May 16, 2011

An increasing number of anesthesia groups struggle with getting the younger partners engaged in leadership roles. This problem exposes several other issues within the group such as a concern over the transition from one generation to the next, overworking a few partners, and stale approaches to group management.

While there are no silver bullets to address this issue, there are practical steps to solve the problem including identifying emerging leaders, creating a development plan, finding opportunities, and providing feedback.

Identifying Leaders

Identifying emerging leaders begins with physician recruitment. Every year, anesthesia students complete their residencies and begin to work in a variety of settings such as private practice, academic practice, and to a lesser extent the United States Military. How groups recruit this young talent speaks volumes with the identification of future leaders of the group. Recruiting is both science and art. Executive and physician recruiters are highly trained at the recruiting process including developing a recruiting plan, interview guides, developing an interview team, and sifting through the volumes of resumes. While most groups don’t use a professional recruiter, the process, tools, skills, and judgment are still needed.

In the book, Hire with Your Head by Lou Adler, the author describes a four step process for performance-based hiring. The process includes performance profiles, talent centric sourcing, evidence-based interviewing, and integrated recruiting¹.

• The performance profile is a compelling job description that describes the real job needs. In short, you want to tell a compelling story about your practice, the specific job you have to offer, and include the leadership development expectations as part of the culture of your practice.
• Talent centric sourcing is the process of designing every aspect of sourcing to attract top people. In short, this is how you reach the top talented candidates you want to interview with the placement of exciting job descriptions, how to get referrals, and when you make phone calls.
• Evidence-based interviewing is organizing the interview to access competency and create opportunity at the same time.
• Integrated recruiting is making recruiting, negotiating offers, and closing a natural part of each step in the hiring process.

Development Plan

After the group has hired the new physician, the next step is to create a development plan which will help the younger physicians to understand the leadership development process and set proper expectations. The development plan includes the ultimate goal for each individual physician, the steps along the way, reading lists, writing opportunities, and community participation.

There are a variety of approaches to leadership development. In his book, The 21 Most Powerful Minutes in a Leader’s Day, John C. Maxwell concludes that a daily regiment of reading, reflecting, and meditating will help to develop a leader on a daily basis². Another approach appears in the book, Lead with Intent by Arne Pedersen, who states that a leader needs to have a development plan that includes seeking additional responsibility in tough and challenging jobs, engaging in self study, and taking additional course work³.

A third approach featured in a Harvard Business Review article entitled, Growing Talent as if Your Business Depended on It, the authors offer a succinct checklist for leadership development:

1. Outline the leadership development process and communicate it throughout the company (your practice).
2. Create leadership development programs that fill holes in your talent portfolio.
3. Utilize tools to help manage the process.
4. Have the board oversee the leadership development initiatives.
5. Reshuffle rising stars ensuring you trade A players with other A players.
6. Make sure your leadership development program is aligned with your strategy, reinforces your brand, and has support from all constituents⁴.

Finding Opportunities

Finding opportunities can be tricky. An approach to leadership development is to look for smaller project opportunities early on that will expose these young leaders to various facets of the practice. Moreover, these opportunities will provide them the opportunity to interact with their colleagues, partners, and business support staff. The opportunities will need to graduate to more complex roles along the way, such as committee members to committee chairs to board member and finally to a physician executive role.

Certain physicians in the group will covet the role of Medical Director. Training for this role is very important and may include some basic hospital or ambulatory surgery center operations training. Fundamental business training in budgeting, finance, human resources, and negotiations would be useful.

Another avenue to help develop young leaders is participation on community or not for profits boards. Physicians will be exposed to midcareer and seasoned executives who might help them to better understand the business aspects of running an organization that can be applied to the practice.

Providing Feedback

One of the keys to successfully developing leaders is providing timely and constructive feedback. This is not a time to rant and rave, but to objectively observe and provide thoughtful feedback that will help them grow. A well structured and thoughtful feedback approach includes:

• The development plan
• The current role/opportunity
• Interviews
• Observations

This approach will help the developing leader see strengths and weaknesses in a variety of settings and better address their decision making and interactions as a leader.

Not all groups have the capacity to execute a formal feedback process.  In these instances, the mentorship approach works well in smaller group settings.  It is best to assign a senior leader in the group to mentor the newer and younger physicians.  These tend to be informal.  The principles of objective and thoughtful feedback are still core to the feedback process.

In conclusion, leaders don’t just appear in groups. They must be identified, developed, and given the opportunities to learn, grow, and prepare the way for the next generation. We are fortunate that there are strong candidate pools in anesthesia.

With best wishes,

Tony Mira
President and CEO

As a quick note, Arne Pedersen who authored Lead with Intent joined ABC last year. He is a former Anesthesia Group Administrator, an expert on leadership, and a bronze star medal recipient from the Persian Gulf War. We are proud to have him on board helping our clients! 

¹ Adler, Lou, Hire With Your Head, Hoboken, NJ: John Wiley & Sons, Inc 2007, pp22 - 23
² Maxwell, John C., The 21 Most Powerful Minutes in a Leader’s Day, Nashville, TN: Thomas Nelson, Inc, 2000, pp 35-48
³ Pedersen, Arne, Lead with Intent, Indianapolis, IN: Indianapolis Business Journal, 2007, pp 101-103
⁴ Cohn, Khurana, and Reeves, Growing Talent as if Your Business Depended on It, Harvard Business Review, October 2005, pg 67