As the nation considers ways to lower unsustainable health care costs and enhance the quality of patient care, renowned diagnostician Gurpreet Dhaliwal, MD, says physicians can learn valuable lessons from Click and Clack, longtime hosts of the popular Car Talk radio program.
“What we need in the practice of medicine is a lot less of House, MD, and a lot more of Car Talk,” said Dr. Dhaliwal, a practicing internist nationally recognized for his diagnostic skill and a strong advocate for patient safety and quality improvement. He also is an associate professor of clinical medicine at the University of California–San Francisco School of Medicine.
Dr. Dhaliwal was speaking to about 200 leaders from the AMA and state and specialty medical societies who had gathered at the AMA’s State Legislative Strategy Conference to discuss upcoming state legislative efforts and trends that will shape medicine’s future.
Rather than working in isolation away from the bedside as does television’s Dr. House, physicians need to work toward systems improvement and strengthening the health care team, Dr. Dhaliwal said. Like Click and Clack, physicians should enjoy their work, build on their teammates’ strengths and evaluate their outcomes.
Dr. Dhaliwal emphasized in his address that change “can’t come from the outside; it can only come from within. But that requires physician leadership.”
“The doctor has the skill and the will to improve their performance and that of the people around them,” he said. “If we don’t take leadership, someone else will—and that might not be good for patients or physicians.”
Dr. Dhaliwal said leadership doesn’t have to take place on a large scale. It can be a matter of what he called “microleadership”—leading by doing.
“The physician who stands up and says, ‘I’m going to improve a quality measurement,’ that person is a leader. If a physician hears a good measurement that is handed down and agrees to do it without complaining, that physician also is a leader.”
In addition to quality improvement, Dr. Dhaliwal said physicians can lead by being good stewards of resources, withholding potentially harmful treatments or tests, and adopting models of physician-led team-based care that make the practice more efficient and better coordinate and deliver care for patients.
Dr. Dhaliwal also underscored the importance of building leadership into physicians’ education. “We need physicians that almost have leadership in their DNA. The purpose of medical education is to improve the health of patients and the outcomes in the communities in which they live.”
Doing so requires a new emphasis in medical school. “Medical education is going to start being grounded in both science and systems improvements. Thanks to grants from the AMA, this change is taking place in 11 schools across the nation and in many other places,” he said, pointing to the AMA’s Accelerating Change in Medical Education initiative.
“Leadership comes in all sorts of shapes and sizes. But it’s a size and shape that everybody needs to try on. Leadership is hard work. Leadership takes training. It is multifaceted .... But the one thing leadership is not is optional. [In the future,] we want to say that it was doctors who were the bright spots and the drivers of innovation.”
