Interview with Dr. Peter Angood

In today's interview, Dr. Peter Angood explains why the best way to empower physician leaders is to join the American Association for Physician Leadership.

 Peter has been the AAPL's President and CEO since 2011.

He began his professional journey as an academic critical care surgeon. He worked in academic settings at Washington University, Yale University, and McGill University. Angood has written more than 200 articles and is a fellow of the Royal College of Surgeons, the American College of Surgeons, and the American College of Critical Care Medicine.

Peter previously served as The Joint Commission's first patient safety officer, the National Quality Forum's senior patient safety consultant, and the chief medical officer of GE Healthcare's Patient Safety Organization. And he was the Society of Critical Care Medicine's president.


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American Association for Physician Leadership's Benefits

The 50-year-old AAPL was founded to empower physician leaders and managers. The evolution of healthcare has evolved and grown increasingly complex. And it is imperative that physicians assume leadership roles in all aspects of healthcare.

The range of services offered by the AAPL is quite impressive:

1. Strong and in-depth information sources (journals, newsletters, and archives);
2. Webinars, Podcast Series, and 85+ educational courses;
3. The Certified Physician Executive Credential; and,
4. Access to advanced business degrees with 5 Universities and 7 Master's Degree specializations.

The benefits of membership are supported by dedicated employees and an excellent technical platform. And the organization provides 350 to 400 educational programs each year.

Importance of Certified Physician Executive

The CPE provides certified physicians with practical insights and a strong healthcare network. Acquiring the designation also requires at least a full year of meaningful experience in leadership and management work. Recruiters now recognize the value of the CPE and often list it as a desired credential in job candidates.

…some of the search firm consultants out there, if they're honest with you, they'll tell you [they] would rather have a candidate with a CPE than a candidate with a master's program.

Summary

Joining the AAPL will help surround you with other physicians already working in management and executive leadership roles. By networking with other members, you will find mentors and coaches to help you follow your leadership path.

By attending live or online courses, you will develop your business and management skills, while demonstrating your commitment to leadership to practice partners and current and potential employers.

If you pursue the CPE and or fellowship, oyo will distinguish yourself as a recognized physician leader.

NOTE: Look below for a transcript of today's episode.


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Transcription PNC Podcast Episode 264

What Is the Best Way to Empower Physician Leaders?

- Interview with Dr. Peter Angood

John: I've spoken about the AAPL many times on the podcast over the past five years mainly because it was a big part of my career transition. I was working as a physician advisor and a little bit of medical directorships and joined the AAPL. And eventually it really helped me to pursue my job as a chief medical officer for a hospital. I thought I would devote an entire episode to this topic today, the American Association for Physician Leadership. And who better to have on as a guest than the president and CEO of the organization, Dr. Peter Angood. So hello, Peter, it's nice to have you on the podcast.

Dr. Peter Angood: Hey John, thank you so much. And I very much appreciate the opportunity and I look forward to our conversation.

John: This should be fun. We're going to give it about 30 minutes or so. There's so much. The organization is really very complex and has a lot of offerings, but before we get into the details of the AAPL, how about just a thumbnail sketch of your background and how did you end up there at the organization?

Dr. Peter Angood: Oh gosh, thank you for the opportunity. I'm a surgeon by background. I spent a better part of 25 years in the academic side doing trauma surgery, surgical critical care. And both of those are multidisciplinary and very systems oriented. So, as I got into mid-career, I found myself thinking more and more about how to create larger scale systems change as opposed to patient-by-patient hospital by hospital.

I was very fortunate as I made that shift, I became the first chief patient safety officer at the joint commission. And that was just one of those career opportunities that really opened my eyes to a lot of the intricacies of our industry and how complex healthcare is actually. I looked after all of the safety initiatives at the joint commission and we did a lot also internationally as well as a bunch of work with the world health organization. Again, that national international exposure was wonderful.

I did that for a number of years and then shifted over to the national quality forum and looked after their safety initiatives and NQFs are all about measurement and how do we get better measurement tactics inside of healthcare. I spent a very brief bit of time with GE Healthcare looking after their patient safety organization.

So, a little insight to the for-profit side of life, but those experiences, John, made me really appreciate that it's all fun and fine to be doing policy development and deployment and all that sort of stuff. But those organizations often didn't have enough physician insight as to really how to deliver care. Take GE for example, a multi-billion-dollar international organization and their true appreciation of how healthcare is delivered from a physician perspective, if you will, was absent.

After those experiences and my ongoing desire for trying to create larger change, I was looking for an opportunity to work in that gap zone, if you will, where I'm still involved and aware of what's going on at that policy level, but also strongly connected to the front line. And I was very fortunate to be chosen as the successor CEO. AAPL at the time was the American College of Physician Executives. The organization is nearly 50 years old now, and I've been here about 10 years and it's been just a wonderful journey in the organization. Truly does sit right in that gap so it influences the policy side, but also very strongly tied to the frontline.

John: Yeah. It's grown, it's morphed over the years. And so, we're glad to have you there. It's been awesome since you've been there these last 10 or so years.

Dr. Peter Angood: Out there. Yeah.

John: Yes. Why don't you give us in a nutshell what the AAPL is? If someone is listening that never heard of it or maybe has heard of it, but has really not looked into it. What is it? What does it do? How does it help physicians with their career advancement?

Dr. Peter Angood: Sure. Well, as I mentioned, it's nearly 50 years old as an organization and the originating CEO, Roger Schenke was a clear innovator in his own right back in the day. And he ran the place for 35, 37 years. And almost I think created the whole concept of physician executives, physician leaders.

While he was running the ship, wound up with a strong constituency of physician leaders who mostly were mid-career, mostly looking at administrative roles in hospitals. And the pinnacle was you get to be a CMO. And yet healthcare's continued to evolve, as you said, in the opening, healthcare's very complex as an organization and so we've become more complex. And as we've been transforming the organization from Roger's beginnings, we really took a different philosophy and that is our society as a whole really continues to look at physicians as leaders.

And the medical profession is still by and large, strongly trusted, and the medical profession is a lead profession. I've taken the philosophy at some level, all physicians are leaders and how do we help physicians embrace that? It's like a responsibility, but it's also a privilege. And so, we're really all about that leadership development, but also professional development along the entire trajectory of a career.

We've expanded and diversified the variety of things that this organization offers. So, we've got very strong and deep information resources. We run a couple of journals, a number of newsletters. We've got a great archive. We've got webinars. We have our own podcast series, had some great guests on that, but then as well, we've obviously continued to expand our educational offerings. We have 85 plus different courses. We have our certified physician executive credential, which is an industry recognized credential. And then you can continue on to become a fellow of the organization. And that's not an automatic, you got to earn the fellowship, all those sorts of things.

And then as well, we have partnerships with five universities and offer seven different master's degrees in there. We've got a large community as you might well expect, and we've got a terrific technical platform to support all of this, the information resources, the education, the networking, the community.

And what a lot of people don't appreciate is that we also do a lot of institutional organizational work. As those of us who are physicians know there's a long-spotted history of the medical staff versus the general administrative staff of hospitals. And they don't always get along. But with the employment trends in about a half of physicians are now employed, many of them by hospitals and health systems, what we're finding is that those institutions are looking for ways to better integrate and engage and to get physicians into leadership roles. And the traditional HR offices are not necessarily all that good at that.

And so, we are working with a good number of institutions. We probably put on 350 - 400 programs a year with different types of organizations to help them with not only the physician leadership pieces, but how to better manage with their medical staff and that whole interface as well. And that's been just wonderful.

And then, yeah, there are a couple of pieces within the international arena. There are not that many countries that have similar organizations such as ours. There are maybe 12 or 14, and they all tend to view us as that best organization, sort of best of breed type of thing into that. And we were just doing some analytics on some of our website stats and purchasing stats. And could you believe this, John? There were 135 countries represented who had been poking around on our website and trying to sort things out. Physician leadership is strong, we're strong and it's just a privilege to be in that role where people want to learn more about it. It's a new era for physician leadership. It really is.

John: Yeah. Things are always evolving. And yeah, I think I've definitely spoken with physicians from other countries and they're looking for assistance in thinking about what direction their career should go and how to get more exposure to leadership and management principles and working together with teams and so forth.

Now, the last thing you mentioned in that whole long litany was working with these organizations. Now I'm kind of thinking some of that with the medical staff is like dealing with let's say burnout and resilience. Does that get into that? Because that seems to be something that's in big demand.

Dr. Peter Angood: Oh yeah. And all those of us that have been in this profession, we all know burnout was happening before the pandemic. The pandemic has brought it forward. The stats are horrible. And yet the way I view it, physicians are resilient as a breed. We got these incredibly long education tracks and then that whole startup of your practice. And so, to walk around telling physicians to be more resilient is kind of a lost cause in my mind.

John: You are talking my language there. We are already resilient.

Dr. Peter Angood: We are.

John: To deal with these other issues.

Dr. Peter Angood: And that's the point, John. It's those other issues, the systems and processes that create frustration that then lead down to the anxieties and the stressors and take this job and shove it kind of attitude that shows up sometimes. And our approach is really kind of in a few different ways. One is clearly there are some individuals who are truly burnt out and they need some assistance and they have to be helped and it's unfortunate, but that's just a reality.

John: True.

Dr. Peter Angood: But we also have to help organizations appreciate and understand that improving their systems and processes will go a long way to improving workforce wellness. And then the third piece therefore then is how to help the physicians in other healthcare professionals to understand better that systems change takes time. Don't just sit and complain about it, but look for ways to engage, help to create more change in the systems and processes. And that will help with sort of an improved awareness of why you're feeling frustrated. And it gives you a longer-range view on things.Because of the respect that the physicians get in organizations inherently and the medical profession as a whole, if we have a strong responsibility to engage in trying to help all of the organizations, whether it's our private practice, our hospital, our post-acute care systems, help them all because folks tend to listen to physicians. So, it's a wonderful opportunity to help abate the burnout by taking that broader based approach.

John: That kind of ties in with something we were talking about before we went live or went on the recording. And that is how the AAPL, although it's an organization for physicians run by physicians, you told me that we were kind of getting involved with other nonphysician components of the system.

Dr. Peter Angood: Yeah. Thanks for bringing that up, John. For a number of years now, multi-professional team-based care has been out there. And a lot of it started in ICUs and emergency departments, transplant programs, all those sorts of things. And so, it's natural that leadership begins to become more interprofessional as well. And as many of your listeners will recognize there's dyad models and triad models. Some of them work, some of them don't. All those sorts of things.

But what we're recognizing in our institutional programs is that as much as 20% - 25% of the participants are actually nonphysicians and organizations are looking more and more for physicians to be the CEO of places. And in that type of setting, obviously then that interprofessional leadership is critical. For those organizations that are more progressive, they're very much encouraging interprofessional leadership. And so, physicians are like "Hey, we're trained and we like being the boss of the team." That's a cool thing, but that's shifting and you can be a strong contributor of a team without having to be the leader of the team.

John: Yeah. That's something that I was not aware of. The extent to which the AAPL was getting involved in that component. So that's awesome. I do want to go back to something you mentioned briefly earlier and you were talking about the different programs and that's the CPE, because I get a lot of listeners who ask about, "Should I get an MBA? Should I get a CPE?" And then I kind of explain what that means. But why don't you give us your take on that? What is the CPE? Who would benefit from it and maybe even how that ties into the MBA and similar business degrees?

Dr. Peter Angood: Yeah. Let's state the other obvious upfront though first, and that is unfortunately medical schools and residency training programs still pretty much do not offer any leadership education or management training. It's gradually shifting a little bit, but that's still going to take a good number of years before that's more common within the undergrad graduate and postgrad areas.

In many ways then AAPL functions as this bridge organization. And as we've said, both of us, healthcare's a complex industry. There are still phenomena occurring. You seem to be a good person, patients like you, your results are pretty good. Your peers seem to like you, congratulations. You're the new CMO here. And you have no background experience. You're holding this high responsibility, high stakes job. How the heck am I going to do this?

So the reality is in this day and age, is that for those individuals who are wanting to help create more change, want to get engaged creating change, you pretty much need some further education and certainly more experiences, whether it's committee work, project work, et cetera. You got to figure out this new arena of leadership and management and how best to fit in there. And again, as we said a few minutes ago, you don't just get to go in and do the command-and-control thing that we've trained to do. So, that takes a new skillset. And as I said at the beginning, it's been 15 years since I've been in the operating room as a trauma surgeon, but I'm still unlearning all that behavior as a trauma surgeon.

John: Yeah, it's different.

Dr. Peter Angood: It is different. I go through all of that to answer your question finally. With the need for some added education, you can do some fundamental stuff and you can do a variety of courses, but we've recognized and for 20 plus years have had this certified physician executive credential. And that is now about 170 hours of coursework. Majority of it is sort of prescribed and there's about 20% of it is elective time.

And then at the end of that 170 hours, there's a three-, three- and half-day capstone weekend, which uniformly is transformative for the people that come in and participate. And the way we view the CPE is different than a master's program and it's very complimentary. And we have had several individuals who've got master's degrees come through the CPE program, do the capstone event and they'll off say, "Darn, I wish I knew about this CPE program before my master's because it's so much more practical, so much more real and it provides me the better tools in which to really do my job." Master's degree programs are great and that's why we offer some. But often as we all know, they're more theoretical, not necessarily healthcare based. And they'll give you a good construct of some of the higher learnings needed to manage and lead, but they don't give you that practical insights. And they don't necessarily give you a strong healthcare network either, which is the benefit of the CPE.

So, you need something, the higher performing organizations that are looking to recruit physicians into leadership roles are often looking for advanced degrees of some sort. And I would love to say that the CPE trumps everything else. No, it's complimentary to those master's degrees. And I can't think of an individual who's taken it that's been disappointed.

John: Not everyone actually completes it when they start it because it is rigorous and it does require some demonstrated performance at the end in terms of what the goals of the program are. Correct?

Dr. Peter Angood: Correct. Yes, absolutely.

John: And by the way, I've mentioned this before in the podcast, I do see that the CPE is sometimes mentioned in job postings for physician executives which is very interesting. And it's been several years that that's been true. So, it really shows that it's a separate complimentary demonstration of one's expertise and experience because like you said, MBA is like book learning. I mean, unless you've actually done it. And I think the CPE also requires at least a year's experience doing some kind of leadership and management work. So, it really shows to those recruiters that there's a different level of ability and expertise there.

Dr. Peter Angood: Yeah, you're absolutely right. That by the time you get to capstone, you've got a well reformulated leadership philosophy, you'll have had to do a project and you will have had to have some experience as you describe. And a dirty little secret, some of the search firm consultants out there, if they're honest with you, they'll tell you I would rather have a candidate with a CPE than a candidate with a master's program.

John: I want to mention before we get to the very end actually the website for the AAPL, which is physicianleaders.org, correct?

Dr. Peter Angood: Correct. Yes. And fresh news. By the time you put this podcast out, I think our new fresh-looking website will be up too. So, I'd encourage folks to have a look.

John: We'll have to all go and take a look at that. Excellent. All right. Let's see. I want you to tease something out a little bit, because you said that CPE is complimentary. A lot of my listeners will ask me this question. "I want your advice. And it's probably difficult to give, but should I get an MBA? I'm unhappy in what I'm doing now. I'm doing some medicine, I'm thinking of moving into some kind of management position. Should I go get an MBA?"

Dr. Peter Angood: Yeah. We often tease. You give a physician a textbook on a weekend and by Monday he'll come back and he's an expert or she's an expert on whatever the topic was. So part of our reflex is to want to learn more.

John: Right.

Dr. Peter Angood: I think there's a deeper set of issues underneath that question. And it gets back to in part we're not exposed to leadership and management through our training, we are idealistic and altruistic by nature. And so, we're looking to create larger scale changes beyond our practice. Not everybody, there's a lot of docs out there perfectly happy seeing their patient volume every day and all that stuff and I commend that. I'm not saying you shouldn't do that.

But even if you're running a practice, you're a leader. The staff are looking to you, the patients are looking to you, your consultants are looking to you, et cetera, et cetera. And so, the onus is on us to sort of own the need to sort of improve our leadership and management as best as we can. And I think if we recognize that then as individuals, or even as a group practice, it's worthwhile getting everyone exposed at least some introductory elements of management, leadership, et cetera.

Organizations, especially the higher performing organizations, more and more are expecting all of their clinical leaders, whether it's a physician and nurse, et cetera, to have some type of added credentialing or education. And I've been told by some of our CPE folks who are strong believers in the CPE, but they're in recruiting type jobs in their delivery system. Their delivery system is like "Hey, you got to recruit the docs with a master's or some other added credential." And so, there's an industry expectation that's evolving.

Does that mean you got to have an itch to create change and go into leadership? You don't have to get a master. You don't have to get a CPE, but just know that the industry oftentimes is looking for something. So, you have to be able to explain your choices. And for time pressures, monetary pressures, family pressures, there's a lot of people who can't afford to do a master's or a CPE, but recognize you have to be able to explain that as you go.

John: Yeah. And there's no way around it, I guess. It's kind of a chicken and egg, but I would say that too, if you join the AAPL and start taking some courses, that demonstrates your commitment and that kind of ties in with the CPE later. What I was advised is if you can get some level of management or leadership job and then get that company to pay for the rest of your education at getting the MBA and or the CPE at the same time, that might be a way to go.

Dr. Peter Angood: Yeah. And what we're seeing more and more is the institutional are sponsoring those kinds of programs. And a little bit of a shameless plug but we've got our fundamentals cluster of courses. You don't have to do the CPE. And we've also got a series of what we call the academies, which are shorter segment focus types of offerings. So, there's the CMO academy. There's the quality academy, there's the safety academy, there's the finance academy. And those types of things can be shown as credentials. And again, to your institution, you're showing commitment to want to do more with leadership and management.

John: There's so many options at the association that didn't exist when I joined 28 years ago. It's great. It's a fantastic organization. So, let's see, if people have questions or are curious, number one, I know you're on LinkedIn, of course. So, if people just want to learn more about you and your background and so forth, again, I'm going to let you give us the website for the AAPL one more time.

Dr. Peter Angood: Sure, sure. It's www.physicianleaders.org. And if your listeners want to reach out to me either through LinkedIn, or you can catch me through my email address, which is pangood@physicianleaders.org. Also, if you're interested, we have a bunch of advisors that can help you sort of guide yourself in terms of where you want to go. And hey, we got a whole bunch of psychometric assessment tools out there as well. You can get a better sense of who you are and what you are. And our technical platform will really help guide you in many, many ways with recommendation engines.

John: The list of services keeps growing as we just spend another minute. So that was a question I was going to have before we close. A lot of physicians asked me about coaching and you said you have advisors at the organization. So how does that work exactly? Is that free if you're a member? Are there paid coaches?

Dr. Peter Angood: There's a spectrum of stuff there, John. The advisors I just mentioned are more staff who will help you understand AAPL better and how to navigate it. But we also offer a lot of professional development services and I neglected to mention that earlier and that's anywhere from we can help you build a better resume cover letter and LinkedIn profile. We can help you with interview skills. We have some mentorship matching and then as well we have a network of executive coaches for those who may want to pursue that line as well. And for some folk's coaching's very, very beneficial. It's shifting coaching. It used to be thought you're in trouble, you better get a coach, but that's not the case anymore. If you just want to get better at who you are, coaching can help. And we've got a nice network of those, but the mentorship is a good way to go also.

John: Yeah. The CEOs and CFOs have been using coaching for years and years, and it's definitely not a negative that's for sure. Okay. Well, that last bit you told me about was actually new to me as well. So, I really appreciate that. Well, we're at our time now, so Peter, this has been fascinating. It's the most in-depth review of the organization I've heard in a long time. So, I really appreciate taking the time and sharing that with me and our listeners.

Dr. Peter Angood: Well, thank you, John. It's been a real privilege to be here. It's a wonderful profession that we all have, and it's a complex industry and physician leadership is really on the forefront of helping to create the next stage of change in the industry. So, it's good stuff.

John: Absolutely. All right. Thanks Peter. And with that, I'll say goodbye.

Dr. Peter Angood: Bye John.

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