Finding a new path.

When a clinician becomes a physician-executive, the shift is abrupt, confusing, and marked by few signposts. To be an organizational leader-especially in the 1990s, in health care more than in any other industry-is to be a master of teamwork, a maven of process, at home with ambiguity, comfortable with change, a nurturer of consensus, yet decisive, ready to move in the face of all the ambiguity. The hyphenated physician-executive lives in a state of culture shock. The first major step to overcoming this unfamiliar terrain is to recognize that the traits of the true organizational leader are, in fact, skills. The second step is to learn these skills, to set out deliberately, this far along in life, on a new kind of training, a new path.