HISTORY AND PERSPECTIVE IN MEDICINE

3.05 Physicians as Leaders and Managers

Dr. Jonas D. Policarpio| November 17,2016

LE 3

OUTLINE Almost 50% of the time, patients would say that there
were instances that he was unable to follow the
regime.
o Problem: they have no access to drugs.
I. Leadership and Management Consequently, problems would happen
A. Definition of Leadership o Good business in PH: dialysis centers
B. The Philippine Healthcare problem (Rationale: people are not able to afford anti-
C. Leadership Vs. Management hypertensives, DM control medicines. As a
D. Kotters comparison of leadership and result, the kidneys are almost the first to be
management always affected)
E. Doctors as Leaders
However, more than 2/5 of those who claimed that they
F. Conclusions
take their medications as prescribed admitted that
II. Hippocratic Oath
there are times when they miss to take their
III. Quiz
medications as scheduled.

OBJECTIVES:
At the end of the lecture, the student should be able to:
1. To know the importance of leadership in a Physicians
Perspective
2. To know the importance of management in a
Physicians Perspective
3. To differentiate leadership and management

Legend:
Remember Previous Trans
Lecturer Book
(Exams) Trans Com
G ! & 4 ! Figure 1. Instances when the prescribed frequency was not followed.
(Source: lecturers ppt)
I. LEADERSHIP AND MANAGEMENT
A. Definition of LEADERSHIP B. Duration of Not Being Able to Follow the Prescribed
Frequency of Intake
There is no simple definition Respondents would miss out taking their medications
up to about 5 days.
Two main tasks:
Figure below gives us the following pertinent data:
o To set a path, goal, or vision for the people o MEAN HPN: 4.83 days
who are being led o MEAN DIAB: 5.03 days
o To motivate people to pursue and eventually o MEAN HD: 5.42 days
achieve the goal Base: Total respondents who have taken medications
for (ILLNESS) in the past three months and with
Central idea is that leaders need vision and charisma. prescribed frequency of intake that is the same with
the actual, but skipped.
B. The Philippine Healthcare problem
! When people just accept, problems happen. At one point in
time, someone should be able to stand up and say no it can be
done!
o Previously, mobile phones can contain only up to 20
songs, until Steve Jobs said Id put 1000 songs in your
pocket. During that time, people told him that it could be
done. But he said it could be done and he did!
The point is, somebody should make others believe in the
idea, which leaders do.

A. In 2002, patients were asked whether there were

instances that the prescribed frequency of intake was not
followed
Figure 2. Duration of not being able to follow the prescribed frequency
of intake (Source: lecturers ppt)

TRANSCRIBERS Barbers, Bautista, Belo, Beltran, Bernaldez, Besana EDITOR Mykee 1 of 3


3.03 Physicians as Leaders and Managers HISTORY AND PERSPECTIVE IN MEDICINE 2020C

C. Prescribed Quantity vs. Actual Quantity Bought (One

Drug)
Among those who bought only one drug the last time,
compliance in terms of buying the prescribed quantity
of drug is high, especially for diabetes.
o However, in reality there are combination of
drugs prescribed.
Base: Total respondents who have taken medications
for (ILLNESS) in the past three months and have
bought only one drug the last time
Figure 4. Prescribed quantity vs. Actual Quantity bought (Multi
purchase) (Source: lecturers ppt)

E. Reasons for Not Being Able to Follow the Prescribed

Frequency of Intake
LEADERSHIP MANAGEMENT Across the 3 conditions (hypertension (53), diabetes
(38), heart disease (41)), reasons for non-compliance
is having vision, a is about coping with with the prescribed regimen are primarily negligence
clear sense of complexity, provides and financial constraints.
direction and stabilitiy, order and o Forgot to take/negligence:
aligning people to it, consistency HPN: 36%
helping people cope DIAB: 39%
with change HD: 32%
o Financial constraints:
HPN: 25%
DIAB: 34%
promotes is transactional and HD: 24%
transformation and promotes the status quo o Busy/no time:
drives change Diab: 13%
o Have seen improvement in their condition:
HPN: 15%
is about doing the is about doing thing right HD: 16%
right thing
C. Leadership VS Management

Table 1. Leadership versus Management

Leadership and Managing are DIFFERENT
o In leadership, the central idea is that leaders
need VISION and CHARISMA. You align
people with you
o Commit yourself to something and find a way
to do it!
o Management is about coping with complexity
and providing stability. Putting things into
proper order.
Figure 3. Prescribed quantity vs. Actual Quantity bought (one drug) We need to develop both
(Source: lecturers ppt) o These models are known as the old
paradigm of leadership. In this day and age,
D. Prescribed Quantity vs. Actual Quantity Bought (Multi- given the pace of change, the old models are
Purchase) simply not enough. Leadership is about
On the other hand, when buying multiple drugs, helping people cope with change, helping
respondents are more likely NOT to buy the prescribed them make the fundamental paradigm shifts
quantity of medications. necessary to cope with the changing
Base: Total respondents who have taken medications demands of the job - Dr. Policarpios note in
for (ILLNESS) i the past three months and have bought his PPT
more than one drug the last time.

LE1 TRANSCRIBERS Barbers, Bautista C., Belo, Beltran, Bernaldez, Besana EDITOR Mykee 2 of 3

3.03 Physicians as Leaders and Managers
D. Kotters comparison of leadership and management
Figure 5. Kotters Comparison of Leadership and Management
Quoting Dr. Policarpios PowerPoint notes:
The academics then started to view leadership as
distinct in its own right, rather than being a subset of
management. Kotter crystalised the differences really
well. Management is about what we do. Leadership
is about how we go about it.
There was a seismic shift in the 70s when people like
Kotter, Kanter Handy started to write about managing
turbulence and chaos in organisations and coping
with change
We also had In Search of Excellence by Peters and
Waterman was also instrumental in changing
fundamentally held beliefs
E. Doctors as Leaders
Doctors are used to working primarily as individuals.
Guard their independence jealously.
They value autonomy highly - but leadership is about
working with others
Are inclined to be analytic rather than creative,
imaginative, and sympathetic
They are happier with puzzles rather than problems
Used to telling people (patients) what to do rather
than inspiring or empowering them
Are driven by science and suffering to behave
tactically and reactively rather than strategically
Are too fond of hierarchies
F. Conclusions
Leadership is important to effect change
Leadership is primarily about setting a vision and
motivating people to want to achieve the vision
Communicating the vision, building trust, empowering
people, and working in teams are also important
Leadership and management are different
LE1 TRANSCRIBERS Barbers, Bautista C., Belo, Beltran, Bernaldez, Besana
HISTORY AND PERSPECTIVE IN MEDICINE 2020C
II. HIPPOCRATIC OATH
I swear by Apollo, the healer, Asclepius, Hygeia, and
Panacea, and I take to witness all the gods, all the goddesses,
to keep according to my ability and my judgment, the following
Oath and agreement:
To consider dear to me, as my parents, him who taught me
this art; to live in common with him and, if necessary, to share
my goods with him; To look upon his children as my own
brothers, to teach them this art.
I will prescribe regimens for the good of my patients
according to my ability and my judgment and never do harm to
anyone.
I will not give a lethal drug to anyone if I am asked, nor will I
advise such a plan; and similarly I will not give a woman a
pessary to cause an abortion.
But I will preserve the purity of my life and my arts.
I will not cut for stone, even for patients in whom the disease
is manifest; I will leave this operation to be performed by
practitioners, specialists in this art.
In every house where I come I will enter only for the good of
my patients, keeping myself far from all intentional ill-doing and
all seduction and especially from the pleasures of love with
women or with men, be they free or slaves.
All that may come to my knowledge in the exercise of my
profession or in daily commerce with men, which ought not to
be spread abroad, I will keep secret and will never reveal.
If I keep this oath faithfully, may I enjoy my life and practice
my art, respected by all men and in all times; but if I swerve
from it or violate it, may the reverse be my lot.
! You may not always be there to cure people but you can
try your best to relieve their pain.
III. QUIZ
1. All are main reasons for compliance except? A. Compliance
B. Lack of Time
C. Boredom
D. Financial Constraints
2. Leadership is transactional, and promotes status quo. T OR F
3. Management is coping with complexity, provides stability, order and
consistency. T or F
4.Leadership has a concrete definition. T or F
5.The Hippocratic oath is required to be taken by all physicians to
swear and, by a number of healing Gods, to uphold specific ethical
standards. T or F
Answers: C F T F T
REFERENCES:
1. Dr. Policarpios PPT
Dr. Policarpios lecture 2016
EDITOR Mykee 3 of 3