What they don't teach in medical school: The interesting story behind UTMC's leadership academy

The University of Tennessee Medical Center in Knoxville is one institution that really recognizes just how huge an asset its physicians are when it comes to creating buy-in for administrative initiatives, championing clinical improvement efforts and succession planning.

While physicians can help streamline and enhance hospital processes, many lack the leadership training and management expertise to effectively collaborate with administrators. This lack of business know-how can also hold back physicians who aspire to pursue healthcare leadership roles later in their careers.

Realizing the opportunity this conundrum presents, Keith Gray, MD, an associate professor with UTMC and chief of the division of surgical oncology, co-developed the Physician Leadership Academy with senior leadership. The three-year program aims to cultivate effective physician leadership from the bedside to the boardroom by teaching management, communication, and leadership skills, fostering effective communication between the medical staff and administration, and empowering physicians to foster change among their colleagues.

One could speculate that the success of the academy may have something to do with who created it: a physician who took on a major leadership role — somewhat unprepared — and realized early on how his lack of leadership training could limit his effectiveness.

The inception of the Physician Leadership Academy

In 2012, Dr. Gray was elected chief of staff at UTMC. Like many physicians across the country, his clinical acumen and amicable relationship with the medical staff likely contributed more to his appointment than prior demonstration of leadership success.

"I'll be honest, I learned pretty quickly that there is very little crossover between clinical expertise and administrative effectiveness, and other physicians have described these same feelings," said Dr. Gray.

He explained that the position required skills and presented challenges for which he felt unprepared given his lack of formal leadership training in medical school.

"I was about a quarter of the way though my year as chief of staff when I realized that I just didn't feel prepared to be as effective in the position as I wanted to be. I decided on the spot that I didn't want any more physicians or subsequent chiefs of staff to feel that way."

During his tenure, Dr. Gray presented an idea to senior administration in hopes of establishing an in-house program for medical staff interested in becoming more effective physician leaders, but who didn't have the time, interest or money to pursue a master's degree in business or healthcare administration. After evaluating established physician leadership programs nationwide, UTMC chose to partner locally with the University of Tennessee's Haslam College of Business to develop a program customized to UTMC's medical staff, culture and strategic needs: the Physician Leadership Academy.

Luckily for Dr. Gray, UTMC had established physician leadership and development as one of its key strategic initiatives in 2010 and was in the process of looking for someone to champion the effort when Dr. Gray presented his idea, according to Steve Ross, DPh, senior vice president for strategic development.

"When we evaluated physician manpower objectives and succession planning, it was clear that leadership development needed to be a high priority within those specific objectives," said Dr. Ross.

Joe Landsman, president and CEO of UTMC, was just one of the executives to whom Dr. Gray presented his idea. Mr. Landsman supports the program and urges other providers to foster similar opportunities and resources for medical staff.

"Engaging physicians in leadership roles and decisions in the medical center improves the relationship and builds a solid foundation that will encourage alignment and enable a healthcare organization to address larger scale transformational issues," said Mr. Landsman.

Once the curriculum was established, UTMC sought to enroll physicians already involved in leadership positions in the medical center and who routinely displayed integrity, humility, good communication skills, confidence, motivation, vision and a sense of balance in their lives.

With an inaugural class of 15 physicians, the leadership academy was officially launched in January 2013.

Creating the program's leadership curriculum

During the first year, physicians commit to a four-hour interactive session one Friday per month. Addressing the macro environment of healthcare leadership, the sessions are taught by faculty from the Haslam College of Business, and include training in leadership styles, negotiation, healthcare finance and LEAN management.

In the second year — called the UTMC Way — senior administration leaders help first year graduates marry newly developed skills to organizational culture and strategy, assist physician leaders in developing their own initiatives, and create an open discussion forum between the two groups.

"The UTMC Way makes our program unique compared to some of the other programs available around the country in that we ask the administration to get involved," said Dr. Gray. "I think that by keeping them involved and encouraging them to spend some small-group time with medical staff leadership, we really fortify the administration-physician relationship."

Together, the hospital executives and physician leaders discuss improvement opportunities, competitor strategies and regional and national trends and changes. In addition to working in small groups, the second year of the program gives physicians a behind-the-scenes look at the how the executive suite operates.

The third year of the program is voluntary for participants and provides a more experiential model of learning. The Physician Leadership Academy's inaugural class

"For physicians that aspire to have a leadership role beyond clinical practice, year three of the academy allows them to spend some time really getting into the hip pocket of the leaders they would one day like to emulate — be it the CEO, CMO, Center of Excellence director or someone else," said Dr. Gray.

On top of being able to work closely with the hospital executives, physicians are able to participate in the selection process of the new, first-year participants during the third year of the program and work together to form ad hoc leadership small groups to tackle new problems.

How the program has impacted physicians and UTMC

After participating in the leadership program, many physicians demonstrate a shift in the mindset from focusing on small, discipline-specific projects to macro-level, hospital-wide initiatives, according to Dr. Gray.

The academy approach has also positively impacted the development and deployment of the clinical standardization pathways UTMC implemented to coordinate and improve care, according to Mr. Landsman.

"The physicians have positively embraced their leadership roles in the process and have not only supported the pathways approach, but have taken responsibility and ownership to develop and implement the medical center's Centers of Excellence-wide pathways," said Mr. Landsman.

In addition, the program has helped the individual physicians in their own careers.

"This program has helped identify both the leadership strengths and weaknesses of our physicians as well as help them to more centrally focus their career path," said Dr. Ross. "As a result, we have experienced a surge in active participation in a variety of areas from younger physicians who have gone through the program."

Overall, Dr. Gray, Mr. Landsman and Dr. Ross are impressed with the results of the Physician Leadership Academy and encourage other providers to implement leadership development programs.

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