I’m convinced I was hired into my first leadership role on a dare. 

I was an NP in a prestigious academic medical center with a shiny new doctorate, full of ideas for new and exciting ways of increasing patient access to care and advocating for APPs.  I had a voice and passion but a total lack of leadership experience. I was in way over my head.

As an APP transitioning into a leadership role, I was surprised at the diversity of skills needed to manage clinical and administrative responsibilities. I needed to learn meeting etiquette, data management, best communication practices, and navigating office politics.

What I lacked in experience, I made up for in relentless enthusiasm, and my positivity took me a long way. I underwent several leadership fellowships, which helped me understand myself as a clinician AND a leader. I formed relationships with colleagues who had degrees and training I didn’t have and gained wisdom from them at every turn. 

I realized that in my years of clinical training, I had gained transferable skills that helped me become an effective leader. I learned to use my clinical expertise to become an integral part of the leadership team, although the evolution from clinician to leader is not always intuitive. Here, I offer some focus areas for clinicians moving into the leadership arena.

Develop Emotional Intelligence

As clinicians, we are trained to understand how words, expressions, and body language come across to others during clinical situations. We are passionate about providing excellent patient care. Still, we can only communicate clearly if we understand our emotions and how they affect others. Emotional intelligence, or EI, allows us to understand and respond to patients’ emotional and educational needs and facilitates effective communication. Leaders with high EI have self-awareness that helps them control impulsive reactions, fosters a supportive workplace, and can inspire teams to achieve their goals. The emotionally intelligent leader understands the emotional needs of staff, resolves conflicts, and builds successful interprofessional teams.

Develop Fantastic Communication Skills

Most clinicians work to hone their style of interacting with patients in a way that builds trust to partner and treat disease. We can quickly adapt our communication style to the individual patient. These same skills are also crucial for leaders. Developing a clear lexicon to make convincing points so your listeners understand you and don't wander emotionally while you speak is essential. Strive to be simple, straightforward, and convincing in your speech and writing.

In the exam room, we know to listen and discern what is and may not be said. This is active listening, where we show interest, reflect or paraphrase, ask open-ended questions, and withhold judgment. The same skills are crucial when leading people and systems.

Try to be still and maintain eye contact when someone is talking. If you're a fidgeter, focus on your breathing as you listen. Only formulate your answer once the other person is finished speaking because your response may differ when you hear the whole story. When there are many details and sometimes high emotions, it is incredibly easy to overspeak and interrupt the flow of ideas, especially in a video conference or on a cell phone. This is exactly like what we do in a medical interview. Silence is powerful. Take a breath.

Similarly, keep your writing concise – like an encounter or surgical note. Research shows us that asking more than two questions in an email will guarantee that only one or two will be answered, thus ensuring you another few emails back and forth. Consider using bullets rather than long paragraphs in emails, just as you may do in an assessment, and plan for clarity’s sake. 

Give a Report

Your hard-learned skills in giving concise medical reports on rounds will serve you well in a leadership role. When making a case for change or presenting a new idea, consider using the SBAR format to frame your thinking. This format is similar to a SOAP presentation and will ensure that your listeners hear your entire presentation, from the background to the ask, and always understand the context.

Learn the Tools

It's essential to become facile in using data to make decisions and enact policies. Become familiar with tools your institution may use, such as Excel, Tableau, PowerPoint, Teams, Slack, OneNote, and Zoom. Learn the tools to help you navigate and organize your communication modalities. You can dictate complete sentences to convey acumen and graciousness, even if you respond to hundreds of emails daily. This alone will set you apart as thoughtful. There are excellent courses for working professionals that can help you with this.

Develop Business Acumen

You must understand finance, operations, and strategic planning. Learn about dashboards, pro formas, profit and loss statements, Gantt charts, project planners, parking lots, and agendas. Perhaps more importantly, develop the ability to interpret and explain these things to others. Clinicians generally don’t emerge from their professional education understanding billing and coding, wRVU, access, total compensation, and other constructs essential to the business of medicine. This is where you can lean into leadership; this knowledge will make you a more decisive leader and communicator.

Hone Your Conflict Management Skills and Develop a Thick Skin

Sometimes, we ask a patient to take a medication that may have unpleasant side effects or undergo a procedure that has a long recovery. Our advice may not be met with enthusiasm, but it is our responsibility to present the plan of care that will benefit the patients’ immediate and long-term health. The same is true with leadership. You may need to make unpopular decisions for the organization's good, and your clinical colleagues may disapprove. Be prepared to confront conflicts, be ready to be encouraging, and be attentive. When summarizing the conversation, keep the organization’s goals at the forefront so the news doesn’t feel personal.

Maintain your Clinical Competence

Most clinician leaders continue their practice at least one day a week. This will preserve your reputation and credibility with other clinicians and keep you close to the organization's clinical needs. You worked hard for those letters after your name. Your clinical training will make you a better leader, ready to advocate for clinicians and their patients.

Become an Expert Team Builder and Mentor

Most clinicians are also mentors and preceptors. We nurture students and help them strive for success. This same skill is key to organizational success and well-being. Think long-term as you design clear team roles and provide support for those moving into them. Look for team members' skills and potential, and take on the role of an enthusiastic coach for those who show promise as leaders. We all need a succession plan; intentionally mentoring and coaching others is part of being a strong leader.

Form a Personal Board of Advisors

Everyone needs mentors, and I think of mine as my personal "Board of Advisors". You can formalize these relationships by asking someone directly to be your mentor and scheduling regular conversations with them. Your Board of Advisors is often made up of trusted family, friends, and colleagues who know you well, align with your values, and can be transparent and honest with you when you cannot do so yourself.

Remember a few things as you move into clinician leadership roles: work hard, be kind, and never stop learning or cheerleading for those you lead.

What do you wish you had known before entering a clinical leadership position? Share below in the comments!

Allison Dimsdale, DNP is a Nurse Practitioner in Durham, NC. She enjoys spending time with her children and grandchildren, husband, and ever-changing assortment of rescue hounds. She loves to kayak, and no longer cooks. Allison Dimsdale is a 2024–2025 Doximity Op-Med Fellow.

Illustration by April Brust