Four Leadership Lessons Medical School Didn't Teach Me
When dermatologist Dr. Stephanie Klein proposed a clinic for urgent skin care needs, she thought it would be easy. Reserve the clinic rooms, schedule the appointments鈥攄one! She quickly found out that moving from idea to reality would require leadership skills that she hadn鈥檛 been taught in medical training and ten years of practice. Accelerate鈥檚 Mari Ransco found out how Klein transformed from busy clinician to leader.
By Stephanie Klein | 4 minutes
LEARN BY DOING
In 2014, Stephanie Klein and Utah鈥檚 Department of Dermatology took a risk. They decided to open a clinic for urgent skin care needs鈥攁 new rash, blisters, skin pain鈥攃onditions that would typically send a patient to an urgent care center or the emergency department. Before the same-day dermatology clinic opened, patients would find themselves with a weeks-long wait to see a dermatologist or perhaps an incorrect diagnosis. Klein said, 鈥淲e know that non-dermatologists have about a 50% chance of getting the diagnosis correct for a dermatologic condition.鈥 Opening the same-day dermatology clinic meant that patients with an acute skin issue would get the right diagnosis from the right provider鈥攁 board-certified dermatologist.
While the immediate demand for the clinic鈥檚 service was exciting, Klein faced many hurdles to success. Leading change requires physicians to move beyond excellent diagnostic skills and efficient daily work, and embrace the hard work of building effective teams. Here are some of Klein鈥檚 lessons.
#1 IMPROVEMENT IS ENERGIZING
Building same-day dermatology gave me the opportunity to be creative. I was happy in my regular clinic practice, but thinking about improving health care really energized me. When I got to take the Value Improvement Leaders class, I loved it. I loved thinking about my mission and the potential financial impact of an urgent access clinic. I have an undergraduate degree in economics. I really loved the creative component of building something new and working on it.
#2 SHARING YOUR VISION IS KEY
I always thought the key to being successful in my clinic was showing up and achieving the best outcome by getting the right diagnosis. I鈥檝e always felt that my job meant working hard. But leadership is not the same. I thought opening the clinic it was just a combination of logistics鈥攇et the appointments, get the staff, get the doctors, get the rooms, and just push it all together and you have a clinic. But it isn鈥檛 that simple.
I received tough feedback from my colleagues, the staff, the residents, and worst of all鈥攖he patients. My coach in Value Improvement Leaders, Dr. Frank Thomas, told me I need to get people on board with the idea of same-day dermatology. I realized that I had to articulate what I wanted and why this was important. But it was so hard. Sharing your vision sounds like such a simple concept, but it鈥檚 really hard in practice.
Sharing my vision has made my team so much more functional. They don鈥檛 want to move around because they know that I care about them, and that they are part of delivering this important care. Just 鈥渄oing a job鈥 can feel empty. Our real work is impacting lives and improving care.
#3 HOW TO SHARE YOUR VISION MATTERS
(Hint: creates shared purpose)
For a while, I would say, "Same Day Dermatology is providing immediate care to the sickest patients by the people who are most trained to be able to provide it." Now I tell stories about the kind of care we deliver. For example:
鈥淎 homeless patient with schizophrenia was frequently admitted to the University Neuropsychiatric Institute (UNI). When he stayed at UNI, he experienced intense itching, which was thought to be scabies. The UNI staff sequestered him so we wasn鈥檛 contagious to others. The patient couldn鈥檛 participate in meals or attend therapy sessions. UNI sent him over to the same-day dermatology clinic, and it turns out this patient didn鈥檛 have scabies or something infectious. It turned out he had dermatitis herpetiformis, which is an autoimmune skin manifestation of celiac disease, with lifelong manifestations. Once we treated him, he was able to heal.鈥
I tell people that we would have never caught this patient without same-day dermatology, and that this service is how we are improving health care delivery for individual patients.
#4 YOU HAVE TO BUILD RELATIONSHIPS TO BUILD A TEAM
I never had to share a vision with a team. I never had to be compelling before. Medical school just teaches you to work in a hierarchy, and you鈥檙e always on the low-end of that hierarchy, until all of sudden, you鈥檙e not. It doesn鈥檛 work if you just tell people 鈥淚鈥檓 starting this new clinic because I want to.鈥 But the idea that we are serving under-served populations, that we are improving quality for patients by getting them the correct care when they need it鈥攖hat resonated with people.
After people shared their negative feedback, I realized I had to build relationships to build a team. For about seven or eight months, I walked around with a notebook, and when someone said something negative about same-day dermatology, I would ask them, 鈥淥k, what exactly are you worried about?鈥 I would write down their thoughts, and I would really listen and learn. People could see that I really wanted to know their ideas. Once they started feeling heard, and could see their ideas at work, we starting becoming an effective team.
CONTRIBUTOR
Stephanie Klein
Assistant Clinical Professor and Director of the "Same Day Dermatology" clinic, Department of Dermatology, 91麻豆天美直播
