The Doctor as a Leader: Handling Difficult Conversations as a Physician Leader

Physician Leader

A Chief Medical Officer that I’m coaching shared with me: “Gail, there’s just so much that training never covered. It’s like they just throw doctors in a leadership position and expect you to figure it all out!”

Indeed, there is so much that goes into physician leadership that your medical training likely never covered. 

Not a good feeling – like showing up to your wedding day without a suit or dress. 

Or diagnosing a brain tumor without an MRI. 

And whether you’re in a formal healthcare leadership role right now or not… all physicians “lead” in one capacity or another. Some of us even “lead” on the pickleball court.

You likely lead support staff or colleagues, or you may even be a leader in your personal life, as a parent or coach.

The Most Important Skill as a Doctor Leader

doctor leader skills

And one of the most important core physician leadership skills you can have is the ability to give feedback.  

Giving effective feedback is the foundation for trust-filled relationships, creating effective departments, and managing conflict. 

It’s also a crucial life skill that extends to the inevitable bumps we have with family members and loved ones. 

Let’s face it – giving feedback as a physician leader can be terrifying. 

We don’t know how the other person will react and often hold back on having tough conversations that we know we need to have – because we just don’t know how to have them. 

But behind these tough conversations are strong relationships and the broader impact that you want as a leader.

So here are the 6 biggest tips I can give you, after coaching 500+ physicians and physician leaders, for giving feedback effectively.

The 6 Keys to Giving Effective Feedback as a Physician Leader

1. Have constructive intentions

It is much easier to receive help than it is to receive criticism. When you give feedback, remember that you are giving. Good feedback is a gift!

Resist the urge to give feedback when you’re angry, upset, frustrated, or when your intentions are anything other than helping the target individual.

Positive, constructive intentions will go a long way.


2 . Address issues in a timely manner

No one wants to receive constructive feedback for a misdeed that occurred months ago. Letting concerns build up over time undermines trust: If you’ve waited this long to deliver this piece of

critical feedback, what else are you not sharing?

By bringing things up in a timely manner, we can create a culture of trust and a culture of feedback within our teams, reinforcing continual growth (which most in healthcare actually want.)


3. Focus on changeable behavior

When giving feedback, we want to assume the best intent and focus on the behavior. Telling someone that they are stupid, egotistical, insecure, or ineffective is going to be far less effective than telling them that something that they did was counterproductive. Perfect candor is not perfect feedback.


4. Anticipate emotion

Receiving feedback is not easy, especially in the realm of medicine, where perfectionism and overwhelm run rampant. Anticipate reactivity, and do your best to resist the urge to engage in

debate or react emotionally if the recipient of your feedback has a negative reaction.

At the heart of effective leadership is mindfulness and self-management. Learning to control

our own emotions and reactions will allow us to remain calm in the face of these difficult conversations.

5. Dialogue, not monologue

Strive to make these conversations just that – a conversation. Give the target team member time to process, and, respond, and ask questions. By engaging in an open and honest conversation, you will find that your relationship is actually strengthened, not damaged.


6. In order to give, we must receive

There are two crucial ways in which this applies to giving feedback as a healthcare leader. Firstly, our staff are going to be much more likely to accept our constructive feedback if they are also receiving praise regularly. With the leaders that I coach, a 3:1 ratio between positive feedback and critical feedback has been most effective.

Physicians universally feel underappreciated (I don’t have to tell you this twice). By

giving our staff more of this appreciation that they crave (physicians are used to that external affirmation!) they will be more likely to receive our constructive feedback.

Secondly, being a leader who is open to receiving feedback, and even seeks it out, will make the feedback you give much more effective. By asking our team regularly for feedback, actively listening, and acknowledging and appreciating that feedback, you become a leader who is

seen as trustworthy, willing to grow, and real.

Conclusion: Next Steps as a Doctor Leader

I hope you found this piece helpful on your leadership journey. Remember, effective feedback is a cornerstone of effective leadership and enables you to build trust-filled, positive relationships as a physician leader. If you’d like more support, you can learn more about how I support physician leaders here

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