Physicians as Leaders: Who, How and Why Now?

Citation

van Zwanenberg, N. (2007), "Physicians as Leaders: Who, How and Why Now?", Journal of Organizational Change Management, Vol. 20 No. 2, pp. 259-260. https://doi.org/10.1108/jocm.2007.20.2.259.1

This felt like a long book, but then may be this impression came about because this is a book aimed squarely at physicians, and judging from the language, style and content, North American physicians at that. Whether any will have the stamina to read it from cover to cover is open to question. Your intrepid reviewer did his best, despite fitting into neither category.

What looked at first to be a mistake, that is, choosing to read the book over a holiday period, turned out not to be, for this is very much a story book. Some 50 or so contributors, physicians all, provide advice, histories, insights and stories. As in many an adventure book, these form the basis for lessons and morals and for uplifting messages. But the process of discovering these is not left to the reader alone with the danger that they might draw the wrong conclusions or possibly puzzle out the plot for themselves. For in addition to its claim as a practical guide, this is an evangelical book. The authors make it clear that their goal is to persuade physicians to take up leadership and they seek to provide both the volunteers and the volunteered with useful knowledge and skills to do so. The physician leader is clearly the hero (or heroine – the text is virtually non‐gendered in its language and balanced in the gender make‐up of its main authors). But even heroes apparently need guidance.

The central premise of the book is that physicians, possibly prompted by the persuasion of this book, can learn about business and become leaders. By contrast, business leaders will not or cannot, so it is claimed, become physicians. Quite why business should be the main source of leadership knowledge and skill is not made clear. From that starting point the book unfolds across five sections of guidance and exhortation.

Medical doctors (not an expression that is actually used in the book but “physician” became wearing) can, so it is asserted, be well suited to lead. They can be experts, executives, pioneers and even members of the US Congress. The competences that they might require are set out and many, many illustrations offered. The list of competences is based, in part at least, on exploratory research conducted by the authors. Based on just over a hundred responses to “highly regarded behavioural and motivational assessments” provided by a company whose president is the husband of one of the book's authors, a range of findings on work style and motivational values is presented. The analysis of these does not extend beyond the use of descriptive statistics. But no matter, most of the book does not refer back to this study.

Some very limited reference is made to more general literature and research in the leadership field – concepts and competences being disposed of in a brief chapter. The existence of medical systems outside North America is hardly acknowledged or their nature investigated. This narrowness of scope, both in terms of concept and situation, is a characteristic of the book; the concentration on physicians and their immediate world feels almost like tunnel vision (no apologies for the medical term).

A section of five chapters, no less, is given over to discussion and examples of “Stepping stones for successful physician leadership” though again the rationale for their choice is not made explicit. The same number of chapters provides guidance in “Becoming a compelling physician leader”. Yet even here, what is delivered is not quite what is promised. Hoping that a subtitle of “Reflection and self‐awareness, focus and goals” might lead on to guidance on becoming a reflective practitioner, one finds instead some ideas from marketing, followed by yet more aphorisms: be true to yourself, admit mistakes and learn from them. The irony of quoting a physician as saying, “I believe every person has a heart  … ” goes completely unnoticed.

This is a very worthy book. It has many homilies – “manage your calendar”; lists – “26 characteristics of a true leader”; points to ponder – “what do you believe is the role of spirituality in medicine?”; and self‐report instruments – “Leadership Vision Assessment”. Criticising it is like criticising motherhood and apple pie. There is nothing inherently wrong in either and descriptions of them from worthy mothers and chefs may make for satisfying, if unchallenging, reading. Many people read and enjoy such books, possibly learn from them; even in a few cases are inspired by them to become mothers or cooks (or even both). But such accounts seldom provide a strong foundation for analysis or even for ongoing guidance in such endeavours. The same may be said for stories of leadership in the medical profession as told by physicians or physician educators.

But back to the heroes and the story book – we should expect pictures and pictures there are – drawn by a doctoral student in history who happens to share a surname with another of the book's authors. We can only wish him well in his studies – as an illustrator he makes a very good historian.

Nigel van Zwanenberg can be contacted at: nigel.van‐zwanenberg@durham.ac.uk