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A Word From the President: Multipliers—The New Leaders for Academic Medicine

AAMC Reporter: December 2012

Editor’s Note: The following column is adapted from Dr. Kirch’s address at the 2012 AAMC Annual Meeting in San Francisco.

In his stirring address at the AAMC Annual Meeting last month, AAMC Chair Mark Laret, CEO of the University of California, San Francisco, Medical Center, vividly described the challenges we face as a community. Mark acknowledged the unprecedented state budget cuts to education that we have seen in recent years. He reminded us of the “good ol’ days” of the doubling of the federal investment in research through the National Institutes of Health—and how that is now a distant memory. In the clinical arena, he spoke of how we can expect reimbursement rates for most payers, especially Medicare and Medicaid, to continue to decline. In short, Mark correctly observed that society at large is demanding a change in its longstanding compact with academic medicine, and he implored us all to start “thinking differently.”

Our keynote speaker, Walter Isaacson, CEO of The Aspen Institute, dissected the lessons in innovation he gleaned as the biographer of Steve Jobs and Ben Franklin, among others. He echoed Mark’s address, reminding us that while change can be challenging, it also presents unique opportunities to innovate.

My address was devoted to the new kind of leaders we will need to create a sustainable future for academic medicine—leaders who can help us meet the challenges Mark outlined so eloquently and drive the innovation that will transform and sustain us in the decades ahead.

For too long, our medical schools and teaching hospitals have tended to seek that one leader with special knowledge to be the “sage at the top,” just as Clotaire Rapaille, author of The Culture Code, says our nation longs for a “Moses” figure to lead as president. As I said last month, I believe that we need a new kind of leadership—not a Moses figure, but rather the kind of leaders that author Liz Wiseman and her co-author Greg McKeown call “multipliers” in their best-selling book of the same title.

Multipliers are leaders who do not pretend to have all the answers and do not stifle the opinions of those with whom they work. Instead, multipliers consistently strive to make everyone around them smarter by unleashing others’ full potential and empowering the broader problem-solving abilities of the entire organization. In short, multipliers are not necessarily the geniuses. They are the geniusmakers. As Wiseman describes, multipliers “invoke each person’s unique intelligence and create an atmosphere of genius—innovation, productive effort, and collective intelligence.” For more on this topic, I encourage you to read the Author Q&A with Liz Wiseman that appeared in last month’s issue of the Reporter.

The more time I spend visiting the nation’s medical schools and teaching hospitals, the more encouraged I feel. I find multipliers emerging at all levels. I see medical students helping to run clinics and outreach programs for the underserved. I see junior faculty developing tools to promote learning and assess learners’ competence, or designing new research models to support team-based, interdisciplinary collaboration. I see residents and fellows engaging entire care teams in safety and quality efforts on the front lines of patient care. And perhaps most important, I see medical school deans and teaching hospital CEOs who know it is not about them—it is about maximizing the team around them.

As policymakers wrestle with the impending “fiscal cliff,” the hard truth is that we all must prepare for a future in which we do more with less. Our best option is not to wait for legislators to impose the path forward upon us. Rather, as the people who know our missions and our institutions best, we must lead this transformation from within by harnessing the intelligence, creativity, and commitment of our faculty, students, residents, and institutional leaders. It will take leaders at all levels acting as multipliers to get us there.

Think about this amazing fact: Working at our medical schools, teaching hospitals, and health systems are nearly 2 million exceptionally talented and committed individuals, including faculty members, medical students, residents, graduate and postdoctoral students, and staff members. What problems could we solve if more of us began to work as multipliers? What creativity and innovation could we unleash? What progress could we make toward improving the health of those we are privileged to serve?

The reality is that our future success will depend less on hierarchical organizational charts and more on building relationships based on shared values and purpose. We need to acknowledge that leadership no longer represents a special gift or power held by a select few. Instead, it is a relationship among committed people that becomes an opportunity for all of us, at any level.

Fortunately, across academic medicine, there is no shortage of individuals who are ready and willing to assume greater leadership responsibilities. There never will be a better time than now to unleash their potential. Moving from the Moses to the multiplier model of leadership could well be the game changer.

Darrell G. Kirch, M.D.
AAMC President and CEO