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
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
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.▪