What other skills are needed by physician leaders during the pandemic? Imagine physician leaders as buckets (Figure 1) that hold support resources (right side of bucket) that others can take out as needed (left side of bucket). Top
In a chaotic system (lower left quadrant), there is little time to act, particularly in a crisis situation, such as that precipitated by COVID-19. Overall randomness makes the relationship between cause and effect unknowable. Because of the lack of patterns and system constraints, a leader must act quickly to (hopefully) “stop the bleeding.” The leader then senses what is happening in the system, where any type of pattern or stability might be present, or where it might be absent. Finally, a response will try to move the system from chaotic to complex. Because of all the randomness and the unknowable, practice is novel. Top
Once the system moves back to the constraints of a complex or complicated system, leaders must quickly adapt to a distributed leadership style or they will lose people’s trust and collaboration. Mayor Giuliani continued to use the command and control style and now fails miserably. His example clarifies the important need for leadership agility, being able to move swiftly from one leadership style to another by recognizing which style is needed and when. Top
Johny Van Aerde, MD, PhD, FRCPC, is editor-in-chief of the Canadian Journal of Physician Leadership and executive medical director of the Canadian Society of Physician Leaders. Top
The COVID-19 crisis has quickly changed all our systems, including health care, the economy, finance, education, and supply chains, from complex to chaotic. Chaotic systems require agility to navigate a wide range of leadership styles from “command and control” to “distributive,” and everything in between. Physicians have been trained as experts, meaning that they are very good at making decisions in the ordered world. The Cynefin framework (Figure 2) describes four systems — simple, complicated, complex, and chaotic — and the leadership styles needed in each case, including the COVID-19 crisis. Top
External links of interest
This COVID-19 Physician Wellness podcast is part two of the first of a series of podcasts aimed at assisting physicians cope in this difficult time. Dr. Curtis Johnston, Edmonton Zone Deputy Medical Director, and Dr. Debrah Wirtzfeld, Associate Chief Medical Officer, Physician Health, Diversity & Wellness, speak about the impact social isolation and social media can have on wellness.