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Viewpoints
Do You Want to Be Among 'Most Powerful' M.D. Executives?
Psychiatric News
Volume 43 Number 18 page 15-15

In 2005, in recognition of physicians' contributions to health care organizations, the journal Modern Healthcare and its sister publication, Modern Physician, began publishing an annual list of the 50 most powerful physician executives in the United States. It is noteworthy that three psychiatrists were among the distinguished physicians named in 2008: Herbert Pardes, M.D., president and CEO of New York-Presbyterian Healthcare System (and a past APA president); Gary Gottlieb, M.D., president of Brigham and Women's Hospital in Boston; and Robert Kolodner, M.D., national coordinator for health information technology in the Department of Health and Human Services.

The selection of psychiatrists to this 50 most powerful list is a testament to their many competencies, especially their boundary-spanning skills. Regrettably, many psychiatrists did not make the list despite their significant visibility and clout. Examples include Rep. Jim McDermott (D-Wash.), who is serving his ninth term in the U.S. House of Representatives, and Jeremy Lazarus, M.D. (no relationship to the author), who is speaker of the AMA House of Delegates and may be elected AMA president someday.

The list also omitted many psychiatrists who have attained leadership roles in academic medical centers, where psychiatrists are represented in greater proportion than other specialists among deans of U.S. medical schools.

The selection process employed by Modern Healthcare to determine the 50 most powerful physician executives raises interesting questions. How is power measured, and why do only a few physicians appear to have staying power (the physicians who make the Modern Healthcare list change significantly from year to year)? Unfortunately, the magazine does not use explicit voting criteria. Readers simply nominate physicians online on the basis of whom they believe are powerful leaders, so we can only speculate about the attributes that make physicians powerful and influential. This leaves open a range of possibilities, including popularity and charisma as well as true leadership power.

Leadership power, according to psychologist David Kyle in his book The Four Powers of Leadership, is an acquired process and is manifest in an individual's presence, intention, wisdom, and compassion. Powerful leaders are omni-present at work and in the community. Their intentions are altruistic, and they are wise beyond their years and education. (Mark Twain allegedly said that he never let school interfere with his education.) Powerful leaders show compassion in their interactions with people at all levels.

Compassion is especially important to leadership. One of my favorite sayings comes from the book Put the Moose on the Table, by former Eli Lilly CEO Randall Tobias. "Let's put the moose on the table" is a simple way of saying to everyone involved, let's confront the real issues and do not ignore the difficult aspects of being a leader, such as dealing with the pain and suffering of people affected by mental illness.

Modern Healthcare also conducts a yearly poll to determine the most powerful minority executives in health care. In that poll, to be considered a powerful and influential minority health care executive, the candidate must have

Many of these criteria apply to physicians and could be used in future polls to determine the 50 most powerful physician executives. In addition, in my opinion, to be considered a powerful leader, physicians must achieve impact through their work with professional societies, patient-advocacy groups, and policy-making organizations.

Psychiatrists, in particular, should participate in medically relevant activities and contribute to the medical literature. It is important for psychiatrists to become more recognized by physicians in other specialties because psychiatrists comprise only about 5 percent of all practicing physicians, according to 2004 AMA data.

Finally, the fact that very few physicians in industry made the Modern Healthcare list suggests that there may be a bias against them or that their work may go unrecognized. Physicians who work for pharmaceutical and managed care companies need to increase their visibility among practicing physicians. Occasionally wearing white coats may raise the profile of physicians in industry as they transition from the bed-side to the boardroom.▪

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