Physicians are supposed to “mind their own business” and let other people who are fully qualified as “health care administrators” to do the leading of American health care organizations in which many physicians are now working. However, many physicians are no longer “minding their own business” – especially when working in systems that often seem to be dysfunctional.
Perry Pugno is a physician among those who are not minding their business and are concerned about leadership in contemporary health care systems. Along with Mindi McKenna, Perry Pugno has written a book about physicians as leaders (McKenna and Pugno, 2006). They frame their work around a fundamental perception that is held by many other people inside and outside the American health care system. This is the perception that improvements in the American system are needed (McKenna and Pugno, 2006, p. 1):
“Nearly everyone agrees that healthcare should be “better” – in fact many would say healthcare needs an ‘extreme makeover.’ Yet few expect significant improvements anytime soon. We are doing what we can to prevent the tragic cases of those who die too young, or those who Jive too long. We keep on striving to help and to heal, even while the practice of medicine becomes ever more challenging.”
McKenna and Pugno point to the role that physicians might play in helping to lead reform in this dysfunction system:
“The issues are complex; answers are elusive. Some have succumbed to engaging in blame games; contributing to the problems rather than collaborating toward new solutions. With increasing frequency and urgency, people are pleading for physician leaders to guide the way through the complexities of contemporary healthcare. Some call upon physicians to help out of belief that the solutions will require perspectives only practitioners can provide. Others believe that without physician involvement, efforts to change will be met with resistance.”
In many instances, however, physicians are nowhere to be found when leadership is required. One of the physicians that McKenna and Pugno (2006, p. 63) quoted in their book put it this way:
“It is tough to come up with names of widely recognized physician leaders. The fact that I can’t immediately list recognizable physician leaders is in itself telling. We physicians lack leaders who can influence, thus raising the bar for the profession. Leadership is needed – individual or through professional organizations.” [Randall Oates, MD Family Physician Founder and President, Docs, Inc.]”
