Last week I traveled from my new home in New London, New Hampshire to Farmington, Connecticut to participate in a leadership conference for a large physician group there. This group, like many physician groups across the country, is making that transition from the current reality of their total dependence on fee-for-service income to a future where they expect to be paid for quality and value. They know that to be successful in the new era of value-based reimbursement and ACOs will require leadership to optimize their population management and quality skills. Their board and leadership team are certain that developing new competencies and creating process changes will be required if they are to continue their record of quality and service to patients all across their state.
As is true for so many medical groups at this time, there is a range of understanding and acceptance within the practice of the changes ahead. This insightful group knows that leadership is critical to transformation and it hopes that it can use Lean thinking and Lean Leadership formulas to make their transition at a record-breaking speed. My former colleague, Tanya Chermak, who directed the Leadership Academy at Atrius Health that gave more than 300 hundred healthcare professionals business and leadership skills in rigorous six-month programs, is helping them with an all-important leadership skills program.
Mary Dawley, who led the implementation of MDI (management for daily improvement) and much of the Lean transformation at Harvard Vanguard, is also helping the group with a pilot practice transformation in one of their units that is eager for change. Mary is the model for “Lean leadership.” She understands the “standard work” of leadership. More than any healthcare professional I know she is comfortable “in the gemba” and can model what it means to coach, teach, and mentor others to be effective leaders in a Lean environment.
Before the meeting Mary and I were marveling over how much we had both learned over the last seven or eight years and we agreed that leadership can be taught but the necessary precondition is “attitude or mindset.” Leaders need to be people who care about the work of better practice, care about people, inspire trust by being trustworthy and personally strive to continuously improve their own understanding and skills. Good leaders learn as they lead. Good leaders must be honest about their own deficiencies and errors and be eager for their own continuous learning. If those qualities are present, amazing results are possible.
