Cleveland Clinic physician: To lead in a volatile, uncertain world, take a lesson from the military

Embracing change often means physician leaders have to work against their clinical training, says Dr. James Stoller of the Cleveland Clinic.

Cleveland Clinic's James Stoller, M.D., describes the current healthcare environment using the military acronym “VUCA,” which stands for “volatile, uncertain, confusing and ambiguous.” It's a combination that creates a leadership challenge for executives.

Technological evolution and changes in patient expectations have accelerated the pace of change in the industry, Stoller,  Chair of the Education Institute, tells NEJM Catalyst. The political uncertainties surrounding the Affordable Care Act only add to the complexity of the situation.

According to Stoller, leaders must acknowledge and embrace change and uncertainty rather than fighting them.

In healthcare, the dichotomy between clinical and executive leadership priorities often requires physician leaders to embrace collaborative efforts that run counter to traditional medical training. 

“Part of the change in the way that we train doctors has to do with changing the hidden curriculum, by making explicit and mindful some of the differences that people experience about being in healthcare,” he says.

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Entrenched hierarchical structures stemming from the typical experiences in clinical training also produce a challenge for developing physician leaders, which produce what a paper published in the Harvard Business Review termed “heroic lone healers.”

In his training sessions, Stoller says he works against this type of hierarchical thinking by modeling a more collaborative leadership style in which he has a series of informal conversations with residents and medical students to gauge their expectations.

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