Docs, Admin Don't Trust Each Other, Says Leadership Expert

Mark Hertling, a Retired Lt. General, was former Commanding General of the U.S. Army Europe and the 7th Army and over the course of a 37-year career, he amassed a wealth of military honors and recognition. He retired as a respected authority in military matters, so much so that CNN uses him as an onscreen analyst on frequent occasions.

What does this have to with healthcare? Everything. Hertling's experience in the battlefield has given him new life in his second career at Florida Hospital Adventist Health System, where he serves as senior vice president of global partnering, leadership development, and health performance strategies. He runs the health system's physician leadership program, using the values he learned in the military to train doctors, nurses, and administrators in eight different courses.

Hertling, who authored a book called, "Growing Physician Leaders" recently spoke with Physicians Practice on his transition from military general to physician mentor in a two-part interview. Part one explored how he made the transition and how he teaches physicians in his program. In part two, Hertling talks about the biggest issues he sees  physicians struggle with in today's healthcare landscape and offers advice to members of the frustrated profession.

Below is part two of the interview.

What are the biggest issues you see with physicians in today's healthcare landscape?

The number one issue is a lack of trust and it flows both ways. That's a critical element of leadership; generating trust in an organization. Doctors distrust the adm

inistrators and the administrators distrust the doctors. Both think the other side is only after money and there is that disconnect. The things we are teaching, it's not PhD-level leadership…these are the basics. What I'm seeing, from the standpoint of a guy who has trained on leadership all my life....as we teach the basics [of leadership] and talk about the basics…these are really smart people, but they've never had an ounce of the kind of training that makes them look at themselves. They are so focused on others. They are overworked. Part of the reason they are overworked is they use some of the wrong techniques. For the most part, physicians don't communicate well. That's causing problems…from a patient experience standpoint and from how you generate answers to tough problems.

In the military, we have problems generating trust with our civilian masters when we talk in our military lexicon. It took me several years [as a] general officer to realize that you have adjust your communication techniques to who you are talking to. This seems simple, but unfortunately most people get stuck in their own profession. I see doctors who don't talk to well to administrators and because of that communication gap…not just with administrators but with patients…things don't get done and there is a constant disconnect and constant contribution to burnout.

What's been the result of your program at Florida Hospital?

We've had 250 people go through the course, 179 are physicians. We have 3,000 physicians at Florida Hospital, some are employed, most are serving at practices, some of which are in private [practice] and some in the hospital. What we try and do is get a mix of all of those and get a mix of the different sub specialties…We're seeing two major changes: Those who have gone through the course are starting to contribute more and [are] trusting the administration because they've got a look under the tent flap. The other change is that our administration...and we have a new CEO and he is hot on this… is saying [they] want physicians involved in the decision making and the task force, as opposed to people who don't understand the connection to the patients.

How can physicians in smaller practices get more involved in a leadership role?

For part of our second [year doing the program], we took a gamble and took in some physicians from private practices who had no association with the hospital. We took one hand surgeon who is part of a two-doc practice in the area. People wondered why we accepted [him] into the course. I said, "He is part of the community. Let's get the word out." Coincidentally he became a physician liaison to the Florida Senate…so while he isn't connected to Florida Hospital, he is now connected to a bunch of legislators that are doing healthcare reform. He is involved, not employed by Florida Hospital but contributing to healthcare at large.

You have a bunch of physicians who want to be leaders. The best thing they've been told to do, they've been told to get an MBA. Whereas an MBA might be a valid degree for some things, for the most part, it doesn't teach leadership. It teaches processes. Whereas that might help, you still have the issue of what's the individual's character, how is the individual presenting himself, and how is he using his intellect to solve problems.

What's your advice to physicians who are frustrated with today's healthcare system?

In order to make change, you can't do it by yourself. You have to learn how to build consensus and be part of a team…All professionals that are dealing with really tough problems will get frustrated. When that happens, you have to push yourself away from the desk for a while and ask yourself, "How do I approach this a different way?"…There isn't always going to be one way to do something. You have to find different approaches with different people. If you want to lead someone else, you have to understand their motivations before you lead them to your motivations.

As human beings, we want it our way and we want it fast. This runs contrary to solving difficult and challenging problems. My advice to doctors: Step back, take a look at how you are doing things, and see if perhaps there might be a different approach. Don't get too tied, emotionally or intellectually, to your argument. You have to be willing to listen to other people and adjust your way.