Rural Physician Leadership Curriculum

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Rural Physician Leadership Curriculum

• West Virginia University
• Rural Family Medicine Residency Program

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Rural Physician Leadership Curriculum

• Module 1
• Leadership Why, Where, What

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Description
Rural Physician Leadership Curriculum

• Funded by HRSA Grant D22HP00306
• Objective 1
• Develop a competency based longitudinal
  curriculum in Rural Physician Leadership

Konrad C. Nau, MD
Principle Investigator Chair, Dept of Family
Medicine-Eastern Division WVU Rural Family
Medicine Residency Program
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Learning Objectives Module 1
Rural Physician Leadership Curriculum

• Understand why leadership development is
  important for rural physicians
• Review traditional leadership definitions
• Operationally define leadership
• Review four growth stages of leaders

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Leadership Why ?

• USA Effective Healthcare Leadership
  shortage area
• Rural Physician shortage area
• Result - rural physicians have increased
  opportunity and impact for leadership early in
  their careers

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Leadership Why ?

• Action Plan for the Future of Residency Education
  in Family Practice / AFMO/August 2002
• Organizational Competencies
• Require residents to master teamwork
  competencies such as leadership, building
  consensus, cooperation, and verbal, written, and
  electronic communication.

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Leadership Why ?

• Satisfaction with Leadership roles may be a
  primary factor in rural physician retention
• Frustration with Leadership roles may be a
  primary factor in rural physician attrition

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Leadership Why ?

• The education of physicians is completely
  stacked against the development of leadership
  qualities needed in todays complex medical
  environment.

Michael S. Woods, MD
Applying Personal Leadership Principles to Health
Care The DEPO Principle , 2001, Tampa, Florida
ACPE, page 13.
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Leadership Why ?

• the system developed to select and train us
  operates counter to engendering good personal
  leadership and interpersonal qualities or
  perhaps we allowed those qualities to be trained
  out of us.

Michael S. Woods, MD
Applying Personal Leadership Principles to Health
Care The DEPO Principle , 2001, Tampa, Florida
ACPE, page 13.
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Leadership Why ?
so that
ATTRIBUTES
RESULTS
Because of
D. Ulrich, et al.
Results Based Leadership , Tampa, Florida
Harvard Business School Press, 1999.
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Leadership Why ?
so that
RESULTS
ATTRIBUTES
Regardless of
Michael S. Woods, MD
Applying Personal Leadership Principles to Health
Care The DEPO Principle , 2001, Tampa, Florida
ACPE, page 18.
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Leadership Where ?

• Patient bedside
• Office / Clinic
• Hospital
• Professional Organizations
• Community

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Leadership Where ?

• PATIENT BEDSIDE
• Traditional focus of residency training
• Face-to-face patient care
• Encourages and rewards specific sets of physician
  behavior
• NOT a focus of this curriculum

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Leadership Where ?

• Office / Clinic
• Recent focus of Practice Management
• Physician as employer
• vs
• - Physician as employee

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Leadership Where ?

• Hospital
• Committees
• Departments/Services
• Medical Staff Officers
• Interdisciplinary Patient Care Teams
• Clinical Pathways

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Leadership Where ?

• Professional Organizations
• State/National AAFP
• State/National Medical Societies
• Academic Faculty Community/STFM

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Leadership Where ?

• Rural Community

• School
• Homeroom mom
• PTA
• School Board

• Church
• Committees
• Liturgy
• Counsels

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Leadership Where ?

• Rural Community

• Sports
• Boosters
• Medical coverage
• Coaching

• Hobbies
• Clubs
• Events

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Leadership Where ?

• Rural Community

• Politics
• Advocacy
• Campaigns
• Holding Office

• Public Health
• News media
• Health Department
• Emergency Medical Services

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Leadership Where ?
Doctor
Employee
Organization
Patient
Michael S. Woods, MD
Applying Personal Leadership Principles to Health
Care The DEPO Principle , 2001, Tampa, Florida
ACPE, page 18.
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Leadership What ?

• Definition
• Leadership is

???????????????????????
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Leadership What ?

• Definition
• Leadership is
• After all these yearsno one is able to
  articulate a comprehensive, absolute definition
  of leadership.

Carson F. Dye
Leadership in Healthcare, Chicago Health
Administration Press, 2000. page 12.
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Leadership What ?

• Definition
• Leadership is
• Contingent upon three primary variables
• The leader
• The followers
• The situation

Hughes, Ginnet, Curphy
Leadership Enhancing the Lesson of Experience
3rd ed. New York Richard D. Irwin. 1998 .
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Leadership What ?

• Definition
• Leadership is
• Adapting principles to circumstances

George Patton
Patton on Leadership , Alex Axelrod , Paramus,New
Jersey Prentice Hall Press, 1999 , page 31.
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Leadership What ?

• Definition
• Leadership is
• A process that focuses on making organizational
  changes, while management is concerned with
  control and results

John Kotter
A Force for ChangeHow Leadership Differs from
Management, New York The Free Press, 1990.
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Leadership What ?

• Definition
• Leadership is NOT
• Controlling people
• Being boss
• Holding on to territory
• Pep talks

James A. Autry
Servant Leadership, Roseville,California Prima
Publishing 2001 , pages 20-21.
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Leadership What ?

• Definition
• Leadership
• Does not simply happen. It can be taught, learned
  and developed.

Rudolph W. Giuliani
Leadership, New York Hyperion , 2002, Page XII
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Leadership What ?

• Definition
• Leadership
• Is a blend of characteristics , and while no
  individual possesses all of the needed talents
  that go into leadership, each man can develop a
  combination to make him a leader.

Vincent Lombardi, SR
What it Takes to Be 1, Vincent Lombardi, JR New
York McGraw Hill , 2001, Page 2.
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Leadership What ?

• Definition
• Leadership is
• Acting in a way that affects people more than
  other peoples acts affect people.
• Competency-based

Ralph Stogdill
Stodgills Handbook of Leadership A Survey of
Theory And Research. New York The Free Press,
1984.
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Leadership What ?

• Definition
• Leadership is
• a social influence process in which the leader
  seeks the voluntary participation of subordinates
  in an effort to reach organizational goals.

R. Kreiter A. Kinicki
Organizational Behavior. New York Richard D.
Irwin, 1997.
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Leadership What ?

• Definition
• Leadership is
• Getting people to reach for common goals by
  helping them see aspects of the world differently
  , and creating a sustainable organization by
  developing leaders.

Noel Tichy
The Leadership Engine. New York Harper
Collins, 1997, page 42.
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Leadership What ?

• Definition
• Leadership is
• Attracting the voluntary commitment of followers,
  energizing them , and transforming the
  organization into a new entity with greater
  potential for survival, growth, and excellence.

Burt Manus
Visionary Leadership. San Francisco
Josey-Bass, 1992, page 10.
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Leadership What ?

• Definition
• Leadership is
• Inherent and learned skills
• Skills are effectively linked with values
• Values are ingrained beliefs that guide our
  behavior and thought

Carson F. Dye
Leadership in Healthcare, Chicago Health
Administration Press, 2000. page 15.
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Stages in the Growth of Leadership
Unconscious Competence
Conscious Competence
Conscious Incompetence
Unconscious Incompetence
Carson F. Dye
Leadership in Healthcare, Chicago Health
Administration Press, 2000. page 18.
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Stages in the Growth of Leadership

• Stage 1 Unconscious Incompetence
• You dont know that you dont know
• think leadership is not your job
• may be resistant to feedback
• developmental needs
• SKILLS TRAINING
• FEEDBACK
• SELF-AWARENESS

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Stages in the Growth of Leadership

• Stage 2 Conscious Incompetence
• You know that you dont know
• most important step toward learning
• may lose your job before you realize
• developmental needs
• MENTOR / COACH
• SINCERE DESIRE TO GROW / IMPROVE

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Stages in the Growth of Leadership

• Stage 3 Conscious Competence
• You know that you know
• effective but not born or strong leaders
• skills not totally natural yet
• developmental needs
• OPPORTUNITY TO PRACTICE SKILLS
• EFFECTIVE FEEDBACK
• CONTINUED LEARNING

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Stages in the Growth of Leadership

• Stage 4 Unconscious Competence
• You dont know that you know
• skills flow smoothly without force or
  hesitation
• ultimate stage of leadership
• seem to be true naturals at their trade
• born leader

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Stages in the Growth of Leadership
You dont know That you know
You know That you know
Unconscious Competence
You know You dont know
Conscious Competence
You dont know You dont know
Conscious Incompetence
Unconscious Incompetence
Carson F. Dye
Leadership in Healthcare, Chicago Health
Administration Press, 2000. page 18.
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Leadership Why, Where, What

• Why
• Need , Opportunity (especially rural)
• Job Satisfaction / Retention

• Where
• Patient Bedside , Office , Hospital
• Professional Org. , Rural Community

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Leadership Why, Where, What

• What
• Leadership is a social influence process using
  skills (inherited and learned) to seek voluntary
  participation of others to reach a common goal
• Leadership Growth Stages progressively develop in
  consciousness and competency

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Leadership Why, Where, What

• The Hope
• By developing leadership skills in young
  physicians , our nations rural healthcare will
  enhance its
• Survival
• Growth
• Excellence