The Clinician as Leader: Why, How, and When.

Clinicians are inveterate leaders. We lead patients through the difficult maze of illness, families through the travails of ill loved ones, and physicians-in-training through the gauntlet of learning medicine. Yet, in the context of a range of leadership styles that effective leaders must be able to deploy situationally, physician leaders have traditionally defaulted to a "command and control" style that fosters the concept of physicians as "Viking warriors" or "heroic lone healers." The perverse effects of "command and control" are that this style conspires against collaboration and tends to be perpetuated as aspiring leaders emulate their predecessors. Because healthcare faces challenges of cost, access, and quality and is in the throes of change, the current landscape requires effective leadership. Though still relatively uncommon among healthcare organizations, frontrunner organizations are offering leadership development programs. The design of such programs requires clarity about requisite leadership competencies and about how and when to best to deliver such curricula. As one example, the American Thoracic Society has launched its Emerging Leaders Program (ELP), which is currently offering a leadership development curriculum to 18 selected emerging leaders. The ATS ELP curriculum focuses on awareness of self and system and incorporates highly participatory sessions on emotional intelligence, teambuilding, change management, situational leadership, appreciative inquiry, process and quality improvement, strategic planning, and organizational culture. Short-term deliverables are the development and presentation of business plans for innovations proposed by the group. Hoped for longer-term outcomes include an enhanced leadership pipeline for global respiratory health.