Why Emergency Medicine Is Great Preparation for Leadership

Mark D. Olszyk, MD, MBA, CPE, FACEP, FACHE, FFSMB, is an emergency medicine physician with more than 20 years of experience in the medical field, including positions with Veterans Affairs Maryland Health Care System-Baltimore Division and Carroll Hospital in Westminster, Maryland, where he is CMO and vice president of medical affairs.

Olszyk has broad experience in areas such as executive management of hospital inpatient operations and outpatient multispecialty medical groups; oversight of physician contracts; care management; utilization review; credentialing and privileging; performance improvement and systems redesign; training and development; and strategic initiatives. He received his medical degree from Columbia University Vagelos College of Physicians and Surgeons.

What are your current leadership responsibilities?

As a chief medical officer for Carroll Hospital Center, I am responsible for the hospital’s adequate provider staffing. This may involve reviewing our workforce requirements, recruiting, contracting, credentialing, orienting, monitoring, counseling, and, where necessary, correcting conduct. I have an excellent staff and team of physician leaders with whom to collaborate.

I’m a fan of the classics. In the Byzantine Empire, the equivalent role was Archiatrus, chief physician. As a metaphor, though, I would prefer to employ a Roman office title: pontifex, bridge builder. I encourage communication and understanding among the numerous medical specialties and departments, as well as the medical staff and the other hospital divisions (nursing, quality, legal, and finance), administration, the board of directors, and the community. I like to believe I contribute to the construction of these bridges.

How did you decide on the sub-specialty of emergency medicine?

Emergency medicine was the last rotation I completed during my internship year. I’d say that by that time, I was a competent intern. I associated my proficiency with what I was doing at the time.

It was a popular specialty; many of my closest friends were going into emergency medicine, and it was the setting of a popular TV series. The hectic rhythm and timetable appealed to my 20-something self. I discovered that I enjoyed some aspects of each medical specialty, and EM provided a means for me to continue performing those aspects, as well as some things that were largely specific to EM: toxicology, environmental emergencies, EMS. I was a Navy physician, and EM was a specialty very much in demand.

Why do you think the ED is a good training ground for leadership?

I was on a call with CMOs from around the state of Maryland. Nearly half of them appeared to have training in emergency medicine. I’ve seen a lot of other emergency medicine doctors favor leadership roles.

EM forces you to make decisions quickly and without all the facts. You instantly inquire as to the most serious and prevalent conditions that this patient might experience. After that, you go through the differential diagnosis while being mindful of anchoring bias. Every other medical discipline interacts with emergency medicine; hence, an EM doctor needs to be at least passingly fluent in each area.

Last but not least, EM doctors collaborate with a dynamic group of nurses, technicians, EMS, and support staff. You must be able to work with a variety of people with various personalities under the most stressful of conditions. It is one of only a few specialties where you have no idea who your patient will be from hour to hour. You must simultaneously be on guard, receptive, and inquisitive. You need to think in parallel.

What are the most important qualities in a physician leader?

I enjoyed watching Apple TV+’s Ted Lasso series. He mentions Walt Whitman in one of his lines: “Be curious not judgmental.” Despite being incorrectly credited to Whitman, this is a wonderful quote.

Demagogs and martinets claim to own all the answers. Great leaders ask questions without fear. They are eager to learn, they examine their own presumptions, and they want to build a better mousetrap. Curiosity is the remedy for confrontation and the precursor to discovery and awe.

For emergency physicians who are considering leadership or executive management in their future, what are the three strategies you would suggest?

Lead, read, and hear.

I have spoken at conferences on leadership. The initial query I pose is, “What is leadership?” No one provides the response I anticipate.

I inform the group that a leader motivates others to act. That is all. Now, you have the option of being a virtuous or vile leader. People might be led once, or they can be inspired to follow for decades.

We desire leaders who are honorable, selfless, sage, and compassionate. How do we attain such leadership? Not (just) by attending classes, but by leading in practice. Seize every chance you can. Local services, religious organizations, charitable organizations, sports teams, and schools are continuously seeking leaders and volunteers.

I was a Boy Scout leader for almost 10 years. If you can hold the attention of 50 pre-adolescent boys who are brimming with energy — which may require cracking jokes, singing, and devising games — you will have no difficulty with public speaking.

Read biographies of prominent figures. You can gain insight from their errors and decisions. Read philosophy, history, and sociology to enhance your mind and creativity.

Finally, listen! Learn to hear what people are saying. Everyone wants to tell their own story and be understood.

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