The Healthcare Crisis: The Urgent Need for Physician Leadership

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Larry Goodman, MD. Goodman is the James A. Goodman has overseen various expansion projects at Rush, such as opening a 40,square-foot outpatient care center in Chicago's South Loop and plans to acquire Evergreen Park, Ill. Prior to joining Rush, Dr. Goodman served as the medical director of Cook County Hospital in Chicago. Robert Grossman, MD. Saul J. In November Dr. Grossman was named a "living landmark" by the New York Landmarks Conservancy for his support in the aftermath of Hurricane Sandy, which required the health system to evacuate patients. Jamal Hakim, MD. COO of Orlando Fla.

Hakim has served in various leadership positions at Orlando Health since , including chairman of the anesthesia department at Orlando Health's Arnold Palmer Medical Center, chief of staff and the health system's first chief of quality and clinical transformation. Today, Dr. Lisa E. Harris, MD. Harris oversees nearly 5, staff members as medical director and CEO of Eskenazi Health, a role she has held since Along with her leadership positions at Eskenazi Health, Dr.

Harris maintains posts as associate dean and professor of medicine at Indiana University School of Medicine in Indianapolis and serves as president of the board of directors of the American Red Cross of Indiana. Marc Harrison, MD. Harrison, a pediatric critical care specialist, began serving as president and CEO of Intermountain Healthcare in Prior to joining Intermountain Healthcare, Dr.

Harrison was the chief of international business development for Cleveland Clinic. University Health. Hart, who joined Loma Linda University Health in , was appointed president of the organization in after taking on the post of CEO in A board-certified physician in preventive medicine, Dr. Hart has also served as director of the organization's center for health promotion and dean of the school of public health. He holds a doctor of public health from Johns Hopkins University in Baltimore, and while working toward his degree, Dr. Hart practiced in Tanzania, where he helped develop the department of community health in Moshi.

Cottage Hospital. Hartmann joined the hospital as a physician in the emergency department in , prior to taking on the posts of president and CEO in In her leadership roles, she has been credited with guiding the hospital through a financial turnaround. Scott Hayworth, MD. Hayworth was appointed president and CEO of CareMount Medical in , one decade after he joined the practice as an obstetrician-gynecologist. He is an advocate for patient care and disease management, having served on the board of the American College of Obstetricians and Gynecologists for six years and the board of the American Medical Group Association for eight years.

Rodney Hochman, MD. Joseph Health Renton, Wash. Hochman helped lead Renton, Wash. Joseph Health in the merger to create Providence St. Joseph Health, a nonprofit health and social services system. Hochman oversees , caregivers in 50 hospitals and more than clinics as president and CEO of Providence St. Joseph Health. He is a board member for the American Hospital Association, and in he was named "innovator of the year" by Press Ganey.

Michael R. Jaff, DO. President of Newton Mass. Jaff, a practicing vascular physician and professor of medicine at Boston-based Harvard Medical School, assumed the role of president at Newton-Wellesley Hospital in Jaff served as medical director of the Center for Specialized Services and the Fireman Vascular Center at Massachusetts General Hospital in Boston, where he also held the role of director of care redesign. Jaff founded VasCore, a vascular ultrasound core laboratory for peripheral vascular devices and pharmacological trials.

Larry Kaiser, MD. Kaiser, a professor of thoracic medicine and surgery, holds many leadership positions at Temple University in addition to his health system posts, including senior executive vice president for health affairs and the Lewis Katz dean at the school of medicine. As CEO, Dr. Kaiser oversees the health system's flagship Temple University Hospital, a bed hospital in Philadelphia, its two campuses and its cancer center as well as affiliated physician practices.

Alan S. Kaplan, MD. He previously served as chairman of the board of the American Association of Physician Leadership.

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Kaplan, an emergency medicine physician, earned a master's in medical management from Carnegie Mellon University in Pittsburgh. Gary Kaplan, MD. Kaplan has continued to practice as an internal medicine physician while holding his post as chairman and CEO of Virginia Mason Health System, a role he assumed in Donald Kearns, MD.

Kearns has spent more than 30 years serving the bed hospital, joining Rady Children's as an otolaryngologist in and rising through the ranks to his post as president and CEO. Kearns, who plans to retire from his leadership roles by the end of , will continue to serve the hospital as an adviser, focusing on key initiatives such as genomics and philanthropy.

Mark A. Keroack, MD. As CEO, he oversees Bay State's academic medical center, three community hospitals, a children's hospital, a network of more than 80 medical practices and Health New England, the system's subsidiary health plan. A trained internal medicine and infectious disease physician, Dr. Narendra Kini, MD. Kini served as executive vice president of clinical operations improvement for Novi, Mich.

He is a board-certified pediatric emergency medicine physician who trained at Children's Hospital of Wisconsin in Milwaukee, where he served as vice president of clinical and support services. Stephen Klasko, MD.

Most Doctors Have Little or No Management Training, and That’s a Problem

Klasko served as dean of two medical colleges and head of three academic health centers before taking the helm at Jefferson Health in Under his leadership, Jefferson Health has transformed into a hospital academic health system with more than 30, employees and 6, practitioners. He has published three books on healthcare and is editor in chief of the journal Healthcare Transformation. In , Fast Company named Dr. Arthur Klein, MD. Klein, who was named president in , oversees Mount Sinai Health Network's group of more than clinical relationships, including 18 affiliated hospitals, five nursing homes and 12 physician group practices.

Thomas Kloos, MD. As head of Atlantic Management Services, Dr. Atlantic and Optimus ACOs, which were among the first to participate in the Medicare Shared Savings Program in , serve 80, Medicare patients and more than , commercial patients. He is a member of the National Association of Accountable Care Organizations and was elected vice chair in Mark Laney, MD. Joseph, Mo. As CEO, Mr. Laney oversees a medical center and more than 60 clinical facilities in a county service area in Missouri, Kansas and Nebraska.

He completed a pediatric neurology fellowship at Rochester, Minn.

James Leonard, MD. Leonard has more than 30 years of experience with the Carle Foundation, first joining the Carle Clinic Association in as a primary care physician. He served in numerous leadership roles at the system, including associate medical director of the Carle Clinic and vice president of medical affairs of the Carle Foundation, before stepping into the CEO role in after one year as interim CEO.

Under his oversight, the nonprofit has undergone a five-story patient tower expansion and acquired the Carle Clinic Association and Health Alliance medical plans. Alan List, MD. List is a senior member in the department of malignant hematology and experimental therapeutics program. Before joining Moffitt in , Dr. List served as a professor of medicine and director of the leukemia and bone marrow transplant program at the University of Arizona in Tucson. He's authored more than peer-reviewed articles and is an active member of numerous professional societies, including the American Society of Clinical Oncology, the American Society of Hematology and the American Association for Cancer Research.

Lockhart served as CMO of Sutter Health's East Bay region and chief administrative officer and medical administrative director of surgical services at the St. He is a board-certified anesthesiologist and a national leader in health equity. Lockhart oversaw the design and implementation of Sutter Health's health equity program and health equity index to reduce healthcare disparities among its nearly 3 million patients. He was also named to California Gov. Jerry Brown's Precision Medicine Advisory Committee in to help advance the state's use of computing and technology to better understand and prevent disease.

David Luna, MD. Luna's passion for healthcare stems from his childhood in New Mexico, where he discovered poor populations and ethnic minority groups did not have adequate access to high quality healthcare. Luna oversees the medical team and clinical operations for the clinic's three health centers, which serve more than , patients annually. He led the clinic through a yearlong transformation of clinical operations, which helped Saban Community Clinic achieve a 30 percent reduction in no-show rates, 35 percent reduction in average cycle time and boost patients' access to care.

Dennis Lund, MD.

Lund has more than 30 years of leadership experience in pediatric healthcare, starting his career as a pediatric trauma and transplant surgeon. In his current posts, Dr. Lund manages the largest pediatric and obstetric healthcare network in Northern California, with more than 60 healthcare locations. He also serves as associate dean of faculty for pediatrics and obstetrics at Stanford University School of Medicine. William Lunn, MD. Lunn started his career as a private practice physician in pulmonary and critical care medicine before cultivating a career in healthcare administration.

His first foray into healthcare leadership occurred at Houston-based Baylor College of Medicine, where he became a founding member and first director of the college's Complex Airway and Pleural Disease Center in He also served as assistant dean of clinical affairs and vice president of medical affairs during his five years there.

Mazziotta, a member of the National Academy of Medicine and the Royal College of Physicians, has authored more than research papers and eight texts. Michael McDermott, MD. Under his leadership, the health system launched a comprehensive strategic pricing analysis to improve net revenue and rolled out a high-reliability patient safety program in with the goal of reducing preventable harm by 80 percent within two years.

Sonia Mehta, MD. Under her leadership, Loretto launched a telestroke service and opened a retail pharmacy. Before coming to Loretto, Dr. Mehta worked with Springfield, Ill. Tomislav Mihaljevic, MD. Mihaljevic joined the Cleveland Clinic in as a cardiothoracic surgeon specializing in robotically assisted cardiac surgeries.

In his role, Dr. Mihaljevic oversees 52, caregivers, including 3, physicians and scientists in its 1,bed main campus and 10 regional hospitals. Mihaljevic, who won the Cleveland Clinic Innovation Award in and , has authored or co-authored more than articles in medical and peer-reviewed journals. Redonda Miller, MD. President of Johns Hopkins Hospital Baltimore. Miller, who assumed her role as the 11th president of Johns Hopkins Hospital in , is the first woman to hold the title in the organization's year history. Miller previously served as vice president of medical affairs for Johns Hopkins Hospital from to and senior vice president of medical affairs for Johns Hopkins Health System.

She has twice been named one of Maryland's top women by The Daily Record and one of Baltimore's best doctors and best doctors for women by Baltimore magazine. Lori Morgan, MD. Morgan, who has more than 30 years of medical and healthcare administration experience, was appointed president and CEO of Huntington Hospital in September After earning her medical degree from Seattle-based University of Washington School of Medicine, completing her surgical residency at Stanford Calif.

Lawrence Moss, MD. Moss is a pediatric surgeon who has made a name for himself in biomedical research, education and health system leadership. While leading 12 departments at Nationwide Children's, Dr. Moss organized the first multicenter clinical trial in pediatric surgery. He has held leadership roles at Yale New Haven Conn. Children's Hospital and Stanford Calif. John Murphy, MD. Hospital and Norwalk Conn. On top of his duties at the helm, Dr. Murphy volunteers on several medical boards and committees, and recently became chairman of the executive committee of the Connecticut Hospital Association.

Murphy began his career as a physician in clinical neurology as a member of the Associated Neurologists of Danbury. Magida Award for "demonstrated notable capability in patient treatment and care" from the Fairfield County Medical Association and the Richard and Hinda Rosenthal Foundation.

Elizabeth Nabel, MD. President of Brigham Health Boston. Nabel, a cardiologist, biomedical researcher and distinguished medical journal author, also is a professor of medicine at Harvard Medical School. She previously served on the editorial board of the New England Journal of Medicine and was editor-in-chief of the Scientific American. Daniel Napierkowski, MD. He joined the health system in as a staff anesthesiologist and later became chairman of Cleveland Clinics' Regional Practice Anesthesiology, where he oversaw 70 anesthesiologists and certified registered nurse anesthetists.

Brian Nester, DO. Nester was appointed president and CEO of Lehigh Valley Health Network in after serving as the health network's chief strategy officer for more than three years. Nester oversees nine hospitals on eight campuses and more than 40 primary and specialty care clinics that have more than 1, primary care and specialty care physicians. He continues to practice as a board-certified emergency physician at the hospital system and is a guest lecturer at Columbia University's Graduate School of Business and Mailman School of Public Health. Janice Nevin, MD. Under her leadership, Christiana Care became a founding partner in eBrightHealth, an alliance of health systems aimed at improving the quality and affordability of care, as well as the eBright Health ACO.

Menser Award from the Wilmington Senior Center, for her commitment to improving the health of older adults. Kurt Newman, MD. Newman began his medical career at Children's National as a surgical fellow in , later becoming surgeon-in-chief and senior vice president for the Joseph Robert Center for Surgical Care in before being appointed president and CEO in Newman oversees more than 6, employees, including 1, nurses and nearly physicians who helped care for 15, emergency room visits, , outpatient visits and , surgery cases in Under his leadership, Children's National launched the first pediatric rare disease institute in the U.

Chamber of Commerce. John H. Noseworthy, MD. Noseworthy was appointed president and CEO of Mayo Clinic in , capping his year career with the health system. Prior to taking the helm, he served as the chair of Mayo Clinic's department of neurology, medical director of the department of development and vice chair of the Mayo Clinic Executive Board. As a neurologist by training specializing in multiple sclerosis, Dr. Noseworthy also spent more than two decades designing and conducting patient clinical trials.

He has authored more than research papers, editorials and books and served as editor-in-chief for Neurology, the official journal of the American Academy of Neurology. Steven Packer, MD. Previously, he served as chief of staff and medical director of the hospital's intensive care unit. He oversees a bed facility that had 12, inpatient admissions and , outpatient visits in Quick decision - making based on situational analysis, knowledge and experience is expected of medical leaders in extremely difficult situations.

Our experience suggests that a medical leader who is not qualified enough would not make the correct decisions under pressure or would be too slow to react on time. Different types of decisions are required during emergency management both at the leader level and at the individual level. Many of them, like hospitalization dynamics, work load of professional personnel, and level of security, have the potential to threaten the accomplishment of the mission, but probably the most complicated for the medical leader in emergency scenarios are the unusual ethical dilemmas.

Emergencies and disasters posit personal, professional, and public interests one against the other and create complex ethical dilemmas which are at the center of emergency management. These dilemmas include treatment priorities, triage considerations, dealing with surge capacity and resource allocation according to survival chances and not according to the individual needs. Medical leaders must be prepared to confront these complex ethical issues in order to be able to make decisions and take relevant action [ 13 ]. We encourage medical leaders to use generic tools during emergencies, but also to create on-site leadership supporting mechanisms, adjusted to the specific environment, that will help establish an ethical and practical system of medical priorities in a chaotic setting.

Such a structured system of decision making was described by us [ 7 ] and similar processes were reported by others after the strike of Hurricane Katrina in and after Hurricane Sandy in [ 17 — 19 ]. A major role for the leader, is to continuously strengthen the team endurance before the mission, and more importantly, during the mission. Building this kind of endurance in a disorganized setting requires leaders to take-care of their teams, to understand their needs even before they are expressed, and to identify desires, ambitions, tensions and fears in order to steer them effectively towards the mission.

This can be challenging for medical leaders because their team may be laboring under a heavy work load, exposed to mental and physical stress, or confronting significant risks. To deal with these challenges Hannah et al. Leaders have to understand the milieu of their team and their organizational behavior and work continuously to motivate them to build and strengthen their commitment to the mission. When trying to strengthen team cohesion and minimize the mental burden during emergencies situations, medical leaders should address several aspects:. The anti - chaos effect The best way to manage and motivate people working in a disorganized environment or chaos is to create order.

Medical leaders should enhance transformation of individual professionals into a team with strong cohesion using ceremonies and symbols, operating under a strict schedule and organizational discipline, and establishing order when needed [ 5 , 19 ]. Sharing information and exposing people to the general picture may help them cope better with the stress, but sometimes it may cause frustration and increase the mental burden. Rest and debriefing effect When faced with people who are in danger and need of assistance, medical personnel in emergency situations tend to work themselves around the clock and quickly wear themselves out.

This can lead people to work less effectively with time and may endanger their mental health. The leader should sometimes work against this tendency and force his staff to rest and re-charge. Another important task of the leader is to establish mechanisms for mental debriefing on a regular time schedule in order to provide them with the opportunity to relieve stress. This task should continue even after the mission ends, due to late onset of reactions to such scenarios among medical personnel [ 20 ]. Leadership is one of the most researched social phenomena, with a wide spectrum of definitions, parameters and theories.

Certain parameters discussed in our model are generic and might apply to leadership in emergency situation not specifically medical ones; nevertheless, medical leadership has its own uniqueness and complexity as discussed above. Regardless of their background, education, training, environment and skills, each leader will use a different leadership style by finding a unique element within themselves, embracing it and using it. No matter which model is used, the most important factor for effective leadership is the interface between personality, skills and capabilities, the interaction with those being led and influencing the immediate surrounding environment.

Effective leaders should possess the ability to switch between leadership styles suited to the different situations and adjust them accordingly [ 22 ]. Effective crisis leadership lies also on the understanding that the inflow of knowledge is so extensive that one person, cannot contain the entire scope of information [ 23 , 24 ], and therefore, as Pearce suggests, leadership is actually an outcome of a web interaction of groups rather than just a direct influence of a leader [ 25 , 26 ]. This dynamic leadership evolves while different proxies interact inside this web and create new types of behaviors and actions making those organizations more creative, flexible, adaptive and affective to deal with the uncertainties.

The leadership role, accordingly, is to create those opportunities for creativity and innovativeness. Our suggested model incorporates the required skills and capabilities developed in times of quiet in preparedness for times of emergency. Assuming that effective leadership requires basic personal capabilities and motivation in order to lead and influence others, one should bear in mind that it can be built and developed just as any other skill [ 27 ].

Therefore, accepting a comprehensive conceptual model to be used as the core for education, training and preparedness is of great importance. All authors read and approved the final manuscript. Oded Hershkovich and David Gilad contributed equally and each should be considered as primary author. Oded Hershkovich, Phone: , Email: moc.

An Urgent Call to Action - Preventing Physician Burnout

David Gilad, Email: li. Eyal Zimlichman, Email: moc. Yitshak Kreiss, Email: moc. National Center for Biotechnology Information , U. Journal List Disaster Mil Med v. Disaster Mil Med. Published online Feb 6. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Dec 12; Accepted Jan This article has been cited by other articles in PMC.

Background Being at the center of clinical service delivery, physicians are the ideal leaders for health care in the twenty-first century [ 1 ]. The model The suggested model is integrative and arranged around two sets of skills: The first are the basic leadership skills—those required for medical leadership mostly during quiet times and that may be adapted to emergency situations.

Basic leadership skills Basic leadership skills include: operating with clear vision and organizational values, implementing strategic and tactical planning and developing communication, negotiation and collaboration skills. Strategic planning is a necessity for medical leadership Unfortunately, young physicians, who focus on a daily, tactical level that is primarily one-on-one patient—physician interaction, come out of medical school with an inadequate ability to implement strategic thinking. Communication, negotiation and collaboration as a strategy Leadership is not only about the leader himself; it is also about developing the personal qualities of communication and negotiation to work effectively with others.

Emergency applicable leadership skills Performing in emergency situations is a higher level of complexity, exposing the medical leader to a different, convoluted, irregular operating arena which requires the ability to process and analyze a new environment, quick decision-making capabilities, and effective management of people, all under emergency conditions. Managing people and building their endurance A major role for the leader, is to continuously strengthen the team endurance before the mission, and more importantly, during the mission. When trying to strengthen team cohesion and minimize the mental burden during emergencies situations, medical leaders should address several aspects: The anti - chaos effect The best way to manage and motivate people working in a disorganized environment or chaos is to create order.

Ashley works with physicians and healthcare teams to develop higher levels of performance and to enhance professional fulfillment. She acts as a Physician Executive Coach, working with physicians in positions of leadership within their hospitals or health systems who are looking to build their core leadership skills in communication, team leadership, conflict resolution, EQ development, influence, and expert management of change.

Organizationally, Ashley applies many of the human performance principles she practiced while coaching Fortune executives as a senior consultant for Accenture.