What makes you a leader?

Dina Baras CPSA, Medical Matters, Messenger 8 Comments

In my last two Messenger articles, I wrote about the value of high functioning teams and the importance of physician engagement. Building on that foundation, I’d like to introduce the topic of physician leadership.

I believe physician leadership is essential for the future of health care in Alberta. However, the term “physician leadership” may be perceived as physicians wanting to be in charge. There may be times when physicians need to be in charge, but that is not what I’m talking about.

Good leaders create an environment that stimulates innovation and creativity, they recognize individual strengths, and they encourage growth and development when it’s needed.

Over the past 30 years, I have had the privilege of learning from some exceptional leaders. Those who stand out recognized the role they played in building and enhancing the performance of the teams they were fortunate enough to lead. They were also exceptionally strong at engaging all team members in executing common goals.

High-functioning teams rely on the diversity of the team members and maximize each person’s unique skills and abilities.  Good leaders create an environment that stimulates innovation and creativity, they recognize individual strengths, and they encourage growth and development when it’s needed.

You don’t have to be in charge to be a leader. You can highlight the talents of each team member and engage everyone even if you have no positional authority. It can be as simple as recognizing when others need help and reaching out, or coming to work with a smile on your face. There are easy things you can do that have a dramatic impact on a team’s performance.

“how can I actively try to help this team perform better?”

If leadership is fundamentally about influencing the performance of a team, what about those who have a negative impact on a team’s performance? Are they leaders? Like many things, leadership is a spectrum from positive to negative. For those who have a negative impact on a team’s performance they are considered to have a negative leadership style. We see that in tyrannical leaders, but you can also see that in team members whose behaviour creates an environment where people don’t want to work or those who diminish the morale of a group thus decreasing the performance of that team.

Self-reflection and self-awareness are two fundamental requirements of good leadership, but they can be two of the hardest things to learn. A question all physicians should ask themselves is… “am I enhancing the performance of the health care team I’m working with, or am I having a negative influence?” The next natural question should be “how can I actively try to help this team perform better?” Neither of these require a physician to be in a position of authority, yet they can have a dramatic impact.

Whether you are in solo practice in a rural community or a specialist in a large urban hospital, you are an essential part of a health care team. Whether it’s formal or informal, you will play a leadership role and your actions can have a significant impact on the care your patients receive.

Let’s all find ways to become better leaders to improve health care in Alberta.

As always, I look forward to your comments.


Dr. Scott McLeod
CPSA Registrar

8 Comments on What makes you a leader?

Noel Hershfield said : Subscribe Oct 13, 2017 at 2:05 PM

 I recently went to an address by one of the contestants for one of our leadership candidates  .He stated that the healthcare in Alberta is in a terrible state, it costs too much money and we are not "getting a bang for our buck" I responded from the audience by saying that as far as I knew the life expectancy of the average Albertan is on par with the rest of the developed world. It is true we have a long waiting lists and I agreed. I told him that when I came to this province in 1965 we had four major general hospitals in a population of about 350,000 people in the city of Calgary.. Almost 50 years later we have a population of over 1,000,000 1/2 people in the city of Calgary and we still have four hospitals.. All this mind you happened during the reign of the conservative party in this province. Now I received a letter from you stating that we have to get together and improve the healthcare in this province. Please detail where healthcare in this province is deficient, and what we physicians can do about it! One way to reduce waiting lists in our emergency rooms is perhaps a little public education. Most emergency rooms are backed up   because of minor problems that could easily wait until they can get an appointment with the family practitioners. The other problem that college possibly address is the fact that we have training too many certain specialists, and that operating room time is at a premium, and many young people have difficulty finding a job. If you're really interested in standards of practice, I would suggest that you investigate the long waiting periods for certain subspecialties, and yet they respond by rejecting the consult, and also suggesting treatment without seeing or talking to the patient! You may start with the division of gastroenterology in Calgary and their central triage system.

    Scott McLeod said : Subscribe Oct 19, 2017 at 8:01 AM

    Good Morning Dr Hershfield. It’s nice to see you write in again. You asked where I think healthcare in this province is deficient, and what physicians can do about it. That’s a big question; in a sense it’s the question for the profession and the College going forward. The key to answering it is in the way you framed it: what can we do about it? We need to start by accepting that we as physicians are part of a bigger system and we have to change along with it. You talked about some of the changes you’ve seen over your long career in Calgary. Maybe the most basic change of all, is in the population we serve. Our health system was built for a younger population and it’s straining to adapt to the reality of aging and chronic disease. You see that every day in Calgary, with 17% of hospital beds on average last year occupied by patients waiting for an “Alternate Level of Care,” mostly frail seniors waiting for continuing care beds. You know better than I, keeping those patients in hospital is not good for them or for the system as a whole. AHS is struggling with the same challenge facing every province: they have to change to serve an older population. As physicians we have to support that change, and take responsibility for changing the way we work too. That does not mean the system is somehow “failing.” On the contrary, I think clinical care in this province is very good; our members serve patients very well, within the model of care we have now. As you mentioned, our life-expectancy compares well with other advanced jurisdictions. A more-specific measure is avoidable mortality: our rate in Alberta is the same as the national average for “treatable” conditions, but significantly higher (worse) for “preventable” conditions. That points to shortfalls in long-term public policy, including injury prevention and smoking, rather than in health care per se. I think our members should be proud of the care they give patients; but the model of practice has to change. In particular, we have to embrace integration with the larger system in ways that enable us to provide better care to more patients. Improving quality of care should also improve value for money, but quality comes first. As a regulator we’re promoting changes in processes and structures that support accountability, but we do not want to approach this from an oversight and punishment perspective. We want to empower physicians to lead their own quality improvement wherever possible. That means we share the information we have with you so that you can do a better job of self-assessment and planning your professional development to address any potential areas of risk. This is the intent behind the MD Snapshot. I can’t tell you what the future is going to look like, but I would suggest that it will not be like it was yesterday or is today. As a profession we need to embrace quality improvement, to make sure it’s driven by our values and the interest of patients, and show we can adapt as a self-regulating profession. This will require physicians to be engaged in the system, work well in teams and understand the leadership roles we have. Scott

      Carrie Kollias said : Subscribe Oct 12, 2017 at 9:24 PM

      Thank you Dr McLeod for this fresh approach from CPSA:
      1. “am I enhancing the performance of the health care team I’m working with, or am I having a negative influence?”
      2. “how can I actively try to help this team perform better?”

      It still amazes me how as physicians, a little care to the team around us has the potential for big impact - even through the small things. It does require generosity though - in time, thought, intentionality and sometimes even financially. As a physician, having the capacity to truly care about others (over and above our patients) does require us to be engaged and have a balance in work-personal life. This is the ongoing challenge for docs slogging it out in the trenches.  “Margin” is key but can be hard to achieve without being intentional. 

        Scott McLeod said : Subscribe Oct 16, 2017 at 3:41 PM

        Dr Kollias, Thank you for taking the time to provide a comment. I appreciate your thoughts and comments. I could not agree more. There are lots of small things we can do day to day that can make everyone's job just a little bit better. Scott

          Christopher Cham said : Subscribe Oct 12, 2017 at 6:33 PM

          The topics of self-awareness, leading self, emotional intelligence,  team building, conflict resolutions, running effective meetings and leadership skills (to name a few) are so foundational to our professional lives that it is astounding that this is not core material in medical schools by now.  With respect to leadership, "you don't know what you don't know" is the place where all of us are... until one takes a "risk" and signs up for a PLI course (or equivalent).  Though the recognition is late, it is not TOO LATE to start developing the next generation of leaders from an earlier position. 

            Scott McLeod said : Subscribe Oct 17, 2017 at 10:25 AM

            Good Morning Dr Cham, Thank you for taking time to comment on my article. There is no time like the present to start working toward improving our leadership skills and no matter how much leadership experience we have, we can always learn more. Scott

              Louis Francescutti said : Subscribe Oct 11, 2017 at 1:19 PM

              • Sure would be nice to see a column from our President as well as from Registrar. 

                Scott McLeod said : Subscribe Oct 15, 2017 at 3:20 PM

                Hello Dr Francescutti, This is a great recommendation and the President and I will look looking for some options for future Messenger articles. Scott

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