How a Military General Became a Physician Leader Expert

There are a few people in the world with the kind of credentials Mark Hertling can offer.

Hertling, a Retired Lt. General, was former Commanding General of the US Army Europe and the 7th Army. In his career, he commanded hundreds of thousands of soldiers, trained thousands of officers, cared for millions of civilians, led countless military campaigns and training exercises, and received numerous military honors. He was also appointed by President Obama to be one of 25 members of the President’s Council on Fitness, Sport, and Nutrition.

With that kind of background, it shouldn't surprise anyone that Hertling's face pops up on CNN from time to time as the network's military analyst. He even got into it with Presidential Candidate, Donald Trump, over comments made on CNN.

What may be more of a surprise to people is that they can also see Hertling's face pop up while chatting with physicians and walking the halls of different healthcare facilities within the Florida Hospital Adventist Health System, where he serves as senior vice president of global partnering, leadership development, and health performance strategies. Since his transition to healthcare in 2013, Hertling has developed a model of leadership at Florida Hospital, using his military background and philosophies to improve leadership among physicians.

So how did a 37-year career military man go from the battlefield to the exam room? Hertling, who released a book this year, "Growing Physician Leaders," recently spoke with Physicians Practice in a two-part interview about his transition to healthcare, what lessons healthcare can glean from the military, the biggest issues that are preventing today's physicians from being leaders, and whether or not you need an MBA as a physician.

Below is part one of the interview.

Your background is in the military, how did you get involved with physician leadership?

It's a long story. I was commanding in Europe and happened to have a chance to attend a dinner hosted by an ambassador in Luxemburg after a Memorial Day service. There were a few people at my table from Florida Hospital. I had given a speech at this Memorial Day service. During the speech…the CEO of the hospital was sitting next to the ambassador, and he had just had a meeting with a few guys from Disney on an idea for a new initiative. It was different than physician leadership. He asked the guys from Disney who he should hire for this new initiative, they said you need to hire a retired general. This surprised our CEO. He asked, "Why should I do that," and they said, "Generals understand the scope and scale of large problems."

At dinner that night, [our CEO] told the ambassador that [I] was the kind of guy Disney told me to hire. The ambassador said, "Why don't you talk to him, he is retiring in a few months." It was a matter of serendipity. I had another job lined up, but they gave me a hard pitch to do this initiative.

Then, after I got here and started working, the guy in the office next to me was the organization's CMO. He used to come in every once and a while and shoot the bull and he'd ask me how I'd deal with a problem in the military that he was having in the hospital. …He told me they were trying to develop a physician leadership based on some of the needs they were having. He asked if I could put something together. At that point I had only been there four months and was still getting to know healthcare. I said I'd give it a try anyway. After doing a preliminary analysis, seeing what programs were available at other organizations, with people allegedly teaching leadership but really just teaching business and management, I told him we could put a program together and do it differently, in terms of teaching pure leadership. [This would be] as opposed to teaching healthcare leadership or healthcare business. He bought off on it and about six months later we started the inaugural physician leadership development program at Florida Hospital.

It was me, designing, teaching it, and providing the output for about 50 combination doctors, nurses, and administrators. We started seeing success based on the things we're teaching. We were teaching the basics of leadership based on a military model. About halfway through the first year, it was apparent we hit on something that might work in our organization. We've now conducted five courses and a year ago, they asked me to put a book together. That's what the book is all about.

Talk to me about your new book, "Growing Physician Leaders"

It is and it is not a description of the course. It outlines what we did and how we used the military model to teach leadership to doctors, nurses, and administrators.  A lot of the physician leadership you read about is doctors being sent away to a school or a seminar. What I persuaded our CMO to do is if we're looking to build teams, improve patient care, and solve the issues in healthcare…it needs to be a team effort. I told him I could teach about 50 people, and said there should be about 35 physicians from various subspecialties, 10 nurses, and 5 administrators across our various campuses.

What we do in the course, there are about eight lessons/seminars at five hours a piece. We started in January, skipped July and August, and ended in October. The first two lessons were attributes and competency of leadership and who they are, as in the people attending the seminar. We did a personality assessment and helped them determine the kind of individual they were and their character, but also the presence they exhibited to others….We talked about professionalism, how physicians and nurses are members of the profession, whereas administrators and members of the C-suite, they are not members of the profession, they are businessmen. You have to look at them from that standpoint, there is a chasm between executives of healthcare and professionals. Professionals lead their profession. Yet, we have a profession in medicine where the professionals are not leading it. Others are leading it for them.

The second lesson was all about values and how you use values to make leadership decisions.   Lesson three and four was all about dyadic leadership, how to lead one other person. What we train in those two lessons is called the influence model. How you take a task, how you understand the motivation you are trying to lead, and how you use different levels of influence to try and get them to achieve what the organization needs… Lessons five and six are all about leading teams. How to build teams, how to put together teams for a specific purpose. We talk about different team building and trust building measures and how to develop team members, so they can take your place someday. Lessons seven is about what the organization - the practice, hospital - does for you and lesson eight is about what you do in return to provide leadership to the organization.

Military and medicine both deal in life and death circumstances. We drive that point home to them, in these professions, you have to adhere to the standards of the profession, understand there is a requirement for training in continuous development, that no one else can do what you do, and you guide the profession in order for society to exist.

That's the course and I draw an outline of that in the book. What I do in the book…every other chapter, I describe what we are doing in class and I recall a short two-to-four page war story of something that happened to me in the military that drove that particular leadership lesson home. Why that lesson is critically important. It's alternating storytelling from a perspective of what we are teaching in the class and a real-world example. I think that's what differentiates this from the thousands of other books and courses out there on leadership. When you read some of the other leadership books, they are talking about philosophy. At our course, it's based on experience, rather than theory.

With my experience, you get me in front of a room full of physicians… and I don't take crap from them. When they start challenging me, I ask them to tell me how they do this. As you peel back the onion, sometimes they need a mirror held up in front of them to discover what they are really doing vs. what they say they are doing. That's the essence of leadership.