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“Leadership is a journey,” said Claire-Cecile Pierre, HMS instructor in medicine at Cambridge Health Alliance and associate chief medical officer and vice president of community health at Brigham and Women's Hospital. “You become a better leader over time. You need space to make errors, reflect on them, and grow. We can't do that if we don’t approach it as a journey.”
In health care, a part of that journey starts in medical school. Physicians train to better identify symptoms, diagnose conditions, and conduct groundbreaking research. Often those who are talented in their content area and are team players assume leadership positions. The leadership role includes a host of new responsibilities, such as navigating difficult team situations, working with human resources, and managing budgets, areas not usually formally covered during medical school or residency training.
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“Leadership training is important,” Pierre said. “Leadership and management can come naturally to some people, but there are processes that can help all leaders improve continuously.” With that in mind, Pierre, alongside five other HMS faculty members, have led the Medical Director Leadership Institute (MDLI) for six years. It’s a 6-month virtual program that helps health care leaders hone critical skills to thrive in their role, achieve organizational goals, and manage during times of uncertainty.
Recipe for a great leader
MDLI evolves year to year, but many of the program’s basic principles remain the same. “To be a great leader, you have to first understand yourself, be open and listen, then coach,” Pierre said. She was once asked to help give feedback about a physician who was not completing their notes on time. Given the typical physician workload and current structure of health systems, that is unfortunately a common challenge.
But rather than jumping to conclusions about the barriers this physician faced, Pierre offered to observe them first. “By sitting with the physician, I was able to ask them what they thought they could do to improve the problem,” she said. “I became aware that this physician was hyperconscious of making mistakes or missing something.” By shadowing the physician, Pierre was able to give them guidance rather than pressure — something that surely would have worsened the physician’s fear of making mistakes.
Equity and leadership
While day-to-day responsibilities like leading a meeting to discuss the upcoming week may become routine, there are implications for every decision, from the format of the meeting to the way it is conducted. “There is a great opportunity to bring an equity lens to the decisions we make every day, even in how we structure meetings,” Pierre said. That includes considering the way neurodiverse colleagues best retain information, being thoughtful of people with mobility issues when choosing the meeting space, and ensuring everyone is heard and has the time to process the information provided, with attention to those who have been excluded for centuries.
In addition to fostering access, diversity, inclusion, and belonging, a leader’s responsibility to equity extends to the patient, whether the leader continues to provide patient care or not. Leaders have access to technology that can help inform equity decisions. By looking at data, they can identify individual and system changes that can help improve equity. “In some ways, we are blind to what others are experiencing,” Pierre said. “As a leader, I have to show my team that I am willing to look at the data, I am willing to get input from those who are most affected, and I am willing to change.” Health equity is a central component of the MDLI program, which equips leaders to create impactful change in their organization and their communities.
The next session of MDLI runs from Oct. 6, 2022, to March 2, 2023, and is eligible for continuing medical education credit. Participants meet twice each month — once for an interactive session and again for a coaching call. The deadline for registration is September 22. To register and find out more information, click here. The course is eligible for CME credit through the Massachusetts Medical Society.
Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Massachusetts Medical Society and Harvard Medical School Center for Primary Care. The Massachusetts Medical Society is accredited by the ACCME to provide continuing medical education for physicians.
AMA Credit Designation Statement
The Massachusetts Medical Society designates this live activity for a maximum of 21.50 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This activity meets the criteria of the Massachusetts Board of Registration in Medicine for risk management study.
