Depending on one’s professional background, some coaches may well be able to provide guidance on some of these “hard” topics, such as finance and operations management. Coaching, however, is not meant to be a mini-MBA. Without enough business knowledge, physician leaders sometimes feel they are “outside” the world of their administrative colleagues and unable to build the business case to influence or drive initiative’s they know to be important. Many physicians I work with go on to get their MBA’s, take in-depth management courses, or make a concerted effort to build their business, economic, financial, and policy knowledge. Understanding the business of health care deepens their ability to interpret what is happening in their institution and make leadership decisions with strong financial, operational, and organizational acumen.

That being said, physicians are quick learners. They know that once they gain hard business knowledge, they still need to understand the art of leadership. As coaches, we can guide them to build self-awareness and learn about leadership through the many small lessons of everyday experience. One client told me, “I feel like I’m building the plane while I’m flying it.” That pretty much sums it up.

Becoming The Boss

One of the first adjustments a physician makes when transitioning into a major leadership role, is becoming the “boss” of their colleagues. On Friday they are “one of them” and on Monday they are “with the administration.” The impact of this shift can be felt in ways both large and small.

Jeff was a client who had recently been named Chair of Emergency Medicine at the largest ER in his state. He had trained at this institution and worked in the ER for many years. Jeff considered his former chairman a wonderful and wise mentor and Jeff planned to model his predecessor’s leadership approach; support the physicians, oversee good medicine, and keep up the academic success of the department.

What Jeff did not understand was how much pressure had built up on the department and how fast financial reform and quality demands needed to be met. The administration sent in a non-physician health care consultant without specific ER experience and the consultant went about his job with a zealous efficiency. Jeff and the medical providers, who were not included in this decision, were dragged in as reluctant participants who felt they were quite capable of leading change on their own. The nursing staff was more aligned with the consultant and the ER quickly devolved into an “us” vs. “them” mentality.