Are physicians “leaders”? Put another way, is “leadership” a necessary or even desirable attribute of the aspiring or practicing medical doctor? The recent revision of the competency framework of the Royal College of Physicians and Surgeons, and specifically the proposal to change the “Manager” competency to “Leader” has sparked some interesting conversation on this issue. The root of this controversy appears to be a sense that the term “Leader” implies an assumption of authority or superiority within the healthcare community. On the surface, this change may appear somewhat presumptuous and concern is understandable. Some recent discussions on parallel issues that have been undertaken at our school may provide some relevant and very timely insights.
The issue of student Resiliency has become a growing focus of interest in our school, with the goal of providing students with awareness of its importance and methods to promote its development. Review of the available literature, and our own discussions, have defined a number of attributes and attitudes that characterize the resilient personality. These include:
- Personal well-being. Resilient people are healthy and energetic, and adopt personal practices that promote well-being, such as attention to personal health, nutrition and fitness.
- A sense of purpose. Resilient people are driven by a deep and abiding sense of purpose that allows them to overcome adversities.
- Perseverance. Willingness to commit to goals and work steadily to completion
- Self-reliance. Acceptance of personal accountability.
- Equanimity. The ability to face both adversity and success in a balanced way, without loss of perspective or purpose.
- Ability to engage adversity effectively. Resilient people are able to not only face adversity without loss of purpose, but learn from those experiences.
Almost at the same time, a number of students have expressed interest in examining the components of Leadership. In the development of teaching material on that topic, a number of component attributes have been developed for discussion. These include
- Stamina. Personal energy and drive.
- A sense of purpose that is aligned with the objectives of the organization they are leading, and which they communicate effectively to members.
- Diligence. Also called “drive”. Leaders tend to be the engines and drivers of innovation and change within their organization.
- Self-assurance. Leaders have and display confidence in themselves and in their organizations that is not “cocky” or pretentious, but apparent and clear to all. Outstanding leaders are able to combine that confidence with a sense of humility that allows them to accept advice, balance opinions and change course when it’s in the best interests of their organization.
- Fairness. Leaders are unfailingly fair in the application of their authority. Their fundamental integrity is unquestionable and clear to all.
- Ability to engage adversity effectively. Leaders are able to guide their organizations through tough times and challenges. They do so by maintaining a focus on the core objectives and values, communicating clearly, and providing support and encouragement.
Do these two sets of attributes sound similar? One can’t help but conclude that resilience and leadership go hand-in-hand. Our leaders are resilient people, and failure in leadership can often be traced to a deficiency in one or more of the resiliency attributes.
Now let’s extend to the Physician’s role, and focus on the application to patient care:
It would seem that there are numerous parallels between the attributes of the resilient leader pursuing the interests of their organization, and the effective physician promoting the health and interests of their patient. The qualities, values and attributes are very similar. The focus of those efforts simply shifts from a group or organization, to an individual, the patient. It’s therefore no surprise that so many physicians become effective leaders in our various academic, community and political structures. The Royal College is absolutely justified in embracing the “Leader” competency.
Anthony J. Sanfilippo, MD, FRCP(C)
Undergraduate Medical Education