The need for effective ethical leaders in health care, as in any profession, is inarguable. Leadership is the foundation for success in any organization. Unfortunately, there is a gap in leadership development in medical education. Currently, only about a third of medical schools have either mandatory or elective leadership development curricula. Some would argue that it is because medical education really has not changed in 100 years. As best practices in education evolve and improve over the years, one can imagine how they ought to evolve in medicine. There is no doubt that both undergraduate medical education (UME) and graduate medical education (GME) result in competent physicians. Consider how much better it would be for patients, staff, and families when their physicians are not only competent doctors but also are competent leaders.
Fortunately, sports medicine, as opposed to other specialties, is in a unique position to be a catalyst for change in medical education in terms of leader development. Why? — because of the clientele we work with. Every day, sports medicine doctors are around leaders in their fields — coaches, team captains, and athletic administrators, to name just a few.
Coaches, at their core, influence (lead) others. Yes, they have to be competent in Xs and Os (just like physicians have to be competent in their clinical knowledge and practice). However, the key to success for coaches is how they influence others, motivate, build teams, and get those teams to perform at their best. That is no different than what sports medicine doctors do. Success in sports requires, at a minimum, teamwork, communications, and selfless service. Success in health care (quality patient care and safety) requires the same things.
As noted above, medical education does not intentionally develop leaders for health care. To address this need, Duke Sports Medicine started the Feagin Leadership Program (www.feaginleadership.org) in 2008. The purpose of the program is to provide a transformational learning experience that develops effective and ethical leaders who positively influence health care. The program is named after Dr. John Feagin Jr., a legend in the field of sports medicine. John Feagin was an exemplar of ethical leadership. It was his combining of medical competence and uncompromising ethical leadership that elevated his practice and aggrandized the man above his peers in the profession.
The Feagin Leadership Program uses constructs in the Duke Healthcare Leadership Model (1) (patient-centeredness, emotional intelligence, teamwork, critical thinking, selfless service, and integrity) as the foundation of the program. The 9-month experience is for selected medical school students, residents, and fellows. Key aspects of the program include didactic sessions, individual coaching, and a team project; all culminating with the annual Feagin Leadership Forum.
The success of the program rests on the fact that the Feagin Scholars have the space and time to engage in developmental experiences (readings, discussions, one-on-one coaching, etc.). Development in any domain requires time and practice. Athletes and athletic teams practice plays and techniques over and over with a goal of perfecting them. Development of leadership competencies requires the same kind of time and practice.
If teamwork is important in medicine, then UME and GME will include curricula on it. If communications and emotional intelligence are important for physicians, then UME and GME will include them. Not including these leadership competencies in medical education sends a clear message that the topics are not important. As the research suggests, “omission of discourse is not value neutral education. There is no such thing. Omission is a powerful, even if unintended signal, that these issues are unimportant” (2). As such, to develop effective and ethical leaders requires time and practice of specific leadership skills. This learning and growth does not and will not just happen by accident. It must be intentional, planned, modeled, and practiced. The Feagin Leadership Program is one example of this. We need many more.
Sports medicine can and should be the leader in medical education in terms of developing leaders for health care. We work in and around coaches, athletes, and teams who understand and value the importance of leadership. It is time we start doing more to help our profession develop the type of effective ethical leader that health care demands.
The authors declare no conflict of interest and do not have any financial disclosures.
1. Hargett CW, Doty JP, Hauck JN, et al. Developing a model for effective leadership in healthcare: a concept mapping approach. J. Healthc. Leadersh
. 2017; 9:69–78.
2. Piper T, Gentile M, Daloz Parks S. Can Ethics Be Taught? Perspectives, Challenges and Approaches at the Harvard Business School
. Boston (MA): Harvard Business School; 2007. 13 p.