Lessons from COVID-19: The business skills doctors need

There are a lot of clinicians who are looking for ways to put management tools—such as finance, strategy, operations, and leadership—together to take on larger leadership roles Image: Shutterstock

In the early days of the COVID-19 pandemic, doctors faced unprecedented challenges. Vital supplies such as facemasks and cotton swabs were in short supply. New protocols had to be developed to isolate infected patients. Treating patients remotely through telemedicine suddenly became standard practice.

All of these abrupt changes called for medical professionals to have a certain level of management prowess, says Robert Huckman, Albert J. Weatherhead III Professor of Business Administration at Harvard Business School.

“Outside of developing a vaccine, the biggest concerns weren’t about developing new medical innovations. They were issues of execution of known activities,” he says. “Particularly in the early days, the pandemic truly placed a premium on those with management expertise.”

As Huckman details in a paper in the journal Academic Medicine, however, most doctors receive little training in leadership and management skills, such as supply chain management, interpersonal communication, and strategic planning. Yet these skills are important for the well-being of doctors and their colleagues and can mean the difference between the life and death of patients, Huckman argues in the article, which he co-wrote with physicians Lisa Rotenstein, assistant medical director at Brigham and Women’s Hospital in Boston; and Christine Cassel, professor of medicine at the University of California San Francisco.

For many physicians who are burned out by the pandemic and may not know where to begin with getting additional training in leadership skills, the paper offers a roadmap for what medical professionals might glean from the Covid pandemic.

“There’s a thirst for this type of information among clinicians,” says Huckman. “There are a lot of clinicians who are looking for ways to put management tools—such as finance, strategy, operations, and leadership—together to take on larger leadership roles.”

Handling hard conversations

The Covid-19 pandemic has revealed the importance of these skills, the authors say. As the virus initially spread through hospitals in early 2020, many doctors had to switch from their traditional specialties to treat patients affected by the virus. Given the isolation of coronavirus patients from family members, many doctors and nurses who were not accustomed to providing end-of-life care became the primary source of comfort for dying patients and their families. At the same time, those providers had to deal with their own mental health and that of their colleagues.

“There was already a high level of burnout before Covid, and not having the means to do anything to ease suffering has got to be extremely taxing,” Huckman says.

Beyond ensuring the health of their patients, their colleagues, and themselves, physicians had to implement new methods for providing treatment, whether in-person or over Zoom. Finally, they had to manage challenges related to securing scarce equipment and restructuring operational flows. All of these activities, says Huckman, required skills in both leadership to “get people to understand a vision for what might be possible,” and management, “to make it happen and put it into practice.”
Technology offers challenges, opportunities

Many of the new opportunities emerging during the pandemic were facilitated by technology. Yet those opportunities came with managerial challenges. Remote patient monitoring represents a case in point. “Medicine has traditionally relied on a physician seeing a patient in person at a moment in time, but the pandemic has highlighted that there are many things that don’t necessarily need to be done in person,” Huckman says.

In fact, Huckman says, many doctors have realized that remote medicine can open up new possibilities for the ongoing care of patients—for example, allowing patients to consistently monitor blood pressure at home with a blood pressure cuff, rather than once every few weeks or months in the office.

Taking advantage of those new techniques, however, will require doctors to learn a variety of new skills, including process improvement, negotiation, and change management. “First you have to convince the provider that a new technology makes sense in terms of delivering effective patient care. Then you need to make sure that the incentives physicians face do not run counter to their using the most effective approach for a given patient. Making all of this happen may require physicians to initiate and manage significant change within their organizations or lobby for changes to external regulation and public policy,” Huckman says.

Changing how medicine is taught

Of course, even if medical schools recognize the need to develop these management and leadership skills, they may not see a way to make time for them within their packed clinical curricula. The good news, says Huckman, is that many of these skills can be learned simultaneously with clinical skills. “Like medicine,” he says, “leadership is best taught through observation, experience, and practice.”

In fact, the case study method used in MBA programs at colleges such as Harvard, the University of Virginia, and Stanford University is similar to the way physicians are trained through medical residencies, in which they face specific clinical dilemmas. There’s no reason, says Huckman, that management and leadership training can’t be integrated into that process, so that as medical students learn how to diagnose and properly treat patients, they also confront problems of supply management, operations design, and communications.

“As you are working on clinical skills that involve interacting with patients,” Huckman says, “you can also be building management skills that involve interacting with colleagues.”

[This article was provided with permission from Harvard Business School Working Knowledge.]