“Healthcare professionals are increasingly asked to weigh in on the issues of medical structure, straining public safety nets, and limited resources. To date, the public debate has been shaped by those other than direct care providers. For years, most doctors believed that even the mere discussion of money in the setting of patient care was a betrayal of the tenets of medicine. By keeping the practice of medicine pure, clinicians have neglected the disparity between scarce resources and an increasing menu of diagnostic and therapeutic options. There is no right answer or one right way to solve the problem. What is clear is that the system now in place is not working. The costs of delaying care and prevention cut to the core of our economy, standard of living, and life expectancy.”[Bridget M. McCandless, MD, Internist, Medical Director, Jackson County Free Health Clinic]
The strength of Equitable Royal Purple leadership often resides in this leader’s compelling articulation of these overarching public policy issues.
“The ‘elephant in the room’ is looming larger than ever. Healthcare delivery simply doesn’t work the way its consumers and payors need and want, but many physicians are too overwhelmed to do anything about it. That’s a large part of why I’m so passionate about the potential for a new breed of physician leaders. Even with managed care and the advent of large practices and IDNs, healthcare remains largely a cottage industry – with each organization or clinic operating as though it were an island. Physician leaders must help physicians grasp how infinitely better healthcare could be if we changed our minds and decided to operate as regional and national teams on behalf of our mutual customer – patients!” [J. Peter Geerlofs, MD, Family Physician Chief Medical Officer, Allscripts Healthcare Solutions, Inc.]
There are declarations and demonstrations regarding the failing health care system. Elegant and heroic gestures express the deep feelings underlying the actions that are taken. There are no borders when it comes to caring about care.
An accompanying challenge takes place when the Royal Purple leader is being asked to be less “deep” and to live more often in the real, expedient world (this concern is often voiced by a Golden Yellow). The Thoughtful Golden Yellow member of an organization (or society) might agree that social reform is a good thing; however, “can’t we take it a bit slower and buttress this reform with some evidence of the injustice that has actually been done?” The important, existential threat for someone with a Royal Purple orientation is being judged as someone who is trivial, unimportant or unoriginal. To be ignored or taken lightly is the ultimate curse for someone deeply involved in the work of reform in an organization or society: “rather you fight against me then not even notice that I exist.”
Conclusions
As I noted at the end of the first essay in this series, where I offered portrayals of three fundamental leadership styles engaged by physicians, stereotypes can easily be elicited, and constructive behavior can often be misunderstood. This can occur even with regard to leaders who incorporate several of these fundamental styles. Yet, the dialogue must take place regarding these hybrid as well as the fundamental leadership styles. Hybrid styles are of particular value in furthering our understanding of the world in which we live—especially the complex and dynamic world of health care. It is rare that a pure variant of a fundamental style will “do the trick”. Nuance and ability regarding leadership are usually required.
In the next essays in this series, I leave the world of leadership styles behind and turn to the matter of leadership competencies. What are the skills and what is the knowledge required to be an effective leader in a health care system – regardless of one’s preferred leadership style. Once again, I look to the insights offered by McKenna and Pugno as they spend time asking physicians how they go about being effective as leaders. I focus in particular on results from a survey McKenna and Pugno sent out to practicing leader-physicians.
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