Training for 21st century doctors: medicine, business, and leadership development

May 16, 2018, Perelman School of Medicine at the University of Pennsylvania

Given the complex and rapidly evolving health care system in the United States, medical schools must focus their efforts on training more physician leaders to master the diverse skills needed to navigate emerging challenges in the field, urge leaders from the Perelman School of Medicine at the University of Pennsylvania in a new Perspective piece published today in the New England Journal of Medicine.

"Academic medicine has been somewhat complacent in the face of the disruptive forces in health care, and as a result, the gap between the -leader workforce and the needs of our system has only widened," said J. Larry Jameson, MD, Ph.D., executive vice president of the University of Pennsylvania for the Health System and dean of Penn's Perelman School of Medicine. "Health care systems need a new prescription to close this leadership gap. Given the societal impact of health care, we need to accelerate the development of skills that are not typically acquired during traditional medical training."

Historically, physician leaders have been chosen based on their national prominence and excellence as master clinicians, star researchers, and revered educators. While these credentials remain important, they aren't sufficient in the current health care climate, the authors write.

Today's physicians practice in an era of changing payment models, rising costs, IT advances, and emerging technologies and therapies that are reshaping the delivery of patient care. Dynamic changes have also come with ongoing health system mergers and market consolidation. To lead effectively in this environment, doctors need not only sharp clinical expertise, but also opportunities to hone their communication, team building, and decision making skills, and gain knowledge of finance and business.

Jameson and co-author Caryn Lerman, Ph.D., vice dean for Strategic Initiatives and the John H. Glick, MD Professor in Cancer Research in the department of Psychiatry in the Perelman School of Medicine, suggest health systems focus on three strategies to create this new wave of leaders: rigorous mining of diverse talent pools to identify the most promising emerging physician leaders; building pipelines of future leaders with targeted leadership development to enable progressively increasing responsibility; and deliberate onboarding processes to integrate new leaders and assure alignment across missions and with the institutional culture.

Training in finance and business planning and personnel management should be central to professional development, as many physician leaders may manage budgets similar to those of medium-sized businesses, for example, and work in organizations which are among the largest employers in their community.

"Given the high rate of turnover among physician leaders, such as department chairs and deans, we can no longer afford to neglect the skills that are essential for leaders to succeed," they wrote. "We believe there is a need for a new generation of leaders who can promote strategic and cultural alignment in the face of rapid change."

At Penn, the Perelman School of Medicine has joined with the Wharton School to create an executive education program which will launch in 2019 for health care and academic medical leaders from across the nation and world. The program will provide targeted leadership development experiences and practical skills to enable today's and tomorrow's leaders of health systems and academic medical centers to adapt to a rapidly changing environment.

The new endeavor joins the Penn-Wharton MD/Master of Business Administration (MD/MBA) program, which is designed for medical students interested in integrating their medical course work with training in managerial, financial, and technical expertise in the health care field.

Another example is Penn Medicine's Healthcare Leadership for Quality Residency Track. This two-year training pathway for future physician leaders is one of only a few in the country to offer a pathway for residents aspiring to be leaders in health care quality, patient safety, or informatics. So far, more than one hundred residents have participated in the program.

To help meet the challenges of an increasingly complex landscape, the authors say, systems should make leadership development an organizational priority—an emphasis which will also pay off in improved patient satisfaction and clinical outcomes.

"The 21st century physician leader must be equipped with a new tool kit of skills for the leadership agility necessary for them to respond proactively to rapidly changing environments," Lerman said. "Leadership development should be an organizational priority, preparing today's medical students and physicians to thrive in a continuously evolving era of ."

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