Reflections of Physician Leadership on Doctor's Day

“Fragmentation is the most toxic agent I can think of in a system of care trying to help people through the journeys that are their lives and illnesses.” - Donald M. Berwick, MD, MPP; Past President and CEO, Institute for Healthcare Improvement; Former Administrator,Centres for Medicare and Medicaid Services in Boston.

In this one quote Berwick summed up everything that was a motivator for me to enter the leadership arena as a physician. Berwick went on to posit that almost every form of defect eroding the quality and sustainability of care – problems of safety, reliability, patient centeredness, timeliness, efficiency and equity – has its roots deeply embedded in failures of cooperation.

May 1, 2014 is Ontario’s Doctor’s Day. (Further information can be found at Every day in Ontario more than 320,000 patients are treated or cared for by a physician. Whether it is in a hospital, a long-term care facility, a clinic or at home, physicians are always deeply engaged in the work of care. More and more however are entering health care leadership roles. In this blog, I thought I would reflect a little on my own journey and provide some thoughts to modestly guide and inspire others to follow.

Historically, some systems have promoted physicians as leaders solely because they were physicians, the accepted wisdom being that because physicians were well educated and spent much of their time in the system, then they should be naturals at leading it. Unfortunately that was not always a successful strategy; because we spend so much time with patients, we are often the least knowledgeable about what happens outside the clinic. To be successful, most modern physician leaders have pursued advanced degrees in leadership and have now risen to lead some of Canada’s largest healthcare organizations.

The CanMEDS Framework describes the abilities physicians require to effectively meet the needs of the people that they serve. Newly graduating physicians are trained as medical experts, communicators, collaborators, managers, health advocates, scholars, and professionals, acquiring unique competencies to meet the demands of modern practice. Advancing the management domain to one of leadership however requires some advanced training and experiences.

Personally, I decided to pursue a Master’s degree in Health Administration at the University of Toronto when I was finishing my residency because I knew early on that it would be vital to be equipped with the specific knowledge, skills and competencies if I wanted to be an effective physician leader. I would encourage others to do something similar. Whether it is through the Ontario Medical Association’s Physician Leadership Development Program, the Canadian Certified Physician Executive Program developed by the Canadian Medical Association and the Canadian Society of Physician Executives, the Canadian College of Health Leaders’ (CCHL) Certified Health Executive Program or any of the myriad of university MBA or MHSc programs, advanced training recognizes and advances physician leadership and excellence through peer-generated, standards-based learning.

There are so many areas today’s physician leaders need to understand: health human resources, negotiation, leading change, information technology, etc… A formal leadership competency framework is immensely beneficial in coping with the pace and complexity of modern healthcare leadership.

Berwick’s leadership has always inspired me to focus on authentically engaging others as one of the most important aspects of my job. The LEADS framework reminds us that without willing, energized, and engaged followers, a leader is unable to accomplish results on any significant scale. Physician Leaders engage others through personal influence, teamwork, communication, and through the creation and management of peer performance expectations. Successful leaders also focus on the whole organization, by providing an engaging vision and by paying attention to the health of the organization.

At Ontario Shores, we have a compelling vision. Our approach to mental health care is focused on recovery, hope and inspiration through discovery. It combines medical, rehabilitation and psychological perspectives in the treatment of mental illness. The shared journey (the co-creation of our clients and our practitioners working together) promotes inclusion and empowerment of patients and treatment options that are tailored to the individual needs of patients to support their well being.

It has been such a privilege to serve alongside all of our clients, staff and volunteers to this point in our journey. Being a physician leader has been an incredibly rewarding part of my career and I look forward to many more years of co-creation together.