Last year, I began my dialogue with you as
members by focusing on change and then discussing an innovation conference I
attended at Duke University. These were broad and easy discussions. With the
New Year, we need a sharper focus.
I would like to start by recognizing how
vital our “work” is to the health of the nation. We train the future leadership
of the US healthcare system. We need to keep in mind our dual responsibility to
the nation and to the students we train as they pursue their careers in
healthcare leadership. If we fail to identify and deliver the necessary
competencies, future leadership will be less well equipped to provide for the
care to our population and may be incapable of changing the delivery system to
respond to health reform and market challenges. We are not the ones leading the
organizations of the future but our students have that responsibility. While
our role is “second order,” it is vital to the healthcare system.
Nobody questions that physicians, nurses and
other clinical specialists must have the education, competencies and in some
cases licenses to practice. Similarly, the finance skills and certification of
most CFOs is not questioned nor are the qualifications of our organization’s legal
counsel. However, when you discuss administrative leadership of healthcare
organizations, the importance of the specific competencies appears less clear
to some. Consider, for example, that today you can move into leadership roles
within our nation’s healthcare infrastructure without appropriate preparation
or demonstrated competencies. Many of
those thrust into these roles rise to the occasion. Some struggle and all face
a steep on the job learning curve. Given that healthcare organizations are
highly complex and heavily regulated, one would think that looking for
qualifications would always be paramount.
I should add at this point that I am not
talking strictly about “senior” leadership but leaders throughout multiple
levels of an organization. While CEOs get a lot of attention, leadership exists
at multiple levels in a healthcare delivery organization. We know that most of
the folks we train will not become a CEO but they will assume significant
leadership roles throughout an organization. The person in charge of Surgical
Services, Ambulatory care, Cancer Center, etc. must demonstrate leadership and
fully understand what it takes to make these parts of the organization provide
high quality and efficient care. Collectively, they keep organizations working
smoothly. Similarly, those assuming administrative leadership roles in medical
practices have an incredibly broad responsibility for leadership and management
of those organizations. Bad leadership and inept management, at any level, can
disrupt the effective operation of an organization.
At this point some may ask, does this
argument imply that assuming a leadership role in a healthcare organization
should require a license? I don’t think that licensing is the answer. If we
have too many individuals assuming leadership roles without the appropriate
competencies, however, we are going to see organizational performance suffer.
The consequence could be a call for licensing of healthcare organizational
leadership. Without getting into a political debate, however, many of us would
prefer the market to resolve this challenge. Rather than have the government
impose a license requirement for a leadership role, it would be better for
organizations to look carefully at the demonstrated competencies of individuals
they hire.
The US has a substantial, established
educational network that strives to provide students with the necessary
competencies to become effective leaders. As a field, we support accreditation
and certification requirements to demonstrate a high level of quality of the
educational unit. More importantly, this
process assists programs to engage in regular self-examination and challenge us
all too continuously improve what we teach and how we teach.
We must keep focused on our special mission
and remember that what we do day to day really matters. In the months ahead, I
want to continue this discussion with a critical examination of why our
particular educational models really matter. Please do not hesitate to comment
positively or negatively.