The University of Washington and Gonzaga University have created a program to teach the next generation of doctors how to become leaders.
An introduction to the story is told by Rachelle Strawther, the director of leadership training and development at the Gonzaga School of Leadership Studies.
“One of my parents was in the ER, had a bad fall. I got there, I rushed over there and people were tending to my mom and I remember at one point the doctor had come in the room, didn’t really say much to anyone in the room, very perfunctory, almost like doing a checklist and asking some questions of the nurses," Strawther said.
"Then the doctor turned on his heel to leave and one of the nurses said, ‘Doctor, Doctor,’ and she was clearly trying to ask him a question. I don’t know what happened, if he didn’t hear her or if he just ignored her, but he just kept walking straight out. And I’ll never forget her face at the door, because she turned around and she just rolled her eyes, very subtly, but you could tell that this is something that happened before," she said.
Stories like this are not unusual. They point to issues like poor communication between doctors and other health care professionals and patients.
“As the family of the patient, we saw that interaction and I wonder is that a systemic issue where nurses feel like they’re not being heard or does that doctor have some stuff he’s got to work on? Is there a hearing issue that needs to be addressed? Those are the kinds of interactions that happen every day in health care, whether or not we see it," she said.
Strawther is now in a place where she can do something about that problem. Her school is now working with the University of Washington School of Medicine to offer leadership training to medical students. Strawther is the instructor.
“Our goal is to prepare students so that they’re able to respond to these challenges, that they’re self aware to notice, ‘Am I listening to people? Am I taking in other voices? Am I being as compassionate in this moment as I could be?’” Strawther said.
Her partner in this endeavor is Dr. Darryl Potyk. He’s a geriatric medicine doctor in Spokane. He's also the associate dean for eastern Washington for the UW medical school and the chief of medical education for the UW-Gonzaga Regional Health Partnership.
He says, though doctors are often seen as leaders in their health care settings and communities, then often have to learn those skills through trial and error.
“Traditionally they (doctors) have not been taught about leadership at all," Potyk said. "It’s been something that we’ve recognized more and more. We hear from our community partners when we work in the clinical setting that doctors don’t have the leadership skills necessary for the roles that they’re foisted into. That’s been recognized more and more by clinical health systems. But even more so recently there’s been a call from big organizations, from the Institute of Medicine, from the accrediting body for residency programs, and others who have said leadership skills need to be part of medical school training.”
So the University of Washington created what it calls a leadership pathway for its students in Spokane, drawing upon the leadership of Gonzaga’s program.
What is it that’s lacking in leadership among doctors?
“I think doctors are often times, in the old school way, trained to be on their own," Potyk said. "What’s lacking is how to influence teams, how to work together in a team, how to lead the team, how to build consensus. But then also that conflict resolution that we often times, in the old school way of thinking, haven’t been taught to do in a constructive manner.”
The students in the program learn leadership skills, in part through exercises that require them to think through real life scenarios.
“They’re walking into a clinic and suddenly they are the clinical leader and they have to form a team and they have to gather people around the mission. But they’re walking in with this tool kit that they can pull from and say, ‘I can look back on my time in the leadership pathway and think of this particular skill that I was taught or this particular theory that’s going to help me get through these tough situations," Strawther said.
“And what we’re talking about with the pathway is an intensive, four-year, longitudinal experience," Potyk said. "This is in a pilot stage right now, so out of our 60 students, we opened it up to 15 students and I think we had 25 apply, which was, at the same time, heartening and disheartening because he had to turn some away. We’re careful that it isn’t an add-on; they’re already drinking from a fire hose. We need to be cognizant of their time and everything else that they’re learning, but also recognizing that, when they go out into the world, people are going to see them as leaders whether they like it or not.”
Potyk and Strawther say the program reaches out into the community to find health care leaders who share their stories and life lessons. Sometimes the lesson is that the doctor needs to step out of the way and let someone else on the team, maybe a nurse, be the leader.
“The physician doesn’t always have to be the top person and that is why Rachelle mentioned that, in the case studies, we have people who aren’t physicians come in and share their stories and some of our mentors are not physicians. They’re hospital executives, people who have a leadership role, and came at this in different ways," Potyk said. "I think it really all comes down to having the humility to say, ‘I can learn from others and I want to learn from others.’”
“Learning how to be a good follower, what’s called good followership, and knowing there are times when, yes, you need to step up, and, yes, you need to facilitate the process," Strawther said. "But other times, even when you’re in a formal leadership role, you should be stepping back and allowing others to have a voice and empowering them to make decisions. I think the fact that we’re talking about this, about even getting the med students to think about the fact that they may be the highest position in the team and yet there may be a nurse who has 20 years experience who really should be deferred to. This is why we’re having these conversations.”
The UW-Gonzaga program is in its first year. As it’s refined, the UW School of Medicine also hopes to provide leadership training to the other students in its five-state coverage region, using technology to disseminate the lessons provided by Gonzaga.