The minutes ticked down until I was to lead my first combined medical executive committee meeting. Installed as medical staff president just a few days prior, 20 medical and hospital administrative leaders looked to me to orchestrate an efficient and productive meeting.

Was I ready for this?

Leaders looked to me

I stared at my computer screen as the participant numbers on this virtual meeting steadily ticked upward. Most attendees had their videos off, but the names, many with C-suite level designations, were clearly visible.

We will give folks a few more minutes to log on before we begin …

Impostor syndrome has been well described in medicine, usually invoked during the early years of training and practice when a physician’s level of responsibility exceeds their perceived knowledge base and experience level.

As I looked around the virtual meeting room, I was brought back, some 15 years, to my first few weeks as a gastroenterology fellow. Just a few days removed from being an internal medicine resident, I was now somehow supposed to be the expert in managing acute liver failure and massive upper gastrointestinal bleeding. It took many months for this feeling of inadequacy to slowly wear off.

Now, thrust into a new leadership role, this self-doubt had resurfaced.

This self-doubt had resurfaced

What qualified me to set agendas and effectively moderate discussions? When spreadsheets popped on the screen, I was bluntly reminded of my lack of formal education in hospital finance. Did I have what it takes to sift through differing viewpoints and build consensus?

OK, let’s begin. Thank you all for joining. We have a busy agenda today. Let’s get started …

While hospital executives spend their entire day effortlessly moving from meeting to meeting, physician leaders are charged with squeezing administrative tasks in between their clinical responsibilities. I spent the seven hours leading up to my first meeting as medical staff president performing endoscopic procedures. Still clad in my navy-blue scrubs and sneakers, it was time to switch gears and enter the world of pressed suits and spreadsheets.

As the meeting rolled on, the dilemmas were numerous.

Should I cut off the hospital CEO who has gone over his allotted presentation time? How do I best acknowledge the CFO’s financial model while respectfully weaving in the impact budget cuts will have on physician wellness? How do I balance my desire to advocate for the medical staff with the financial realities of hospital-based medicine?

OK, so we are running a bit behind schedule. Let’s try to wrap up discussion in the next few minutes. I would like to hear from folks who have not yet weighed in …

I checked the clock. Our 45-minute meeting was now at the 1-hour mark. Where did the time go? Had we even accomplished anything? I quickly ran through the rest of the agenda, asking presenters to give their department updates in 60 seconds or less. We approved committee minutes, the credentials ballot, and by-laws changes in a few short minutes before I announced that we were, alas, done.

My reward for successfully completing this meeting was a second meeting, this time for medical staff leaders only. Buoyed with confidence and comforted by some familiar names on the screen, I eased into meeting number two with less trepidation.

Physicians, somewhat unknowingly, spend their clinical careers preparing for leadership roles. We spend hours every day listening to patient complaints, offering empathy, and building rapport. After thousands of patient and family interactions, we instinctively know when to listen so that patients feel heard and how to deliver advice that will instill confidence and hope. Crafting plans, laying out the possible paths ahead, and pivoting based on test results or changes in patient status are all part of our day-to-day.

More than any formal curriculum, these honed interpersonal skills prepare us to be successful physician leaders. Whether dealing with patients or department chairs, more than anything, people want to be heard. Solutions are the end goal, but even the most fiery physician knows that change takes time. Meeting attendee satisfaction, like patient satisfaction, is largely tied to how well leaders acknowledge raised concerns and the respectful, collaborative way they craft the path forward.

Great job!

You handled that issue really well!

Feedback from colleagues arrived via text

The unsolicited, yet much appreciated, feedback from colleagues arrived via text later that evening. I had gotten through my first round of meetings as medical staff president and emerged largely unscathed, and dare I say, energized.

Transitioning from clinical practice to medical leadership does not require physicians to fake it (till they make it). While formal training in leadership can be helpful, especially in areas such as finance, we are well equipped to assume leadership roles and drive practice and hospital change based on the skills we have developed in clinical practice.

We may be missing some fancy letters after our names, and we may show up to meetings in scrubs, but this is, after all, our world, and we are more than ready to lead.

There are no impostors here.

What clinical skill has helped you most in your leadership roles? Share in the comments.

Anish A. Sheth, MD, is chief of gastroenterology at Penn Medicine Princeton Health and is the author of several books on gut health including the best-seller, "What's Your Poo Telling You?" He is a mid-career physician who loves practicing medicine and is looking for ways to keep the fire burning!

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