March 29, 2018
After offering me his congratulations on my new job as Chief Medical Officer, a physician colleague said to me, “so, you're not a real doctor anymore.” This isn’t the first time a physician in a leadership role has heard such a comment.
I went into medicine to learn how to care for people, hoping to have a positive impact on the patients I am privileged to meet. I’m passionate about my chosen specialties (anesthesia and critical care) because I like working as part of a team, I like seeing the results of my work, and I have a side of me that likes to feel some sense of control.
My work as a system leader doesn’t provide the same instant gratification: the health system is difficult to navigate and it can take a significant amount of time to influence change. But a patient’s bedside is not the only place physicians can make a meaningful difference. By working alongside managers, directors and system leaders, physicians can have a positive impact on both patients and the system that serves them. We don’t have to choose one or the other.
Not convinced? I’m writing this from the Intensive Care Unit (ICU) at St Paul’s Hospital. It’s the end of day three of seven. I’m working alongside the rest of the ICU team as we support patients and their families through their crises. You will receive this message from me on day seven. I predict that by then, I will be more than physically tired. I will have shared in moments of relief and elation with patients and their families, and moments of profound sadness and loss. I will be looking forward to my days off to rest and reconnect with my own family.
Before making the transition to a single provincial health authority, a
Physician Advisory Network provided advice and guidance to the transition team concerning the role of physicians in a new organizational structure. It was recommended that all physicians in system leadership positions should continue to work in their clinical fields of practice.
Why did the network make this recommendation? Physician leaders who continue to engage in active clinical practice maintain ties to the patients they serve, to their colleagues and to the system.
A physician with an active practice is better able to understand what actually happens at the point of patient care. In other words, practicing physicians know what it’s like in the real world.
I’m finding that being a physician, who is also a full member of our executive leadership team, to be challenging and interesting. My time in the ICU is almost a reprieve from a new job that, on occasion, feels overwhelming. In the ICU, I’m used to getting quick feedback on how things are going. It feels comfortable and gratifying. My clinical work also shows me what works and what can be improved.
I’m also learning that working as a physician in a leadership role is not a sacrifice, it’s a privilege. I encourage each of you to pursue a leadership role within the health system — try something new, learn a different skill or lead a project within your area of expertise. You will learn and grow, and you will likely discover a new way of providing care to our patients. I’m hoping we will collectively change the definition of what is a “real” doctor.
Dr. Susan Shaw
Chief Medical Officer