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123 FINANCE CMO / CARE DELIVERY Why 100 Florida Hospital Physicians Are Learning 'Table Manners' at Gettysburg By Emily Rappleye P hysicians from Orlando-based Florida Hospital are getting schooled in military history — and it's helping them lead differently. One hundred Florida Hospital providers trekked to Gettysburg, Pa., in August to reenact the decisions made in the bloodiest battle of the Civil War. Leadership choices in the Battle of Gettysburg not only changed the course of the war, but decided the fate of nearly 8,000 sol- diers. e clinicians spent months before the one-day reenactment studying stories of an individual soldier from the Battle of Gettysburg. Led by a professional historian, staff portrayed their character's decisions during battle, explained why they made those decisions and demonstrated how they contributed to the survival or demise of their fellow soldiers. Participants walk away with a better understanding of how personal- ities, relationships, personal health and perspective impact individual decision-making and group outcomes. is team-building exercise is part of a larger, eight-session leadership course at Florida Hospital led by Lt. Gen. Mark Hertling (Ret.). Aer retiring from his post as Commanding General of the U.S. Army Eu- rope, where he led more than 40,000 soldiers, Lt. Gen. Hertling was brought aboard Florida Hospital to oversee global partnering pro- grams, leadership development and health performance strategies. Now his experience turning 19- and 20-year-olds into Army sergeants is also used to teach physicians and other clinicians how to lead. "It's not like the sexy programs you read about in leadership books," says Lt. Gen. Hertling. Yet simplicity may be what makes the training stick. He told Becker's the program has spurred a noticeable change in how physicians in particular view leadership. "ey are beginning to take up the mantle of leadership — volunteer- ing to lead teams, problem solving, task forces or even the transfer to a clinically integrated network. Quite a few have been appointed to lead- ership positions in the hospital," he says. Finding a seat at the table Physicians weren't always so quick to assume leadership at Florida Hos- pital, which is one of the largest hospitals in the country with hybrid model of employed and independent physicians, many of whom dis- trusted hospital administration. For several years, Florida Hospital tried and failed to find a physician leadership program that worked, according to Lt. Gen. Hertling. In the first year of the program, he recalled a partic- ularly frustrated physician exclaim, "Why don't these people listen to us? We have the answers! Why can't we get a seat at the table?" Florida Hospital is not alone. For example, a physician at New Lon- don, Ct.-based Lawrence+Memorial Hospital very publicly lambasted his hospital leadership by circulating a letter in early 2015 about the hospital's "unnecessarily downward spiral" and "us versus them" atti- tude. Part of the problem is hospitals around the country tend to lack physician leadership at the executive level. Among the country's more than 6,330 hospitals, only about 5 percent are led by physician CEOs, according to data from the American Hospital Association. "When you take a look at who is leading healthcare organizations, it is mostly businessmen. is is not good or bad, but they are different than the folks who are the foot soldiers," Lt. Gen. Hertling says. "If we really want to solve the problems we are seeing in healthcare today, we have to include physicians." e course he developed recognizes many ways to lead beyond the C-suite. But physicians, who are well-versed in the science of medicine, may still need training in the art of engagement and collaboration. For this reason Florida Hospital limits the course to physicians and other clinicians who are not already in leadership positions, according to Lt. Gen. Hertling. Without a preconception of leadership, training pro- duces leaders at all levels who can be agents of change. "Leadership is all about dealing with people," Lt. Gen. Hertling says. "Business management is mostly about systems and processes. What we are focusing on is how to engage with others, inspire them and get to know them on a personal level." Teaching table manners Aer the first class of 50 clinicians, Florida Hospital doubled the size of the course, training 100 staff members annually. Now it is conducting research to quantify the effects of the course on HCAHPS scores and patient and employee engagement. Perhaps most importantly, the course changed the way teams get to- gether, solve problems and interact with each other, according to Lt. Gen. Hertling. Aer the outburst from the frustrated physician, Lt. Gen. Hertling says he told physicians, "It's great you want a seat at the table, but you have to have table manners…You've grown up in a cul- ture where you are the smartest guy or gal in the room and you want it your way. To be a true leader, you have to see it other people's way and be humble." is unofficial mantra has helped physicians become more self-aware while still taking the reins and building trust in the organization. Lt. Gen. Hertling published a book on physician leadership in May entitled Growing Physician Leaders: Empowering Doctors to Im- prove Our Healthcare. n "When you take a look at who is leading healthcare organizations, it is mostly businessmen. This is not good or bad, but they are different than the folks who are the foot soldiers." — Lt. Gen. Mark Hertling (Ret.)