Black belt leadership in the medical profession

June 1, 2005

Gleaning ancient wisdom from his study of the martial arts, a seasoned physician offers practical advice to help improve communication with staff and colleagues, cope with difficult patients, and chart a course toward a more balanced professional and personal life.

In today's world, physicians are required not only to provide top-notch patient care, but to run a successful practice, mentor younger colleagues, and keep up with new developments in the specialty. While there's rarely time to do it all and do it well, it may surprise you to find out the one thing that has most helped me keep my balance in carrying out these responsibilities: my longtime study of the martial arts.

I'm convinced that the tenets of traditional martial arts can frame medical leadership in a positive, effective way, and I'd like to show you how.

At first glance, martial arts training may seem to have nothing to do with medical leadership. The fact is, however, that there are many common threads, among them being the ability to understand human psychosocial conditioning, face fearful situations with a clear mind, act with respect, communicate openly, and free oneself from ego-based goals. These elements make up what I like to call Black Belt Leadership, which emphasizes the value of ancient wisdom in the modern world.

When we can recognize our conditioning and that of others, learn to listen as well as to speak, develop a sense of self-confidence and mutual respect, all the time looking beyond our self and focusing on those we train, positive new elements show up in our work. I believe that the future success of any training program depends on this, and that's why I've chosen these points.

We are the result of our training and psychosocial conditioning Our conditioning impacts how we view others; and theirs affects how they see us. Positive conditioning causes us to stop for a red light; negative conditioning pushes us to fight back when we're provoked. Caught up in everyday activities, we don't always recognize conditioning, or know what to do about it when we do. Conditioning, if unrecognized and unacknowledged, can create unique challenges between individuals and groups.

A reputable leader recognizes that people are genuinely well-intentioned and kindhearted. So, when colleagues or patients are perceived to act less than kind, a leader needs to recognize that underlying training or psycho-social conditioning contributes to this behavior, and needs to take action based on this knowledge. Consider a few examples of conditioned behavior that can emerge in our workplace, and how they can affect a practice.

Medical professionals are conditioned to be decisive and direct. A surgeon may act autonomously and make a strong-impact decision at a moment's notice. Medical professionals are conditioned by medical school and residency training to be decisive and direct. We tend to tolerate slow processes poorly.

This type of conditioning is in direct conflict with business people, who have been trained to be consensus builders. They're accustomed to making decisions by team or committee input-by feeling each other out rather than being directive. They know that the process of change can be slow, and rewards from decisions are not always immediate. Being pointed and direct may seem abrupt to them, which is why a conversation between a clinician and a business person can sometimes result in serious conflict. An effective leader recognizes the obstacle that this kind of psycho-social conditioning can create and attempts to move beyond it to balance the relationship.

As an example, the physicians on our staff recently realized that our current ultrasound equipment wasn't state of the art. Within the last year, many of our physicians had approached me with a request to update our equipment. Our practice administrators, who are not physicians, heard this request and engaged in a process to address the feasibility of replacing our current machines with a return-on-investment proforma.

The time it took to assemble a business model became intolerable to our physicians, who wanted an answer now, being concerned about patient care.