Abstract
This chapter examines the importance of teaching leadership to surgeons and adding leadership training and development as part of contemporary surgical education. Teaching leadership to medical students, surgical residents, fellows, and other surgeons is a challenge, and yet it runs to the heart of medical professionalism. If we consider where surgical practice will be in the next 5–10 years, there will be a growing need to train every surgeon to become a more effective leader, and every leader must be a collaborative team player.
There are at least three reasons why surgeons should be educated and trained to be leaders. First, there is a new and blossoming science of medicine and management. Second, complex medical organizations such as hospitals should be led by people trained in the underlying disciplines and applied medical sciences. Third, there is growing research evidence that managers with clinical backgrounds can run better health-care organizations, and that some physician-led multispecialty groups already outperform organizations run by lay managers. Owing to their roles in operating rooms and in clinics, surgeons may be uniquely positioned to be leaders; nevertheless, they may not be prepared to lead. Consequently, not everyone will agree that every surgeon should be the ascribed or emergent leader.
Leadership training and development requires activity in the presence of knowledge. It requires an application of knowledge as well as experience and skills, and a willingness to commit to the responsibilities of leadership, to understand the importance of leader as a role model, and to believe in the capability of the team. To develop surgeons into effective leaders, I will introduce several concepts and tools and a model to guide leadership behavior. I argue that leaders who can assess their own behavior will always be on a steep and asymptotic learning curve: obtaining feedback, reflecting on their behavior and outcomes, and learning from small mistakes. I believe that physicians are uniquely qualified to lead because leadership requires many of the same skills physicians already possess: the abilty to think strategically, to diagnose situations moment by moment, and to guide and mobilize people to want to deal with challenging situations. In this respect, some surgeons may have notable abilities (knowledge, skills, and experience) to be leaders; and they may also have appreciable disabilities. I will argue that what makes leaders effective is their ability to diagnose and analyze complex situations and to adapt their leadership styles. So, while there may be few “born” leaders, we can train many surgeons to become better leaders. That may be the most important and hopeful lesson for the future of health care.
