Leaders in Medicine

We spend so many years in school learning how to be a physician, studying the biology and physiology, apprenticing on the wards, developing a framework to go from symptom to diagnosis, memorizing diagnostic tests and treatments. But as I near the end of my residency, I begin to appreciate that our education has not taught us how to become leaders. And as I've begun to appreciate the ebbs and flows of policy, health care reform, business management, hospital systems, and "bigger picture" issues, I've realized this is a big deficiency. We need good doctors, good physicians. But doctors are trained in a framework, a system, and in many respects, this system is not sustainable. It is the leaders who will innovate, change, create.

But compared to other fields, medicine doesn't engender leadership. Our classrooms in medical school - at least in the past - revolve around passive learning. We spend all our time trying to absorb a massive corpus of knowledge. When we first learn things, we memorize and regurgitate. Even as we progress in our medical education, the information is merely applied or data interpreted. We aren't trained to imagine, question, and create, at least not to a great extent. In residency, we are structured into hierarchical teams; we don't learn to challenge the way things are or question authority. This is the way medicine is learned for many reasons, and innovative education systems are starting to change things. But I compare this to the environments my friends in business, law, PhD, or design school experience. They are given problems without discrete answers and work in teams to design solutions. They think outside the box, try things, fail, make changes, and persist.

I've been in the operating room for three years, and I haven't come up with a single invention. I know the inefficiencies, the problems, the things I wish I could do. But I haven't been equipped with the skill set or toolbox to create something de novo.

But identifying the problem is the first step. We need leaders in medicine. Changes in health care, the way people are insured, the way physicians are paid, the relationships with industry, the way it is delivered need to be spearheaded by physicians. I feel like I have a long way to go to accomplish this. But if I am really to engage in medicine, I need to do a little more than write blogs and give patients naps.