukhtar, M. M. (2014). Review: Effects of leadership styles on quality of services in healthcare. European Scientific Journal, 10(18). doi:10.19044/esj.2014.v10n18p%25p
Kristensen, S., Christensen, K. B., Jaquet, A., Beck, C. M., Sabroe, S., Bartels, P., & Mainz, J. (2016). Strengthening leadership as a catalyst for enhanced patient safety culture: A repeated cross-sectional
experimental study. BMJ Open, 6, e010180. doi:10.1136/bmjopen-2015-010180
Shekelle, P. G., Pronovost, P. J., Wachter, R. M., McDonald, K. M., Schoelles, K., Dy, S. M., . . . Walshe, K. (2013). The top patient safety strategies that can be
encouraged for adoption now. Annals of Internal Medicine, 158(5 (Part 2)), 365-368. doi:10.7326/0003-4819-158-5-201303051-00001
Trybou, J., Gemmel, P., Desmidt, S., & Annemans, L. (2017). Fulfillment of administrative and professional obligations of hospitals and mission motivation of
physicians. BMC Health Services Research, 17(28), 1-10. doi:10.1186/s12913-017-1990-0

12. • ACCOUNTABILITY
– Execution
– Sustainment
• Psychological empowerment
• Transformational Development
• Emotional Intelligence
• Integrity and Trust
• Charisma and Enthusiasm
• Cognitive flexibility
• Holds himself and others accountable
• Hires effective people and grows them for
success in their role
• Sets and communicates clear expectations
• Listens, removes barriers, and empowers
front-line decision-making
• Remains visible and supportive
• Sets and communicates a clear vision
• Is willing to change and adapt the plan when
indicated at any level of the organization
12
Elements of an Evolutionary Change Leader
Northouse, P. G. (2016). Leadership: Theory and practice (Seventh ed.). Washington, DC: SAGE.

13. • Tim F.
– Medical sub-specialist
– Seasoned veteran at a high-tech, high socioeconomic burden academic center
– Highly respected in his institution for his service and clinical skills
– Respected and well liked
• Administrative leadership through likability, time-served, and clinical
prowess
A New Story
13

14. • Tony R
– Family physician/primary-care sports medicine
– Spent 15 years in practice maximizing individual and team performance in a
sports setting
• Watched a lot of line leaders (ie. coaches)
• Watched a lot of referent leaders (ie. quarterbacks)
– Got a degree in IT Management
– Spent hundreds of hours in mandatory leadership development courses
– Even spent some time learning from psychologists and organizational
development specialists
– Opted for a research degree in leadership, focused on physicians as leaders
• I was bored
• I thought it would be a good example for my adolescent sons
Final Story
14

15. • Emotional Intelligence
– Self-awareness
– Self-regulation
– Motivation
– Empathy
– Social skills
• Transformational leadership
– Charisma
– Inspiration motivation
– Intellectual stimulation
– Individual consideration
15
Leadership Styles to Get You
(and your new physician-leaders)
Started

16. • Cognitive flexibility
– Communication variability
– Complexity decision-making
– Self-determination
– Creativity and innovation
– Divergent thinking
– Behavioral adaptability
• Situational leadership
– Delegating
– Supporting
– Coaching
– Directing
16
Other Concepts to Get You
(and your new physician-leaders)
Started
Blanchard, K. H., Zigarmi, D., & Nelson, R. B. (1993). Situational leadership after 25 years: A retrospective. Journal of
Leadership & Organizational Studies, 1(1), 21-36.
doi:10.1177/107179199300100104
Reiter-Palmon, R. (2003). Predicting leadership activities: The
role of flexibility. Psychology Faculty Publications, 13.
Retrieved from http://digitalcommons.unomaha.edu/psychfacpub/13

17. Composition of Leadership Style
Personality
•Myers-Briggs
•Introvert/extrovert,
sensing/intuitive,
thinking/feeling,
judging/perceiving
•16 distinct types
•Hermann Brain
Dominance Index
•Analytical, organized,
feeling, holistic
•1 primary and 2
secondary
•DISC
•Dominance, Influence,
Steadiness,
Conscientiousness
•Everyone is a blend of
all 4 in different
proportions
Mindset
•Transformational/
People oriented
•Focus on building
relationships
•Build up people and
teams
•Examples
•Servant
•Charismatic
•Transactional/Task
oriented
•Focus on achieving
specific tasks,
accomplishments, goals
•Rewards system for
positive exchanges
•Examples
•Command-and-
control
•Management by
exception
Approach
•Goleman – Primal
Leadership or Emotional
Intelligence
•Commanding
•Visionary
•Affiliative
•Democratic
•Pacesetting
•Coaching
•Hersey & Blanchard -
Situational
•Delegating
•Supporting
•Coaching
•Directing
•Lewin
•Authoritarian
•Democratic/
Participative
•Delegative/Laissez-
faire
Follower Theory
(behavior)
•McGregor – Human
Nature
•Theory X
•People are passive,
dislike work, need to
be strictly overseen
•Theory Y
•People are
responsible,
trustworthy, perform
to the highest level
•Implicit leadership &
followership theories
•Lead or be led based
on how the individual
believes he or she
should (or wants) to be
led
•Motivations of followers
•Position-based
•Calculated
•Safety-based
•Meaning-based
•Identification-based
Communication
Style (exchange)
•Leader-Member
Exchange
•Dyadic relationship
•Partnership
•Empowerment
•Cognitive flexibility
•Adaptation of thinking
and communication
for the situation
•More direct when
necessary, politically
correct when needed,
etc

18. References
Alloubani, A. M., Almatari, M., & Almukhtar, M. M. (2014). Review: Effects of leadership styles on quality of services in healthcare. European Scientific Journal, 10(18).
doi:10.19044/esj.2014.v10n18p%25p
Aranda, R., & Tilton, S. (2013). Myers-Briggs personality preferences may enhance physician leadership success in non-clinical jobs. Physician Executive Journal, 39(3), 14-20. Retrieved
from https://www.physicianleaders.org/publications/journal
Blanchard, K. H., Zigarmi, D., & Nelson, R. B. (1993). Situational leadership after 25 years: A retrospective. Journal of Leadership & Organizational Studies, 1(1), 21-36.
doi:10.1177/107179199300100104
Boje, D. M., Rosile, G. A., Saylors, J., & Saylors, R. (2015). Using storytelling theatrics for leadership training. Advances in Developing Human Resources, 17(3), 348-362.
doi:10.1177/1523422315587899
Kristensen, S., Christensen, K. B., Jaquet, A., Beck, C. M., Sabroe, S., Bartels, P., & Mainz, J. (2016). Strengthening leadership as a catalyst for enhanced patient safety culture: A repeated
cross-sectional experimental study. BMJ Open, 6, e010180. doi:10.1136/bmjopen-2015-010180
Nigam, A., & Gao, M. (2017). The future of clinical leadership: The critical role of front-line doctors. BMJ Leader, 1(4), 33-35. doi:10.1136/leader-2017-000021
Northouse, P. G. (2016). Leadership: Theory and practice (Seventh ed.). Washington, DC: SAGE.
Quinn, J. F., & Perelli, S. (2016). First and foremost, physicians: The clinical versus leadership identities of physician leaders. Journal of Health Organization and Management, 30(4), 711-
728. doi:10.1108/JHOM-05-2015-0079
Reiter-Palmon, R. (2003). Predicting leadership activities: The role of flexibility. Psychology Faculty Publications, 13. Retrieved from http://digitalcommons.unomaha.edu/psychfacpub/13
Shekelle, P. G., Pronovost, P. J., Wachter, R. M., McDonald, K. M., Schoelles, K., Dy, S. M., . . . Walshe, K. (2013). The top patient safety strategies that can be encouraged for adoption now.
Annals of Internal Medicine, 158(5 (Part 2)), 365-368. doi:10.7326/0003-4819-158-5-201303051-00001
Silverman, E. (2017). Sharing and healing through storytelling in medicine. JAMA Internal Medicine, 177(10), 1409-1410. doi:10.1001/jamainternmed.2017.2996
Stilwell, R., Pasmore, W. A., & Shon, D. (2016). Change leader behavioral inventory Development and validation of an assessment instrument. The Journal of Applied Behavioral Science,
52(4), 373-395. doi:10.1177/0021886316663406
Trybou, J., Gemmel, P., Desmidt, S., & Annemans, L. (2017). Fulfillment of administrative and professional obligations of hospitals and mission motivation of physicians. BMC Health
Services Research, 17(28), 1-10. doi:10.1186/s12913-017-1990-0
Xirasagar, S., Samuels, M. E., & Stoskopf, C. H. (2005). Physician leadership styles and effectiveness: An empirical study. Medical Care Research and Review, 62(6), 720-740.
doi:10.1177/1077558705281063

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