In the early days of the COVID-19 pandemic, physicians faced unprecedented challenges. Vital supplies such as face masks and cotton swabs were in short supply. New protocols needed to be developed to isolate infected patients. Remote treatment of patients through telemedicine suddenly became standard practice.
All of these sudden changes required doctors to have a certain level of leadership ability, says Robert Huckman, Albert J. Weatherhead III Professor of Business Administration at Harvard Business School.
“Apart from developing a vaccine, the biggest concerns were not about developing new medical innovations. It was about performing well-known activities,” he says. “Especially in the early days, the pandemic really put a premium on those with management expertise.”
As Huckman details in a paper in the journal Academic medicine, however, most physicians receive some training in leadership and leadership skills, such as supply chain management, interpersonal communication, and strategic planning. Yet these skills are important to the well-being of physicians and their colleagues and can mean the difference between patients’ lives and deaths, Huckman argues in the article he co-authored with physicians Lisa Rotenstein, assistant medical director at Brigham and Brigham. Boston Women’s Hospital; and Christine Cassel, professor of medicine at the University of California San Francisco.
For many physicians who are burnt out by the pandemic and may not know where to begin with further training in leadership skills, the paper offers a roadmap for what physicians can get out of the COVID pandemic.
“There’s a thirst for this type of information among clinicians,” says Huckman. “There are many clinicians looking for ways to put management tools – such as finance, strategy, operations and management – together to take on greater leadership roles.”
Handle hard conversations
The COVID-19 pandemic has revealed the importance of these skills, the authors say. When the virus initially spread through hospitals in early 2020, many doctors had to switch from their traditional specialties to treating patients affected by the virus. In light of the isolation of coronavirus patients from family members, many physicians and nurses who were not accustomed to providing end-of-life care became the primary source of comfort for dying patients and their families. At the same time, these providers had to deal with their own mental health and that of their colleagues.
“There was already a high level of burnout before COVID, and not having the means to do anything to alleviate suffering must be extremely stressful,” Huckman said.
In addition to ensuring the health of their patients, their colleagues and themselves, physicians had to implement new methods of providing treatment, either in person or over Zoom. Finally, they had to deal with challenges related to securing scarce equipment and restructuring operating flows. All of these activities, Huckman says, required skills in both leadership to “make people understand a vision of what could be possible,” and leadership, “to make it happen and put it into practice.”
Technology offers challenges, opportunities
Many of the new opportunities that emerged during the pandemic were facilitated by technology. Yet these opportunities came with managerial challenges. Remote monitoring of the patient represents an example. “Medicine has traditionally depended on a doctor seeing a patient in person at some point, but the pandemic has highlighted that there are many things that do not necessarily need to be done in person,” Huckman says.
In fact, says Huckman, many physicians have realized that telemedicine can open up new possibilities for the ongoing care of patients – for example, allowing patients to consistently monitor blood pressure at home with a blood pressure cuff instead of once every few weeks or months on the office.
However, taking advantage of these new techniques will require physicians to learn a range of new skills, including process improvement, negotiation and change management. “First, you need to convince the provider that a new technology makes sense in terms of providing effective patient care. Then you need to make sure that the incentives doctors face do not contradict that they use the most effective approach. “To make all of this happen, doctors may need to initiate and manage significant changes in their organizations or lobby for changes in external regulation and public policy,” Huckman said.
Changing the way medicine is taught
Of course, even though medical schools recognize the need to develop these leadership and leadership skills, they may not see a way to make time for them within their packaged clinical curricula. The good news, Huckman says, is that many of these skills can be learned in conjunction with clinical skills. “Like medicine,” he says, “leadership is best learned through observation, experience, and practice.”
In fact, the case study method used in MBA programs at colleges such as Harvard, University of Virginia, and Stanford University is similar to the way physicians are trained through medical residences where they face specific clinical dilemmas. There is no reason, Huckman says, that management and leadership training cannot be integrated into that process, so as medical students learn to diagnose and treat patients correctly, they are also confronted with problems with supply management, operations design, and communication.
“When you work on clinical skills that involve interacting with patients,” Huckman says, “you can also build leadership skills that involve interacting with colleagues.”