CARLSBAD, CALIF. — As hospitals continue to employ an army of docs, aiming to pursue population health and clinical integration, physician leadership is more important than ever. Maybe CEOs should be looking to someone who has distilled leadership development into a science — the U.S. military — to figure out how to turn their soldiers into sergeants.

That's been the case at Florida Hospital, which, since last year, has employed retired U.S. Army Lt. Gen. Mark Hertling as its senior vice president for global partnering and physician leadership development. Med schools and hospitals, ideally, should be instilling leadership skills in doctors from Day 1, Hertling told attendees at the Siemens Health Executives Forum earlier this week, but that's far from the case.

He recently took the hospital’s CMO and a group of docs to the army training center to see how they shape fresh-faced 19-year-olds into leadership material, and the hospital leader was amazed.

"We do just the opposite with doctors," Hertling recalled his CMO, David Moorhead's saying at the time. "We beat leadership out of them from their undergraduate to their graduate schooling to their residencies to their first assignments in a hospital. Anything that might be perceived as leadership, we tell them to knock it off because they're always competing with each other. They're not building teams and they're not doing the kinds of things that you would expect leaders to do."

So, Florida Hospital tasked Hertling with designing a program for docs that instilled some of the principles and methods of military leadership training. Surveying the field, Hertling said he found that many institutions were confusing business management training with shaping future members of the C-suite. Putting a doctor through a couple of courses on finance doesn't make him or her management material.

They're about halfway through the first course, and already seeing "phenomenal results" with the first class of 35, which includes both administrators and clinicians. One early lesson Hertling said he's learned is that hospitals want to give docs a seat at the table, but most of them never learned how they’re supposed to act when they get there.

"We want doctors to have a seat at the table but, unfortunately, as one physician told me, no one has taught us table manners," he said. "We come in, because of our scientific backgrounds, throw some things down, expect everybody to look at us like godlike creatures who have all the answers, and do all of the things that we're telling them to do. And, unfortunately, that's not how the real world works."

Florida is running an eight-month course that trains physicians for five hours a month. Some doubted that busy docs would raise their hands, but they've seen about three times the number of self-nominees that they expected, proving MDs' strong desire to learn.

Some of the key things they've emphasized, Hertling said, include the importance of defining leadership as influencing and inspiring your team (rather than motivating, since most people self-motivate); providing leaders with the tools to carefully consider risks (rather than just taking gambles); and the importance of an "after-action review" where, every two days, things grind to a halt and leaders can "pick scabs" to figure out what needs fixing and how.

Having older docs or "graybeards" shadow their younger counterparts and provide them with useful feedback on how they can improve has also proved fruitful, Hertling added.

"When you have someone watching you in a collegial manner, who is trying to help and who doesn't have anything to gain from it other than the improvement of the hospital, it's a good thing," he said.