Calling Physician Leaders: Step up and Advocate

Over the next few months, there will be a lot of speculation on the state of the healthcare in our country. For physicians and patients there will be questions about the survivability of the Affordable Care Act, the ever increasing cost of care, and the sustainability of value-based payment systems. Under a Republican president and Congress, we will likely move towards a free market healthcare model. What does that mean for the millions of people who have already been disenfranchised by free markets? Will MACRA requirements fade in the wake of potential changes to Medicare? What will this mean to how we care for our patients as well as ourselves?

In this uncertain environment, physicians, employed and private, must come forward as leaders in the system. We need to come forward in pursuit of sustainable healthcare delivery models. Physicians have often let policy makers determine the details, but we cannot be on the sidelines any longer. We cannot find ourselves lost in the shuffle of burdensome demands of maintenance of certification, unproven quality markers, and ever growing stacks of paper work. We need action.

The task may appear overwhelming and unmanageable, but every journey starts with one step forward. You do not need to change the whole world but claim responsibility for the small piece you are standing on in your own local communities. We will find that the "one-size fits all" policies will not be adequate and we will need to start in our own backyards. Find the leader within and emulate those traits of an effective leader:

1. Leaders ask questions. Look in your communities, your institutions, your own office and question areas that impede providing good health to your patients and your colleagues. Are the policies set in place sensible, or do they create unnecessary barriers? Oftentimes policies are created by administrators with little not experience in the practical aspect of medicine, we need to step up and ask the hard questions.

2. Leaders present solutions. It is easy to complain. Finding fault in the running of an office, hospital policies, or government regulations can be done by anyone, and often is. Become informed behind the rational for policies and develop solutions. Be open to acceptable compromises and do not lose sight of what you really want. When dealing with sensitive issues we can become blindsided to merely winning and lose sight of our original objective. Leaders understand the short and longer term goals, having the vision to focus on what really matters.

3. Leaders are comfortable with being uncomfortable. We need to agitate sometimes. We need to sit back and endure uncomfortable silence sometimes. Finding solutions may put us in rooms with individuals who fundamentally disagree with us or have different values. When opinions vary, especially on heated topics, discomfort permeates. True leaders, make discussions safe. They do not resort to threatening tactics or personal insults. True leaders are often respected by those who disagree with them even on tough issues because leaders create an environment safe for difficult conversations. Be respected, not feared.

We need leaders committed to action. Get involved locally in your communities. Identify groups that speak on matters important to you, whether it is your specialty society, state medical society, or other local or national advocacy groups. Volunteer your time, lend your voice in policy making, and step up into leadership positions when opportunities present themselves.