© Springer International Publishing AG 2018 341
T.S. Köhler, B. Schwartz (eds.), Surgeons as Educators,
https://doi.org/10.1007/978-3-319-64728-9_20
Teaching Surgeons How to Lead
Jon A. Chilingerian
Where will surgical practice be in 10 years? Uncertainty, pressure, complexity, and
novelty confront every health-care organization today. Situations are dynamic as
futures unfold. One surgeon, trying to head off a feeling of an impending catastro-
phe, recently sent me an e-mail with a request for help that said:
...I am past president of my medical society, and past president of the medical staff at my
hospital. Right now, I am struggling to lead our medium sized, single specialty private
practice group...We are dealing with falling surgical reimbursements along with crushing
practice overhead...while we are struggling with conversion to value-based reimbursement
and ICD 10, and meaningful use and crippling physician burnout...The healthcare environment is turbulent, and surgeons work in an era of patient-
driven organizational forms, advances in biomedical science, accelerated techno-
logical development, and complex health policy reforms. Medicine is no longer a
private relationship between patient and surgeon with a promise of good outcomes
[ 12 , 45 ]. We live in an age of public reporting, online patient communities, and
multiple performance requirements [ 14 ]. Surgeons not only have to achieve excel-
lent technical outcomes, they must also offer outstanding patient experience and
efficient, low- cost care [ 48 ]. The ambiguity of how to deliver care that meets those
requirements contributes to the uncertainty.
What kinds of solutions exist to solve these problems? Should a struggling
surgical group hire outside consultants, restructure, reduce staff, retreat from some
insurers and procedures, or partner with a hospital? Reorganizing or restructuring
J.A. Chilingerian, PhD
Brandeis University, Heller School, Waltham, MA, USA
Public Health and Community Medicine at Tufts School of Medicine, Boston, MA, USA
Organizational Behavior and Health Care Management at INSEAD, Fontainebleau, France
e-mail: [email protected]