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Institute for Leadership in Medicine
Under development, the Institute for Leadership in Medicine, is intended to fulfill a two-fold purpose: to offer a center of education that provides competent training to physicians and non-physician healthcare providers in leadership theory and practice; and, a place to debate scientia: understanding, wisdom and knowledge as it relates to leadership in medicine; a veritable think tank.

Many people assume that, because of their advanced education, their high-profile status in the community, and the prestigious role that they play in healing others, physicians, as a class, are automatically seen as the leaders that walk amongst us. Of course there are leaders found within the profession of medicine, but one does not necessarily find them at any higher incidence than what is found in the general population. In fact, Peter Drucker in his forward to Hasselbein, et, al, says: “the lessons are unambiguous. The first is that there may be ‘born leaders,’ but there are surely too few to depend on them.” 1 If leaders are not born, they develop skills, over time, to give interpretations or understanding to followers as to what happens within organizations. 2,3 Since leaders manage meanings, they exert a strong impact on organizational outcomes, 4 especially as they relate to group processes, matters of personality (individually and organizationally), methods of inducing compliance, the exercise of influence or persuasion, of power relations, as an instrument of goal achievement, and as an initiator of structure within which the form is complete. 4 So if leaders are not born, from where do they come; especially physician leaders? We are often left to answer that question by referring to something found innate in their formal medical education experience; yet, according to Larry Mathis, “there is nothing in a physician’s education and training that qualifies him to become a leader.” 5 So the only answer left for us is that they become leaders by serendipity or accident.

Certainly, the practice of medicine is being buffeted by tremendous forces that would change it; negatively to many. These buffeting forces have placed the profession in a reactive position instead of a more advantageous proactive one. Our leaders find themselves operating from a management perspective rather than from one of leadership. Although the terms have been used interchangeably, there is a difference in their definition. In fact, Kotelnikov says that in today’s new economy old ways of management no longer work and will never work again. The magnitude and pressure of environmental, competitive, and global market changes is unprecedented. Although interesting and exciting, it also accentuates its extremely volatile and chaotic nature. Addressing these new challenges with more of the same old- and tired-management solutions is a recipe for stagnation, or worse, failure. Successful change, however, requires leadership. 6 In these times of uncertainty, unusual challenges, and difficulty, physicians are looking for help in understanding questions about what matters, what to do, what direction to take and what they should not do. Providing people with the answers that help them with these difficult questions is the essence of leadership. 7  

At present, there is no formal structure through which osteopathic physicians can be developed in the proper leadership skills to stand firm against these cascading forces. Would it not be prudent for osteopathic medicine to have a place like the ancient Areopagus of Athens,8 the Curia Hostilia in the Roman Forum, 9 or the city gates of ancient Israel where the elders/senators gathered to debate scientia: understanding, wisdom and knowledge? From where else can the profession expect answers unless it comes from skilled experts that know the ins and outs of osteopathic medicine? Of course this level of expertise requires leaders to move from a cellular-level of understanding to what Heifetz calls the balcony perspective 10 of leadership; which takes a much broader view of issues and is a skill not taught in most medical schools, or for that matter, business schools.

The profession of medicine has often been left out of the picture as it relates to the development of new initiatives out of fear that the beneficiaries will modify the system to their advantage. However, by deferring to others outside of medicine to define it, physicians have been relegated to the role of followership verses leadership. The time has come to define the practice of medicine from a physician perspective; not in the image formed by outsiders. Therefore, enter the Institute for Leadership in Medicine (Institute); a place in which issues affecting the practice of medicine can be explored, where new ideas can be researched, scholarly interaction on issues related to the practice of medicine can be examined and proposed, and where new physician leaders are developed.

However, before the Institute can be expected to lead medicine into a self-determined and bright future, it will require the services of competent and knowledgeable experts in the various components of leadership (human capital development; ethics & values; strategic design, planning & implementation; change, global leadership; strategic foresight & futuring; and, creativity & innovation) to which the Institute will dedicate its resources. The criteria used to select, assess, train and certify the Institute’s senior fellows (those heading the previously-mentioned department components), must receive the highest level of consideration in order to assure that the utmost level of competency and expertise reign within the Institute’s leadership.

So, stay tuned, as OIS commits its resources to the creation of this most valuable organization, that expects to change the future of medicine.

References
  1. Hasselbein, F., Goldsmith, M, Beckhard, R. (Eds). The Leader of the Future. San Francisco, CA: Jossey-Bass.
  2. Jongbloed, L, Frost, P.J. (1985). Pfeffer’s model of management: An expansion and modification. Journal of Management. 11, 97-110.
  3. Pfeffer, J. (1977). The ambiguity of leadership. Academy of Management Review. 2, 104-112.
  4. Bass, B.M. (1990). Bass & Stogdill’s Handbook of Leadership: Theory, Research, & Managerial Applications (3rd Ed.). New York, NY: The Free Press.
  5. Mathis, L.L. (2001). The Mathis Maxims: Lessons in Leadership. Houston, TX: Leadership Press.
  6. Kotelnikov, V. (2007). Leadership vs. Management. http://www.1000ventures.com/business_guide/crosscuttings/leadership_vs_mgmt.html. Retrieved: July 22, 2008.
  7. Taffinder, P. (2006). The Leadership Crash Course: How to Create Personal Leadership Value (2nd Ed.). London, GB: Kogan Page.
  8. Areopagus. http://en.wikipedia.org/wiki/Areopagus. Retrieved: July 22, 2008.
  9. Curia Hostilia. http://en.wikipedia.org/wiki/Curia_Hostilia. Retrieved: July 22, 2008.
  10. Heifetz, R.A. (1994). Leadership Without Easy Answers. Cambridge, MA: Harvard University Press.