A call for SCAI members to become physician leaders.

Abstract

In 2010 Robert Kocher MD painted a grim view of two possible futures 1. Both included accountable care organizations (ACOs) as key players in the United States health care system. In one version of the future, physicians took responsibility for leading ACOs, and consequently set the policies by which ACOs operated. Physicians were key decision-makers, advocated for excellent patient care, and reaped the economic benefits of efficient care rendered in the ACOs. In the other, very different vision of the future, physicians ceded control of ACOs to hospital administrators who operated their ACOs to benefit hospitals. In this vision, physicians dwindled in status, influence, and economic well-being, and patient care suffered. Kocher's message is clear: take a seat at the leadership table, or be on the menu. This paper is a call for interventional cardiologists to step up to positions of leadership to make sure that Kocher's second vision of the future does not come true. One theory of leadership holds that good leaders are good leaders because they have certain inborn traits 2. The opposing theory holds that good leadership is learned. Both are partly true. Either way, the drive and ambition required to be an interventional cardiologist makes us particularly well-suited for leadership. Most interventional cardiologists have many traits of “natural” leaders. We know how to set goals, make decisions under stress, learn and rebound from failure, and lead and inspire teams. All of these are important for successful leaders. Some leadership skills must be acquired through study, including business and financial savvy, negotiation, and knowledge of organizational behavior. But if they can be mastered by college business majors they can also be learned by physicians. Other qualities such as emotional intelligence and relationship-building, if not learned through medical or interventional cardiology training, can be picked up by aspiring leaders through hard work and a measure of humility. Interventional cardiologists are used to mastering new skills and techniques on the job; if we can learn new structural heart disease procedures we can learn how to read a financial statement or develop a strategic plan. Interventional cardiologists need to take leadership positions in health care for two reasons. The first is the welfare of our patients. As payment systems transition to “value-based”, and as health systems seek ways to make health care more efficient, no group is as well-positioned to understand threats to patients from health care reform, or to guard the interests of patients, as are physicians. Physicians have a moral obligation to lead health care organizations at all levels so as to protect the interests of their patients 2. The second reason for physicians to learn leadership is to retain control of their own fate. If you aren't leading, someone less competent may be leading you. If you aren't leading, someone with a non-patient-oriented viewpoint may lead your organization. If you aren't leading, someone else may lead you down a path of professional dissatisfaction. Academic physicians 4, surgeons 5, family practitioners 6 and heart failure physicians 7 have issued calls for their colleagues to become physician leaders. This is your call to leadership. Not only do interventional cardiologists have the same reasons as other specialists to become leaders, but interventional cardiologists are particularly well-suited to do it. Colleagues – answer this challenge, prepare yourself for leadership, and step up to leadership positions in your organizations. Thanks for critique and contribution to this article by Jeff Adams MBA, Susan Frye MBA, and Mary Stark MFA.