COMMENTARY

Healers in Need of Healing Cannot Heal

Herdley O. Paolini, PhD; Mark H. Greenawald, MD

Disclosures

May 20, 2016

In This Article

Ignoring Proven Principles and the Science of Leadership

Sadly, attempts to address these real challenges often ignore proven principles of leadership development and holistic personal growth. Book study is necessary, but not sufficient alone, to learn to be a healer. Information on wellness is not the same as being well, and effective leadership cannot be learned through knowledge acquisition alone. If the primary goal of a leadership academy is "teaching physicians to understand the metrics, the business of medicine, and the government regulations," it should be labeled as what it is: a management course.

There is no question that an understanding of metrics, business, and regulations is important, but this isn't what makes a leader. Absent from a physician leadership development curriculum too often is a clear understanding of what physicians are experiencing at this time and place, as well as any process for them to gain better self-understanding. Self-understanding can be thought of as one's strengths, growing edges, past and present experiences in medical practice, learned behavior and its effect on ability to succeed, and how to enlist others in a way that they call meaningful.

More foundational leadership formation is supported by the latest neuroscience research—in particular, the neuroscience of leadership. Advances in functional MRI have identified why inspiring and supportive relationships are crucial. They help to activate parts of the brain that make it possible to be open to new ideas and to be more socially oriented towards others.[7] What this means is that instead of seeing this type of leadership as "soft science," we would do well to understand how we are "hardwired" to connect. That connection matters at every level, especially when attempting to change deeply embedded patterns and immunity to change.[8]

In essence, change efforts that do not activate the parts of the brain that produce "positive emotional attractor" states (mainly through social means) and instead are based on coercive or cognitive-only methods rarely succeed in the long run.[7,9,10] In addition, this latest research also points to the ability of leaders to identify and to manage well their own internal states as being essential to the ability to influence others, as these internal states are unconsciously perceived by others. In other words, those being led pick up not only on the words of the leader but on the wholeness of the leader.

We believe that this is the fundamental reason why transformational leadership—or, as Parker Palmer and others call it, "leading from within"—is crucial at this time and place.[11,12] It will seize the opportunity to achieve the long needed integration first of the personal (ie, the "who" of leadership), then the personal with the professional, and finally the professional with the systems and environments of practice. Only then will physicians truly lead in engaging and inspiring others towards new development, new learning, adaptation, and innovation, ultimately changing the production pressure, the poor design of the work flow, and the proportion of non-value-added work towards the ultimate achievement of the triple aim. We are not going to have a cadre of effective physician leaders until we have a cadre of well and integrated physicians. And we are not going to have authentic healthcare culture transformation until we have a transformation of individual clinicians.

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