See the Advisory Board's take on this story.

Health care leaders need a unique set of skills to manage innovation and guide their organizations during a time of rapid change, Robert Pearl, CEO of the Permanente Medical Group, writes in Forbes.

"Real change" in health care requires leaders who can help doctors change how they practice medicine, Pearl writes. But physicians tend to resist change, and many traditional leaderships skills need to be modified to work well in the unique context of health care, Pearl says.

Physician-centric leadership

Pearl shares several tips for health care leaders working to engage physicians in initiatives to improve and modernize care:

• Use influence, not authority. Physicians value clinical and personal autonomy, and they frequently come from diverse backgrounds. That makes it difficult for groups of physicians to reach a consensus on new approaches to care—and it makes top-down mandates for change unlikely to work, Pearl says. Instead, leaders should use their influence to construct a vision and build a case for change that doctors can buy into.

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• Engage doctors emotionally. While physicians are taught to think analytically, medicine is also an emotional profession. Leaders must "engage the heart" to change physician behavior, Pearl says. For instance, when leaders talk to doctors about reducing medical errors, they shouldn't just cite data and peer-reviewed research—they need to use emotionally powerful stories. "Bring the family of a patient who died from a [hospital acquired condition] into the room, and everyone will lean forward and listen intently," he writes.
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• Explicitly define change—and let doctors track their performance. Frequently, doctors' first reaction to new initiatives is to worry that they will be overwhelmed by new demands. Leaders can overcome this fear, Pearl writes, by explicitly defining change in terms of "specific and observable actions"; explaining the broader context of process changes so doctors know why they are important; and providing doctors access to their performance data to help them stay on track and self-manage.

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• Build trust. Physicians will only follow a leader they trust, Pearl says. But trust requires consistent in-person engagement, not just memos. Moreover, trust is all about being consistently honest. "Leaders who deceive people sometimes can get away with it once, but rarely twice," Pearl writes.
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• Stick with what works. Adopting physician-centric leadership strategies is a challenge. Some leaders may want to "cherry-pick some approaches and ignore others," Pearl writes. But long-term success will only come to leaders that fully embrace a management style that recognizes the unique challenges of leading physicians (Pearl, Forbes, 1/21).

The Advisory Board's take

Julie Riley, Physician Executive Council

Robert Pearl’s observations echo many of the comments we've heard from health care organizations who have successfully engaged physicians to achieve clinical transformation.   

As Pearl notes, success hinges on understanding the unique challenges physicians face. But it also requires understanding the unique contributions physicians can and are making to care transformation efforts. In our research on physician leadership last year, we found that an increasing number of physician leadership roles are focused on implementing change within the organization. (Learn more about changes in physician leadership structures and bring the discussion back to your organization with our Market Observations and Discussion Guide.)  

However, for these physician "change agents" to be effective and use their influence, they must be effectively positioned within the organization. Banner Health's clinical leadership infrastructure is a great example of how to harness physician influence to create standards all clinicians can follow. (Learn more about Banner's clinician-centered infrastructure here.)

Change agents, as Pearl suggests, also need to be able to engage doctors emotionally and to communicate change in a way that builds support for a shared vision. While that may sound daunting, it's actually a skill that every physician leader can learn. Our Physician Communication Toolkit equips leaders with the tools they need to craft messages that reach and resonate with the entire medical staff.