Converse Like a Leader

The Hospitalist. 2009 February;2009(02):

February 1, 2009|The Hospitalist

Communication is an integral part of a hospitalist’s job: from admission interviews to conveying orders to nursing staff, communicating clearly and precisely is part of numerous best practices. When a hospitalist assumes a leadership role, however, the types and styles of communication change. A committee chair or department head must be aware of the messages they send—both literally and in the most general sense of the term. This transition to leadership can be tough.

“Physician communication is focused on clinical outcome. That’s easy for someone trained in medicine. But in leadership communication, there may not be a defined outcome,” says Timothy J. Keogh, PhD, assistant professor at The Citadel School of Business Administration in Charleston, S.C. “That’s a difficult switch from clinician to leader; maybe half of the problems a leader faces can’t be solved.”

Dr. Keogh and William F. Martin, PsyD, MPH, summarized their research data in “Managing Medical Groups: 21st Century Challenges and the Impact of Physician Leadership Styles,” published in the September-October 2004 issue of Journal of Medical Practice Management.

In the transition to leadership, [hospitalists] sometimes forget that they have these skills, and they can use these to be a great leader.

The Basics

The most basic communication skill a hospitalist leader should practice, according to Dr. Keogh, is “being less direct than [he or she] would like to be.” Dr. Keogh, who teaches communication skills as part of SHM’s Leadership Academy, says, “Data shows that physicians prefer to be more precise and cover topics quickly. In a leadership role, the initial part of the communication or conversation needs to be chattier. Some physicians believe that this uses up too much time, but, in fact, it doesn’t take that long and it’s a necessary step.” Acknowledge others’ need for connection by making eye contact, pausing, and exchanging quick pleasantries. “Leaders need to be able to say things in passing, greet people, et cetera,” Dr. Keogh stresses.

But what about in-depth communication?

Don’t Wait—Collaborate

A guide by general surgeon Kenneth Cohn, MD, provides unique strategies for managing collaboration among healthcare professionals. “Collaborate for Success! Breakthrough Strategies for Engaging Physicians, Nurses, and Hospital Executives” (Health Administration Press, 2006) offers case examples and practical tips help readers use constructive conflict to improve communication, maintain the loyalty of outpatient physicians, encourage physicians to reach consensus on clinical priorities, use clinical teams to reduce malpractice risk and improve outcomes, adopt disease-based approaches to patient care, and more.

What Makes Physicians Happy

What would make you—and other physicians—more satisfied with your work? “Secrets of Physician Satisfaction: Study Identifies Pressure Points and Reveals Life Practices of Highly Satisfied Doctors” by Richard J. Bogue, et al, published in the Nov. 1, 2006, issue of Physician Executive, offers the results of an in-depth physician satisfaction survey conducted at a Florida hospital. Factors including prestige, relationship with colleagues, and availability of resources all come into play. Download it.

Career Satisfaction Resource

Released in 2007, SHM’s comprehensive “A Challenge for a New Specialty: A White Paper on Hospitalist Career Satisfaction” can be used by hospitalists and in hospital medicine practices as a toolkit for improving or ensuring job satisfaction. Based on a review of the literature on physician burnout and general career satisfaction, the white paper outlines four pillars of career satisfaction: autonomy/control, workload/schedule, reward/recognition, and community/environment. Access the document in the “Practice Resources” section of SHM’s Web site.

Management Topics

If you supervise hospitalists, you can condense discussions of your expectations—at least compared with managers in business fields. “Physicians are skilled, well-trained individuals, so you don’t have to do so much of this,” Dr. Keogh says. “They have an internal sense of quality and you don’t really need to motivate them. It’s a matter of adjusting the edges.”