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‘Effective leadership is required to lead and drive changes at all levels of the health system’

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The healthcare industry in India is at crossroads. It is expected to reach $372 billion by 2022 driven by rising incomes, greater health awareness, lifestyle diseases and increasing access to insurance. The world’s largest funded government schemes Ayushman Bharat was launched last year along with several other schemes for ensuring ‘Healthcare to all’ — which is not just equitable but accessible and affordable too. In other words, the constitution of India considers the ‘right to life’ to be fundamental and obliges the government to ensure the ‘right to health’ for all. But have we ever imagined, how all of this has been possible. It is leadership – taking responsibility, assuming ownership for success, and doing the right thing in the larger interest of the society.

Years ago, when I was working in Australia, I overheard a nurse talking to another nurse “I don’t want to be an Indian” – and my ears became more alert and I asked her what does it mean? And whom was she referring to? She was surprised that I asked her the question, and she asked me if I have not heard the saying. I said NO. In Australia and many other countries people think Indians are good followers and NOT leaders – this is what the British have made us or believe? She was referring to her career, that she wants to progress higher up and not get ‘stuck’ at one level. Either way, industrialisation required people to ‘work like sheep’ and not think or ask questions. But the modern world encourages one to think, ask questions, and be curious – so more opportunities for one to develop leadership skills.

Healthcare leaders know about change
The need to adapt as individuals, as organisations, and as an industry—is obvious. What is less apparent are the leadership skills that are most important in today’s uncertain and complex environment. For decades, US-based healthcare providers, insurance companies, pharma and device firms have been operating in a shifting landscape. Advances in technology and new standards of care, new business models, a growing population, and changing demographics have propelled ongoing change in the healthcare sector. Regulation, access to care, cost pressures, and legal and ethical considerations add to the complexity, as does healthcare reform. In this context, it can be difficult to know if organisations have the leadership talent they need to set direction, create alignment, and gain commitment among employees, partners, and stakeholders as they seek to provide safe, high quality patient care. Leadership is something that has been debated over the years/ decades with the primary question, “Is a leader born or made?” But one thing is for sure, whether they are born or made, one has to have the instinct to become a leader either way.

Healthcare leadership skills
The healthcare sector is experiencing significant and rapid change, with dramatic change yet to come. In an evolving and challenging environment, healthcare organisations must ensure high levels of technical and professional expertise.

At the same time, they must develop the leadership capacity needed to adapt and succeed in the future. In my view, leadership skills can be taught and can be learnt, only if someone wants too. Harvard Medical School and Harvard Business School among many others have started lot of leadership programmes especially in the last few years – focusing on more medical doctors – because they want leaders in the healthcare sector. Is it only the healthcare sector – that needs leaders? No – even companies like Accenture are heavily investing in leadership programmes. Every company hopes to ‘train leaders’ and GE has been running their Crotonville Leadership Programme in the US, which is very popular but can be attended only by invitation.

It is essential for everyone to know that a hospital or any healthcare facility is a unique environment and as a highly regulated industry, leaders in healthcare should only know only know and adhere to all regulatory standards, but also lead by example and must ensure that all appropriate training is imparted all levels. To rise as leaders with countless departments working together in healthcare facilities, one must maintain a solid collaborative relationship with each one of those departments to ensure better outcomes. The top priority for leadership development in the healthcare sector is to improve the ability to lead employees and work in teams.

I realise that I have been a leader from childhood. I was leader of my class in the primary school, high school and in college and so on. During my medical schooling, I even became Secretary of the House Surgeons’ Association – and revolutionised the way the medical representatives treat the fresh medical graduates among few things. College life was tough – as I was always in ‘confrontational mode’ for injustice….which is an indication that leaders don’t like to tolerate injustice. These qualities probably played a crucial role in me attaining quickly leadership roles in the UK, Australia too – where I was in-charge of the junior doctors, lead to establishment of protocols, setting up NICUs and so on. leadership trains you in many things as you go” and you become better at it as you go.

Additionally, it is important for any healthcare organisation to create strategies to provide current and future leaders broad, cross organisational experiences, and learning. Healthcare leaders have gaps in several areas that are essential for learning and long-term success: having a broad functional orientation, self-awareness and career management. Organisational training and development, succession planning and individual feedback, coaching, and development efforts should address these gaps. Today, we have completed more than a decade of when Cloudnine was started in 2007 and it required leadership to ‘establish’ – and make it ‘successful’. Leadership roles make you arrogant as you don’t tolerate injustice but at the same time if it involves consumers in a hospitality industry – you need to learn to swallow your pride – opposite of your leadership qualities.

For any leader to be successful, the ability to adapt to change and to meet business objectives are strong points. They need to be resourceful, straightforward and composed. At the same time, they should be fast learners and willing to “do whatever it takes.” There are several types of psychological analysis of a person, including the famous type coach – wherein a person is classified into a four letter type of analysis and this is supposed to indicate if one becomes a good leader or not? Leaders are not supposed to be emotional but clearly there are lot of leaders who are emotional and successful, clearly showing that one system cannot judge everyone.

Where are we?
Healthcare being a state subject, healthcare outcomes have remained divergent based on the quality of the state administration. In the book ‘Leadership in Health Care’, Gunderman suggests that people who have a high need to achieve may not be the best leaders. Success of an organisation rests on responsibility and control at the group level, and the required wider diffusion of responsibility and control may not suit some high achievers. A better leader may be an individual with a high need for power but who thinks in terms of the group and takes responsibility for what happens in it. As a leader, it will be important to understand what really motivates the group of healthcare workers to increase performance of the group and value of what they produce (better results at lower cost). Leadership is something we need to ‘learn more’ and become think tanks – which the modern world is trying to create. Leadership in healthcare is very much needed in our country, at present there is paucity of the same. Effective leadership is required to lead and drive changes at all levels of the health system to actualise goals of the ongoing reforms in healthcare organisations.

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