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Doctors Aren’t Leaders and Pigs Can Fly

By October 9, 2016 April 4th, 2019 No Comments

If you have a little extra time on your hands and want to read some nonsense, then go ahead and google, Why doctors don’t make good leaders. You’ll find headlines like:

It goes on and on, but the notion that doctors make poor leaders is just hogwash. Let me go on record as saying that with rare exception all doctors are strong, amazing, competent leaders.

That’s right, you don’t need to turn us into leaders; we are born leaders!

We aren’t interested in some contrived list of reasons why doctors are lost little lambs in need of shepherding either.

What they are really saying is that doctors aren’t good followers.

Let me explain:

To most doctors, the patient-physician relationship is sacrosanct. It is our job to provide clinical excellence and advocate for our patients in every realm including with bureaucratic agencies that would seek to deny them needed care.

Our leadership is on their behalf as that is where our true allegiance lies.

Unfortunately, healthcare has changed. Doctors are no longer in charge. The government bureaucrats, hospital administrators, and other third party payers have inserted themselves into the driver seat.

Their priorities are different than ours.

They speak less about individual patient care and more about “cost containment” and “population health” as well as “consolidation” and “health care spending”. Their focus is less about patients and more about money.

Those same third parties that hijacked medicine want doctors to follow their lead. In fact, they want us to become cost control leaders. As you can imagine, focusing on the cost of care instead of quality patient care doesn’t sit well with many of us.

Knowing that it wouldn’t sit well with patients either, these third parties use deceptive marketing terms like “quality care” or “value-based care” to sway an unsuspecting public that their intentions are somehow noble.

Unfortunately, when the priority is saving money and not quality patient care there is bound to be conflicts. These conflicts manifest themselves in the form of foolish mandates with a real potential for harm.

Take for example:

The government mandate of patient satisfaction scores; We doctors knew that was a terrible idea and it turns out that higher satisfaction correlates with higher mortality.

How about CMS penalties for readmission?

Again, another mandate that looks to be flawed. A recent research article found that the mortality rates for patients treated for heart failure, COPD, and strokes had better mortality scores at hospitals with higher readmission rates than those at lower ones.

And do I even need to mention the debacle that is the electronic medical record?

Is it any wonder why we are bad followers?

This inept push to cut costs in healthcare has real consequences for patients and we doctors will not be complicit.

It is this resistance from doctors to comply with the powers that be that has lead to all of this hooey about doctors being poor leaders.

If you have a little more time on your hands, now google “physician leadership training.”

Wow! There has been an explosion of training programs out there to teach doctors “how to be leaders.” However, this isn’t the leadership training we all got in medical school and residency.

No, this is less about being a strong patient advocate and more about getting doctors to comply.

Consider these statements from one of those doctor leadership-training websites:

“A shared history and a common language give physician leaders the credibility among their colleagues and other providers needed to garner critical support for clinical integration.”

“This allows driving the value agenda for initiatives such as reducing variations in care, reducing readmissions, developing a patient-centered medical home, implementing best practices and other value-driven initiatives.”

“If you have physician leaders, you are more likely to have the medical staff follow the organization’s direction; They’re much more likely to follow other physicians than they are administrators.”

There you have it, this has nothing to do with leadership. This is all about getting the medical staff to follow the organization’s direction.

And if doctors won’t listen to hospital administrators, insurance company executives, or the government bureaucrats, then maybe just maybe one of their own can convince them that quality patient care should take a back seat to cost containment.

Healthcare is broken and the fight to preserve quality patient care has lost out to the almighty dollar. To the winners goes the spoils and the government will continue to pass crushing regulation designed to get us in line with their agenda.

Value-based care doesn’t come from a government mandate or a computer algorithm. And training doctors to coerce other doctors into complying with nonsensical mandates is not the definition of leadership.

True leadership in medicine always has been and always will be about doing what is right for patients.

There are roughly 900,000 doctors in this country who go to work every day and apply their expertise and advocacy for the good of the patient.

Now that is real leadership!

Dennis Bethel, M.D.

About the Author: Dennis Bethel is an ER physician and a real estate investor who blogs about both on his website NestEggRx. Medicine is changing and he believes strongly in the power of passive income to create options for doctors that allow them to practice medicine on their terms.

If you’d like to learn more about creating passive income outside of medicine using real estate, check out:

Multifamily Real Estate Investing 101; What Every Doctor Should Know About Investing in Apartments

 

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Dennis Bethel

Dennis Bethel

After 18 years of working in the trenches of a broken health care system, Dennis Bethel, M.D. extricated himself from medicine utilizing the power of passive income from real estate. Now he helps others conquer their number one financial fear, cut their biggest expense, and tame the greatest threat to their careers.

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