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John led a panel discussion on Monday night at the American College of Physician Executives meeting in Phoenix.  This blog is based on conversations with physicians who attended the event. 

PHOENIX — Presidential popularity is an up and down kind of thing depending on the issues at hand and the political climate in the nation’s capital.  That is a political and governing fact of life.  

TrustThe popularity of the current President is no different.  However, he has always been buoyed by the overall admiration and trust of the voters.  That changed recently as thousands of Americans began receiving notices from their insurance companies cancelling the healthcare coverage that he repeatedly said they could keep when his signature healthcare reform law was enacted.

The President has apologized and admitted he and his team should have been clearer.   His political spin-doctors are already busy trying to explain that, at best, the President did not really lie because the coverage they were losing was substandard, lacking the protections included in the Patient Protection and Affordable Care Act (ACA).  At this point, that is a stretch distinction that does little to salvage the President’s reputation.  His repeated assurances that if people were satisfied with their existing plans then they could keep them, now appears to be the Presidential equivalent of shooting one’s self in both feet.

The President’s fast and loose slip of the lip and the price he is now paying in the admiration and trust department is an important lesson in leadership.  Trust and respect are valuable, fragile things.  With his poll numbers sliding, the President is losing critically important leadership clout.  Unless he recovers some degree of public trust and admiration he could well be a lame duck by January.  That means his ability to advance his agenda will be severely compromised if not completely derailed.

Once lost, trust and admiration is very hard to recover.

This is an important career management lesson that cannot be forgotten. 

Doctors seeking to move from clinical medicine to executive leadership should pay close attention to this Presidential bumble because losing trust and admiration, for a physician executive, is particularly consequential.  Here is why: Over the next five to seven years, healthcare will be forced to transform itself from a “heads in the bed” business model with compensation based on the number of procedures performed, to one in which physician and hospital earnings will be tied to clinical outcomes, patient satisfaction and keeping patients healthy and out of the inpatient environment as much as humanly possible.  This sort of paradigm shift will require physician executives to guide their clinical colleagues from a place of comfort through incredible turmoil to the unknown.  This will be hard because many of these changes will be counter to a lifetime of learning and practicing.   Some will resist, in the belief that somehow it will all work out, that the tide of reform and transformation will simply go away.  Of course, it will not.   

I have frequently heard the story about a physician turned CEO who so often offended his colleagues when making and communicating tough decisions without regard as to how those decisions would play out in the doctor’s lounge, that those physicians repeatedly showed their disrespect and lack of trust by referring to him as mister rather than doctor.

From my perspective, a physician executive’s ability to build a cohesive, patient-centered health system of clinicians and lay personnel is precisely the reason we would hire them.  Losing trust with their colleagues defeats the whole point of hiring a doctor to lead an organization.

What are your thoughts?