When Dr. Shubhayan Sanatani took over as division head of Pediatric Cardiology at BC Children’s Hospital in 2015, he initially found the complex mesh of managerial, academic and practical duties more than a little dismaying. He felt snowed under by the information and input he had to absorb and he struggled with financial planning and oversight. Probably the most daunting challenge, however, were his new responsibilities to his colleagues around human resources issues. “[The circumstances] could be a union issue, working through the hiring process, or a personnel situation,” he says.
Like every physician, Dr. Sanatani had undergone years of intensive study and training, but almost none of it was geared to his new managerial role. He saw himself as being “in the sandwich,” answering to many different constituencies – whether patients, funders or colleagues – and attempting to satisfy often conflicting needs. Yet health and medical institutions are finding it beneficial to promote physicians to senior management positions, after a trend toward hiring professional managers proved generally less fruitful. Meanwhile, strong leadership is more vital than ever at a time when the need for institutional change is acute.
Fortunately for Dr. Sanatani and institutions that rely on physician-managers, a then-two-year-old program was there to assist. The Physician Leadership Program (PLP) offered through UBC Sauder’s Executive Education was launched in 2013 after months-long consultations with the BC Patient Safety & Quality Council, UBC Faculty of Medicine, Doctors of BC and B.C. Health Authorities.
“The PLP really speaks to the value of and need for truly customized learning,” says Bruce Wiesner, Associate Dean of Executive Education at UBC Sauder. “The initiative is the result of a close collaboration with Vancouver Coastal Health and with the healthcare sector to tailor an approach that blends research with practice. I believe that enabling physicians to better manage their administrative duties while honing their leadership skills is a potent combination.”
Two UBC Sauder faculty members with disparate backgrounds and research interests lead the PLP. Daniel Skarlicki, Edgar F. Kaiser Professor of Organizational Behaviour, focuses on organizational justice and fairness and how leaders add value to organizations.
Professor Mahesh Nagarajan, chair of UBC Sauder’s Operations and Logistics Division, is an expert in mathematical modeling whom researches and consults on operations management in the healthcare field, looking, for example, at surgical capacity and planning. Together, they mapped out a 10-day program divided into four modules.
The first module is about how physician leaders can understand themselves, expand their skills and better apply them within an organization. “In healthcare you can’t simply tell the people you work with what to do,” says Skarlicki. Rather, leaders need to expand their understanding of how to lead in a complex environment, sharpen their interpersonal skills that enable them to analyze situations, influence actions and effect change.
The second investigates the complexities of healthcare and Canada’s often-convoluted system, and helps physician-leaders develop strategies to manage within it. “How do you lead?” says Skarlicki, of an often-overwhelming hospital environment. “There’s all this chaos going on around you.”
The third module is operational in nature, addressing how initiatives can be introduced and then measured, in terms of value and quality. “The focus is on better outcomes at lower cost,” says Nagarajan. “Can we collect and use data based on real numbers and good science to make decisions that pay off?”
The final module takes advantage of the program’s unique structure, wherein the 10 days are spread across several months. During this time each participant undertakes a real-time project involving organizational change. It provides them a chance to practice their leadership. In the final class participants report back on their progress and discuss what they learned.
“Maybe it’s to reduce waiting times or waste, or to make a system more efficient,” says Skarlicki. “It’s really about patient outcomes and the potential to save lives.”
Dr. Sanatani’s project for example, was to find a solution for a highly specialized position that had long been precariously filled using term and temporary appointments.
“Part of the idea is to learn from one another,” says Skarlicki, while another easily overlooked but vital feature is the way that participants gain a network and support group.
Dr. Sanatani agrees that, for him, the program was highly practical but also psychologically affirming, with two crucial takeaways: “I wasn’t alone” and “There is hope to make things better!”
The program’s very existence is recognition of the leadership role physicians should be playing in healthcare, and a hopeful sign, he says, adding that he personally gained tools and insights that he believes will help him be a positive force.
Skarlicki notes that the collaborative nature of the program and the way that it can be incorporated into a physician-manager’s job with little disruption is unique. To date, the PLP has graduated about 450 physician-leaders and has attracted interest from other provinces and jurisdictions, along with laudatory evaluations from participants and professional assessors. Skarlicki believes that the program has come along at a critical juncture in the healthcare field. “We have to be innovative and execute change. There’s no choice,” he says, citing healthcare’s ballooning share of government budgets, the aging population and the growing shortage of physicians.
“Of the many things we do at the business school, this has to be one of the most important.”
Dr. Sanatani says he’s been encouraging colleagues to enter the program and is “waiting for the sequel.”
“There’s a lot to learn if Canadians are going to get the healthcare system they need,” he says, “or even keep the one they have.”
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