While at the US Department of Health and Human Services I began looking at telemedicine, a way to leverage technology to bring medical care outside the traditional locations to see clinicians – hospitals and offices. I realized the technology was easy. Implementing its use was hard. Hard because of personalities, hard because becoming an effective leader or manager takes time and hard because we physicians aren’t trained to manage people. We’re trained to give orders (I even wrote an book that included the challenges: Telemedicine and Telehealth: Principles, Policies, Performance and Pitfalls.)

During my tenure at the Veterans Health Administration I observed over and over the results of not listening to all involved, of not acknowledging others’ suggestions (whether or not you followed them), and of trying to implement change from the top down. VA shut down BearingPoint’s Core Financial and Logistics System (Core FLS) after taxpayers paid $278 million. It’s easy to point fingers. It’s harder to sort through systems issues that guarantee failure. And you need folks in charge who are seasoned, expert leaders—but that’s not one of the subjects of medical school.

My journey from clinician to manager and leader was fraught with missteps, anger and confusion, as shared in “The Essential Difference between Managing in Medicine and Management in Business.” According to Google’s research, the most important skills are not generally taught in medical school: the most important characteristic of their best teams is emotional safety. That’s right – no pimping and no bullying. Both actions are embedded in medical student education, residency training, and the Republic of Medicine. STEM (Science, Technology, Engineering and Math) knowledge is the least important individual characteristic for those in the best teams.

From the selection process through success in medical school and residency, test scores in science and performance on rounds (the herd of physicians, fellows, residents, interns and medical students that go from patient to patient on hospital wards) are rewarded. We teach what we learn, and systems tend to reinforce themselves – unless you add something to help them find a new equilibrium. So Jack Penner, a Georgetown University School of Medicine student and I began coaching as a method of teaching and supporting the personal and leadership learning which has been missing for medical students. We created and implemented A Whole New Doctor, a program to provide pro bono coaches for medical students.