As physicians, we easily fall into the trap of blaming outside influences (e.g., insurance companies, regulators and big hospital systems) for our daily frustrations. We become quietly resigned to long hours and declining payments.

Paradoxically, because we write “orders” we also become accustomed to having things our way in our offices and hospitals. But as emerging physician executives, we must reject these attitudes in order to successfully lead.


The Surprise

I was meeting with one of my direct reports and it looked like I had an opportunity to do some coaching. Jerry was seated across from me, ready to go over his weekly report.

He left the discussion of his new project until the end of the meeting. He was frustrated. He had completed part of the project. But the director of another department had failed to complete her part, which was required to move to the next step.

“I sent the partially completed application by email 2 weeks ago. I still have not heard back. I am so frustrated with Susan because she constantly does this. She always keeps me waiting.”

“As the project manager on this,” I asked, “did you contact her to see what's going on? Did you offer to help free up other resources so she could focus on this part of the project?”

He responded, “No, I didn't. She knows her role in this project and how important it is. I shouldn’t have to babysit her. I'm so tired of directors like her not following through. I do my part, and I expect them do theirs without having to be reminded all the time. If this project fails, it's not on me.”


I had not heard one of my directors so blatantly play the victim in quite a while.

broken attitudes

Failed Leadership

Jerry demonstrated one of the premier attitudes that would keep him from advancing in the organization. He was blaming someone else for the pending failure of a project he was leading.

There may or may not be a reasonable explanation for why Betty had not completed her part of the project. But whether he liked it or not, Jerry was accountable for the success or failure of the project we were discussing.

He might have considered these possible explanations, rather than exhibiting the attitude he did:

  • Did she go out of town unexpectedly?
  • Was she given another task by the CEO or CFO that kept her from this project?
  • Were there unexpected staffing shortages?
  • Did she even receive the email request from Jerry?

I've observed several colleagues transition from clinician to formal leader. During the process they each adopted new behaviors and attitudes and rejected some old ones. Reflecting on this, there are at least three counterproductive attitudes that every physician leader must jettison.

Three Attitudes to Reject

1. Victimhood

When you're in charge, your role is to get the job done. You must plan, communicate, coordinate and manage. And when a project goes “off the rails,” you need to be accountable.

After making a mistake or failing to meet a deadline, here are the steps to take to reestablish accountability:

  • Admit that you did not prepare fully, communicate sufficiently, or manage appropriately.
  • Restate your understanding of what needs to be done.
  • Explain how you're going to rectify the problem.
  • Commit to resolving the issue and completing the assignment by a specified deadline.

2. Resignation

As a leader, having committed to proceed on a goal or critical initiative for the organization, you do not have the option of just quitting. You have to muster all of your skills, engage others, and shift your approach even if you're frustrated and tired.

3. Self Righteousness

As physicians, we have learned that in many situations we are the experts. We are asked to make clinical decisions based on extensive training, mentoring and experience. We are seen as the final decision maker.

But when we enter the realm of management, we are often less experienced that our peers. We need to adopt an attitude that is more collaborative, to listen more, and to offer an opinion only when asked. Our direct reports may have more expertise in management than us, since they have come up through the hierarchy (from front line worker to supervisor to manager or director). The best approach to a problems may be to ask our staff: “What do you think we should do?”.

And in our role as executive team member, we should listen intently, engage in the conversation, and express our opinions. But, even if we don't agree completely with a final tactical or strategic decision, we must align with the CEO and executive team and support the chosen actions.


In your next meeting, see if you can identify these attitudes in your colleagues. How do they affect your assessment of them as leaders?

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