Dr. Lennox Hoyte is a board certified OB/Gyn physician and fellowship-trained in Urogynecology and Female Pelvic Medicine and Reconstructive Surgery. He treats women with prolapse, bladder and bowel incontinence, overactive bladder, childbirth related pelvic floor injury, and complications related to vaginal mesh surgeries. He offers a wide range of successful surgical and nonsurgical therapies to treat these problems, specializing in advanced robotic surgery to correct vaginal prolapse, and is one of the leading robotic prolapse surgeons in the world.
In addition to his role as a clinician, Dr. Hoyte is active in the development of intellectual property related to the practice of medicine; he has filed and obtained US patents on devices ranging from bladder drainage aids, to instruments for enabling prolapse surgery, as well as methods for accurately measuring intravascular blood volume. He is also Chief Medical Information Officer for the USF Physicians group, tasked with designing an electronic health record optimized for delivering high quality healthcare outcomes, while decreasing the documentation burden on providers .
How do you view physician leadership? Can physician leadership be taught?
Traditional medical training is based on the idea of becoming the best individual, becoming masters in our specialties. This training process was designed for a time when physicians ran the healthcare enterprise, and everyone accepted healthcare to be an extremely hierarchical arrangement, with doctors sitting on the top of the pyramid. And this is something we have been taught all our lives. The traditional system was based on the master-apprentice approach, where seniority conferred authority.
Let me explain: As a student, you start by getting the best grades so you can be the top of your class to create the most competitive medical school application. You work hard to differentiate yourself, and demonstrate your uniqueness. In medical school, you work hard again to be at top of your class, so you can be picked by the best residencies. Then, predictably, you’re trying to be the best resident, in order to be accepted at your chosen fellowship, or land the best job. Then you go for a fellowship, and guess what – you’re trying to prove that you’re the best fellow. This sequence does not naturally lend itself to the kind of training required for leadership.
For me, leadership entails something entirely different. It’s about inspiring individuals to work together to achieve amazing results. It is about bringing ordinary people together to accomplish extraordinary things. The leader is not the one with the best ideas, but rather the person that inspires others to come up with the best ideas, and choose the ones that are suitable for solving the problem at hand; to obtain agreement among team members and stakeholders, and to guide the team so that they obtain the desired results. In so many ways, I see leadership as the job of inspiring others to achieve, to fire them up, and aim them at the problem to be solved. It requires a unselfish mindset that puts the team and project first. That’s quite a different mindset from what we are taught in the traditional path of medical training.
Physician leadership can be taught, and this teaching must encompass the entire career, starting with medical school, and continuing through clinical training, and lifelong professional education after formal training is completed.
How does physician leadership impact work performance?
For us at USF Health, many of us were inspired by our former Dean Dr. Klasko, who presided over the creation of USF Health. His objective was to create an collaborative approach to healthare, which led to the integration of the University of South Florida Morsani College of Medicine, the College of Nursing, the College of Public Health, the College of Pharmacy, the School of Biomedical Sciences, the School of Physical Therapy and Rehabilitation Sciences, and the Doctors of USF Health. For him, physician leadership was prerequisite for this integration and collaboration. The Physician Leadership Institute (PLI) itself was a spin-off from this exercise in collaborative innovation.
I remember how we participated in a specific workshop with the Physician Leadership Institute in which we were challenged to find a solution to a problem. The team stood around in a circle and tried to accomplish the challenge, with modest success. No one was speaking up. It occurred to me that, as individuals who are trained to be right, physicians face an element of risk in voicing ideas or opinions that may be wrong. This leads many to avoid speaking up unless they are 100 percent certain that they are right. But this is not the way that unbelievably amazing things get accomplished. Amazing things get accomplished when we start out with less than perfect ideas and progressively improve them to get to the results we want to achieve.
I realized then, that the job of the leader is to “make it safe to speak up”. I offered a few suggestions, which were not very good ones, but what I learned and witnessed, was that the initial, modest ideas led others on the team to offer progressively higher quality ideas.
Soon, we were hearing ideas from everyone, and the best solution came, unexpectedly, from the physician who was the quietest one in the room.
It’s like when you gather around and ask your friends to start telling jokes. The first jokes aren’t very funny, but then people loosen up and start telling funnier and funnier jokes. The leader is the one who breaks the ice and makes everyone comfortable.
As a clinical fellowship director, along with our other faculty members, we produce specialists in female pelvic medicine and reconstructive surgery. Rather than apply the traditional, hierarchical, authoritarian work environment familiar to medical trainees, my PLI training and subsequent experiences directed me to become an enabler/guide instead of a boss, or foreman. I seek to become a stepping-stone for my trainees – to help them learn, grow, and master our sub-specialty; to serve as a launch pad for them to do greater things.
In my role, I have the privilege of watching our fellows grow their clinical capabilities, work collaboratively, cover for each other, produce amazing results, while building a team culture above and beyond what I have seen in training before. The team feels more like a family now, and I have to say, our fellows are doing magnificently, succeeding beyond our wildest expectations. Healthcare employers are taking note as well. Our fellows are being considered for some of the most competitive employment opportunities. That makes me think that we are producing a quality product.
What would you tell someone who is skeptical of the idea of physician leadership?
I would ask them to experience it before passing judgment.
Has physician leadership helped you beyond the workplace?
Doctors do not want to fail at anything we do. In fact we practice risk avoidance and have made it an art. This is good in some areas. In other areas, however, it leads to scarcity of innovation, and keeps us boxed in, victimized by our current set of problems. Physician leadership training has taught me to use failure as a tool for improvement, which leads to future successes. If you’re not failing, you’re not creating opportunities for future successes.
Each specialty has a set of fundamental principles, an evolving knowledge base, and the leader needs to master these, in order to be able to guide and inspire the team. I also believe that if you take care of the basics, the fundamentals, the rest takes care of itself. This first lesson of leadership is something I try to practice in all aspects of my life.
What else would you like to add?
As our industry is challenged to improve accountability and outcomes, physicians are going to need to drive the change. For example, most doctors (myself included) do not know the costs of the treatment plans that we offer our patients. Many of us are disconnected from the business side of activities. I think that this is unacceptable. We need to gain a better understanding of the costs of the services that we offer to our patients; so that we can help to drive these costs down.
Also, because of the increasingly interdisciplinary nature of patient care, doctors will be required to become more collaborative team players, skilled at initiating and managing change. That can’t and won’t happen without physician leadership.