Physician Leadership On Nonprofit Boards

Practical insights for physician board members and chief executives.

Physician leaders are often asked to serve on boards of nonprofit organizations.  Physicians in transition may also want to explore this—not only as an opportunity to apply their leadership skills outside of clinical practice—but also as way to give back to their communities.

I have found that a lot of ink has been devoted to the theories that drive nonprofit board leadership—but perhaps, too little about the nuts and bolts of ensuring effective boards.  While serving on a nonprofit board can be richly rewarding, it can also present a leadership challenge.  Depending on your past experience, you may want to take a closer look at the practical aspects of nonprofit governance, including formulating board structure and process, developing a strong partnership between board and staff, and structuring effective board and

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Physician Self-Leadership

The most challenging one to manage is you.

Self-leadership isn’t a concept most physicians think about very often.  Yet leadership capability relates as much to how we lead ourselves as how we lead others.  Some of the greatest barriers we face along the path to "making things happen" lie within us.

Most physician leaders can trace their greatest obstacles to something personal—a fear, insecurity, or self-imposed limitation.  As we consider past conflicts that really drained our energy—such as a partnership that didn’t work out or a team that fizzled under our watch—we must challenge ourselves to acknowledge our role in the failure.  Our flawed judgment is often the root cause.

As you lead others—in clinical practice or in a non-clinical role—you may very well be your greatest liability.  Self-leadership is about awareness, tolerance, and not letting your own natural tendencies limit your potential.

Find a Path to Self-Awareness

The forces of organization, community, and leadership capability often evade us because our tendencies—to generate more ideas, to isolate ourselves, and so on—get in the way.  Our best hope for staying on track is to notice when we drift off course and to figure out why—to be self-aware.  Self-awareness is a critical skill in leadership, but it is deeply personal.  It is not about our actions but about the emotions that trigger our actions.

With increased self-awareness, we become better students of ourselves.  When we make mistakes, we are able to identify what we could have done better more readily.  When we receive feedback from others, it becomes more actionable as we come to understand its correlation with our emotions.  The path to self-awareness never ends, but we must cross it nonetheless.

Learn From Your Mistakes and Failures

Most of us have a hard time with failure because we feel not only the professional loss but also the personal hurt when our ideas fail to gain traction.  But this tendency poses a problem for us as we commit ourselves to act without conviction.  Projects that encounter or end with failure have great value—but only if we can recognize it and reap the benefits.

When we experience failures, we must remain open to the lessons that can be learned.   Grasping the realizations that come with failure is a crucial part of the learning process.

When something goes wrong, there are three questions we should seek to answer: What external conditions may explain the failure, what internal factors may have compromised our judgment, and are there any “gems” in the unintended outcome?

Avoid the Trap of the Visionary’s Ego

During my time in the medical device and pharmaceutical industries, I had the opportunity to participate in a lot of meetings in the executive suite during both the expansion and bursting of the bubble that followed it.  I always found it interesting how every challenge was presented as an unusual one-off.  The business leaders would nod their heads in affirmation.  “This is an unusual time," someone else would say. 

Despite history, the tendency to think that a given opportunity or challenge is a one-off still persists.  Some call this tendency “visionary’s ego,” when a leader’s default thinking is that he or she is the exception to the rule.  As physicians, we may be susceptible to bouts of this form of narcissism.  While our tendency is to approach every situation with a fresh set of eyes, we should also accept a grounding realization: not much is entirely new—and yes, we can learn from the past.

Challenge yourself to have some perspective.  Don’t get caught up in the novelty of what you are doing that you lose touch with what’s been done before.  As you encounter negotiations in healthcare organizations, collaborations with partners, or unique decisions or investment opportunities in your business, ground yourself with the fact that the situation you face isn’t as isolated and unique as you might think.  Previous knowledge is yours for the taking, often risk-free and time-tested.  Today never feels like it will be history, but it will.  And more than likely than not, you will look back and realize that you should have known. 

Challenge Conventional Wisdom

As you harness the lessons from the past, you must also question them.  Of course, nobody should disregard good advice and fall victim to visionary’s narcissism.  But as physicians, we cannot become imprisoned by the status quo.  We need to reconcile our tendency to seek the advice of experts with out desire to do things differently—and perhaps better.  We should be wary that “best practices”—the tried and true ways of doing things—often become conventional wisdom—and conventional wisdom is often wrong.     

Consider Yourself an Entrepreneur

Whether you work for a large corporation or on your own, when it comes to leading ideas, ultimately you are an entrepreneur.  Entrepreneurs are not the ones with the best ideas, says Andrew Weinreich, a trailblazing entrepreneur, “They’re just the ones willing to jump off a cliff without the answers." 

Some feel the hardest part of pursuing a new venture is pulling the trigger—being mentally into it or not.  So, when you come across ideas worthy of your time and energy, it is important to know which assurances you need—and which you don’t—before you decide to take the plunge.  You will never have all the answers, but you need to feel that the risk of giving it a go is less than the risk of not trying.  You don’t need to see the finish line, but you do need enough momentum to stay afloat.  What matters most is your ability to keep moving your idea or venture forward, day by day.   

Be Willing to Change Your Mindset

Physician leaders who have done extraordinary things often talk about times when they made decisions that were unpopular—but necessary for their success.  Perhaps it was leaving clinical practice to pursue their passion—or quitting a well-paying job to start a company.  Maybe it was saying no to an opportunity that seemed golden to others.  Because of their decisions, their paths were unconventional.  But in the midst of discouragement from their families and friends, they persisted and gained confidence from being challenged. 

Just remember that the uncharted path is the only road to something new.  As pressures mount, you need to stay the course and consider the doubts of others as an indication of your progress.  

Keep an Eye on the Clock

In hindsight, it’s easy to talk about assuming a different mindset and defying the status quo.  But it is very difficult to take the leap.  Many of us postpone our dream pursuits for a whole host of reasons.  We’re waiting for the right time—but are not sure when that time will come.  We may have good reasons for not doing something, but we pay a price for postponing action.

Consider keeping an eye on what you’ve done with your time.  Think about the last time you sat through a dull meeting.  Recall how you tuned out the conversation but became aware of the time you had lost.  During that time, were you taking any risks to develop other opportunities or move a new venture forward? Were you marketing yourself for an opportunity to get closer to your true passion—or develop a new area of expertise?  Were you expanding your network and connecting with the opportunities around you? Depending on your point of view, this could be either a painful reminder of wasted time and lost opportunity—or a motivational reminder to use every minute to pursue your dreams in the next chapter of your life.  

Physician Leadership Of Teams, Part II

Read Part 1 of Physician Leadership Of Teams here.

Developing Your Team and Increasing Its Effectiveness

Leadership involves skills and abilities that are useful whether you are a physician in clinical practice or an executive in industry.  You could be developing a new medical device or managing a clinical trial for a pharmaceutical company.  Simply put, leadership is everyone’s business.  And the ability to build a team and improve its performance is becoming increasing important.     

Charles Elachi, director of NASA's Jet Propulsion Laboratory, put it best: “No matter how good you are, the thing that makes the difference between success and failure is how good a team you have.”  The team you build, develop, and contribute to will reflect—above all else—the behavior you model.  The symbolic aspect of your behavior, both as a team leader and as a team member, is often its most influential dimension.

In my experience, the best teams demonstrate a number of key attributes.  Here’s what I’ve learned about high-performing teams—and what we can do as leaders of teams:

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Physician Leadership of Teams

Using a team charter to make sure your team is on the right track.

You could be a physician in clinical practice—or work for a medical device or pharmaceutical company.  Chances are you will need to be able to lead a team to achieve a desired outcome. 

Working in teams can be terrific—if team members work well together.  However, if people are pulling in different directions, the experience can be dreadful.  Without sufficient direction, teams can focus on the wrong objectives, fail to use important resources, or be torn apart with avoidable infighting.  What's worse is that they can fail, sometimes with dire consequences for the organization.

Creating a team charter is one of the most powerful ways a team can make sure it’s on the right track—and everyone is committed to the work of the team. A team charter is a set of agreements that define the purpose of the team, what it wants to achieve, why it is important, and how the team will work together. As the team encounters obstacles or roadblocks, the charter can serve as a “roadmap” to keep the team on course—and focused on the end result. 

As a physician leader, you can take an important step in guiding your team in the right direction. By using the chartering process, you can help your team clarify its purpose and values, develop goals and strategies to accomplish the desired outcomes, and create a written agreement that captures the common understanding.

For teams to get off on the right foot, team charters should be drawn up when the team is formed. This helps to make sure that everyone is focused on the right things from the start. However, drawing up a team charter can also be useful if a team is in trouble and people need to regain their view of the big picture.

Here is a checklist I’ve used in business to develop a team charter that can help drive momentum and keep the team focused on results:

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The Essence Of A Physician Leader

Evolving view of physician leadership: Breaking the mold.

Prevailing models of leadership have prevented organizations from developing a broad range of leaders who can work together to create strong leadership teams.  Conventional models are now giving way to a different approach to leadership.  Physicians looking for non-clinical roles may have a competitive advantage, given their backgrounds and the evolving view of leadership in industry.   

In the past, conventional wisdom suggested there was one best way to be a leader.  Neophytes were taught that leaders were born with the skills they needed—and further development was not necessary.  The privileged few led by telling others what to do, and their subordinates were expected to follow.  These leaders tended to be autonomous and often made decisions and took action independent of others.  Like the fictional character, the “Lone Ranger,” this type of leader became an enduring icon of American culture.     

Today, a new model of leadership is emerging.  The trend suggests there is more than one way to demonstrate leadership.  A diverse set of leadership styles is essential for the success of an organization.  Leadership involves skills and abilities that can be learned—and all leaders—regardless of their level and experience—can strengthen and improve their skills. Moreover, the best leaders are also team players.  They operate systemically, much like a team captain.

Conventional Model                  Emerging Model

One best way                           Leadership pathways

Static                                        Developmental

Born                                          Made

Individual                                  Systemic

Lone Ranger                             Team Captain

What Physician Leaders Really Do

Many have expounded on the difference between management and leadership.  Simply put, management is about coping with complexity; leadership is about dealing with change.  Leadership complements management; it doesn’t replace it.  Physicians seeking leadership positions in industry will need to understand the difference—and build on their clinical experience. 

The Difference between Management & Leadership

Companies manage complexity by planning and budgeting—and setting goals for the future.  By contrast, leading an organization to change begins with setting a direction, developing a vision and strategy for the future.   Setting the direction of change is fundamental to leadership.    

Management develops the capacity to achieve its plan by organizing and staffing, creating an organizational structure and delegating responsibility.  Leadership is about aligning people around the change vision. 

Management ensures its plan is achieved by controlling people, monitoring results, and problem solving.  But in leadership, achieving a vision is about motivating and inspiring people—keeping them moving in the right direction.

Despite leadership’s growing importance, the on-the-job experiences of most people undermine their ability to lead.  One way to develop leadership is to create challenging opportunities for yourself or your staff members.  A key to developing a new skill is finding a way to practice, which you can do through a special assignment to broaden your exposure.  More importantly, some say that creating a culture of leadership is the ultimate act of leadership.  Physicians in industry may be uniquely suited to drive this change in culture and mindset. 

Management                                     Leadership                  

Planning and budgeting                    Setting direction

Organizing and staffing                     Aligning people

Controlling and problem solving        Motivating and inspiring people

Produces predictability and order         Produces change