Hard Cases: When Physician Whiplash Gets in the way of Good Medicine

This article is part of LinkedIn's Hard Cases series, where healthcare professionals share the toughest challenges they've faced in their careers. You can read more about it here and follow along using hashtag #HardCases.

?One emerging challenge in the health care industry as of late has been the phenomenon of "physician's whiplash." Nowadays, more and more physicians are being tasked with leadership roles, responsibilities they didn't exactly train for during their years in med school. As Gordon Barnhart notes in his piece on the subject, because physicians are not necessarily inherently adept to tackle leadership tasks, they can end up coming into conflict with more traditionally minded executives in their health system. 

"Physician whiplash is almost inescapable because the preparation and approach that makes for good medicine is, in many ways, 180 degrees from what makes for good leadership," writes Barnhart. "This is not a question of problem individuals, nor is it a right-wrong issue. It is simply a natural challenge facing highly competent people stepping into new roles with different requirements for success."

Example: A physician, trained in medical school to collect data, make independent decisions and prescribe solutions, who now leads a team or is in an organizational leadership position, continues to act independently. Not taking into consideration the intelligence and opinions of others. Leaving his/her team out in the cold. This can lead not only to bad decisions, but will certainly lead to disengaged followers and therefore to poor implementation. Not engaging one’s team, especially at senior levels in large, complex systems, is a costly, but not uncommon mistake of Physician Leaders. And when we’ve seen this happen, the physician is usually “shocked” that people are not “following his/her orders,” or are doing so begrudgingly. Good leadership usually involves a good deal of engaging, debating, discussing, persuading, understanding others and changing one’s own mind. This is not a “waste of time,” rather it is the way to engage others in the processes of change and enabling other leaders who must help others change as well. Which is especially important in industries and organizations which must change in order to survive and prosper.

Barnhart continues to point out that it's important for senior executives to be aware of this trend and to manage it as best as possible. Otherwise, clashes between executive-led and physician-led leadership initiatives can end up resulting in anger, frustration, uncertainty, an unwillingness to commit and undermined confidence on both sides. It could even discourage future physicians from looking to step up into leadership positions.

Thankfully, the two groups are hardly mutually exclusive. There are a number of areas where physician and executive qualities overlap, making for some prime common ground to build a functional relationship on and avoid physician whiplash. Much like typical executives, physician leaders are also:

• Aware of their purpose and significance
• Credible and committed
• Exceptional learners
• Outcome-driven and responsible
• Prone for levying high expectations on their peers and themselves
• Remarkably intelligent and multi-faceted thinkers
• Strong and tested performers under pressure.

Highlighting these areas are key for bridging the gap between physicians and executives, mitigating any possible occurrence of physician whiplash.