Celebrating & Cultivating Physician-Leaders

reprinted from Issue 17, Fall 2013 of Frontiers of Medicine (PDF)

Josh Adler, MD (right), at UCSF Medical Center. Adler is one of many Department of Medicine faculty members who are leading system change within UCSF’s affiliated medical centers.

We often describe what faculty members do in terms of their clinical care, research and education efforts,” says Niraj Sehgal, MD, MPH, associate chair for quality improvement and patient safety. “But we tend to minimize leadership positions by referring to them as ‘administrative’ roles. These positions provide real opportunities for faculty to lead system change and influence delivery of care, particularly within our respective medical centers.”

Many Department of Medicine faculty occupy key roles within our medical centers to lead this very change. Just a few examples include:

UCSF MEDICAL CENTER

Josh Adler, MD
chief medical officer

Adrienne Green, MD
associate chief medical officer

Mike Blum, MD
chief medical information officer

SAN FRANCISCO GENERAL HOSPITAL (SFGH)

Alice Chen, MD, MPH
chief integration officer

Will Huen, MD
associate chief medical officer


SAN FRANCISCO VETERANS AFFAIRS MEDICAL CENTER

Rina Shah, MD
deputy chief of staff

Ben Davoren, MD, PhD
associate chief of staff for medical informatics

In addition, the number of faculty with medical director positions (for example, risk management, informatics, ambulatory care, and quality and safety) is also increasing.

The immense challenges of health care reform require us to create a system that is more integrated, collaborative and interprofessional. Achieving optimal outcomes for our patients now depends less on individuals working autonomously, and more on teams working together to provide cost-effective and patient-centered care. This shift requires skills that are not necessarily emphasized in traditional medical education – such as communicating effectively and managing and developing teams – but they are essential for physicians succeeding in today’s complex health care environment.

“Leading Clinicians and Clinicians Leading,” a recent New England Journal of Medicine article, stated that “clinicians want a greater leadership role but feel unprepared or disempowered.” The Department of Medicine is cultivating physician-leaders at all levels. A few examples include:

  • Health Systems & Leadership Track: As part of the broader UCSF Pathway in Health & Society, our residents can participate in a two-year longitudinal experience that provides knowledge, skills and mentorship to prepare for leadership careers in health systems improvement. Residents complete an intensive group project each year addressing a quality or policy concern. This year, they developed an innovative program at SFGH to improve the care of patients with alcohol dependence. The program is led by Edgar Pierluissi, MD.
  • Department of Medicine Leadership Initiative: Through the Department’s Strategic Planning process, this program was created to provide division chiefs with a professional development opportunity that includes completion of 360-degree reviews, executive coaching and a workshop series on key leadership topics. Beth Harleman, MD, associate chair for strategic planning and implementation, leads the program team.
  • UCSF Center for the Health Professions: This center offers a portfolio of leadership development programs for physicians, nurses, pharmacists and other health care professionals. Programs are both grantfunded and developed for particular clients, including Blue Shield, Kaiser, and IPC The Hospitalist Company, Inc. Sunita Mutha, MD, is the center’s director, and Sehgal directs two of the physician leadership programs.

“The need for physician-leaders will continue to grow, and we have an opportunity to train and develop such physicians in the same way we’ve done for our educators and researchers,” says Sehgal. “We also have the responsibility to meet the needs of trainees who come to UCSF with an explicit career goal of creating a better health care system.”




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