Excellent communication skills required.

Consideration for any executive position requires one essential quality: excellent communication skills. Unfortunately, this important competence may be belittled by the doctor-candidate, or, worse yet, the prospective manager commits grammatical errors in writing, makes inappropriate use of metaphors in speaking, fails to send thank you notes and acknowledgments, or has unsightly typographical errors in his or her presentation materials.

The successful physician executive must demonstrate superior proficiency in use of "the King's English." The ability to speak extemporaneously, to write a clear and coherent paragraph, and to use computer word processing programs with facility are absolutely indispensable skills. Faux pas committed in speaking or writing, combined with a lack of social intelligence (knowing what is appropriate to communicate and what is best kept to oneself) are a major cause of career implosion.

What is the doctor-candidate to do if he or she lacks the ability to speak "on his or her feet," the cultivation to know what is appropriate to share, or the facility to write a concise paragraph? Short of going back to college or enrolling in a charm school, I would proffer the following:

* Develop a love affair with words. Listen carefully to those (such as radio and television news anchors) whose business it is to use words correctly. Keep a steno pad and paperback dictionary on your person at all times, and when you come across unfamiliar words or phrases, ask yourself if you can define them and whether you understand their contextual usage. If not, look them up and write the definitions in your steno pad. After a short while, you will accumulate a collection of new words and phrases that can be incorporated into your own vocabulary.

Read as many different source materials as possible: magazines, journals, and newspapers to be sure, but also have on your person one or more books that you read daily. Never be without a book in your briefcase, and read whatever strikes your fancy. There will be times when you'll find yourself reading all nonfiction: business, psychology, economics. There are other times when you'll grow tired of reading only things that are good for you and retreat into a trashy novel. Don't forget the classics, poetry, Shakespeare, and the King James Version of the Bible; the beautiful, musical resonance of the English language fairly sings from the pages of the Psalms or Ivan Turgenev's wonderfully crafted novellas and short stories.

I keep a daily journal, and, in the back, I maintain a list of books I've finished. I enjoy competing with myself, "upping the ante" by setting higher reading goals each new year. I also enjoy seeing what subject areas I've covered, and if it seems I'm spending too much time on business or some other subject, reading something completely different. Rule #1 for this system: You only write down books you successfully complete, cover to cover.

* Read The Elements of Style by Strunk and White and practice Rule #17: "Omit needless words." Buy this pithy 92-page book and devour it! There is no other source comparable to Strunk and White's "Elements of Style" that will improve your writing style more quickly. To quote from the introduction: "Seven rules of usage, eleven principles of composition, a few matters of form, and a list of words and expressions commonly misused- that was the sum and substance of Professor Strunk's work."[1] Professor Strunk is emphatic in his exposition on Rule #17, "Omit needless words." If there is one piece of advice to glean from this gem of a work, it would be that: develop an economy of word usage, expressing an idea in a word or two.

* Create public speaking opportunities. Nothing will improve your speaking abilities more than actual public presentations. For a clinician or a physician executive, there is a plethora of opportunities to do this. Volunteer for a panel discussion in an area of your expertise, agree to participate in health seminars at your place of worship, take part in presentations at a local medical school, and don't shy away from the more direct, work-related speaking opportunities that are part of your job.

In addition to improving your skills in extemporaneous speaking, you also enhance a host of other preparatory skills leading up to the presentation, including making a speech outline or preparing slides and overhead projections with computer software programs such as Powerpoint[R] or Harvard Graphics[R]. The ability to size up an audience, to prepare 5 or 6 "bulleted" slides, to speak coherently, to anticipate questions, and to field a provocative discussion are invaluable tools to acquire early in your career.

* Two other indispensables: Letitia Baldrige's New Complete Guide to Executive Manners and John Lucht's The New Rites of Passage at $100,000+. A book on business etiquette? Absolutely! Letitia Baldrige was Chief of Staff to Jacqueline Kennedy during her years in the White House and has written this bestseller on everything from writing the perfect business letter to getting the most out of meetings. You must not only read this cover to cover but keep it in your office as a useful reference (her sections on "The Executive At Ease" and how to write a note of condolence when an employee's family member dies are especially useful information).[2]

I credit John Lucht's book with my successful transition to Blue Cross Blue Shield of Massachusetts. Failure to obtain a desired management position often has more to do with ignorance about social and business nuance than with objective criteria in your resume. Do not underestimate the importance of adequate preparation for your interviews, down to the polish on your shoes. John Lucht likens this in Chapter 16 to a "pre-flight checklist of practical tips": "check the forecast" by asking your recruiter about last-minute information; "pack your flight case" by putting into your buffed leather attachee extra copies of your resume, your Mont Blanc[R] pen, and the Wall Street Journal or the latest Physician Executive; and "keep an eye on your radar" by reading the interviewer's body language.[3]

* Your curriculum vitae, thank-you notes, and personal stationery. Presentation is everything! Your curriculum vitae must immediately communicate the thoughtful, high-quality person that you are. Dispense with old resume formulas that list background information in dry, chronologic order and instead tell others exactly what they want to know about you: your administrative, financial, and communication skills. Job history, education, and publications should follow, and do not end your CV with the sophomoric phrase "references available upon request."

Have an assortment of high-quality, engraved, personal stationery at the ready. Letitia Baldrige and John Lucht go into greater detail about this, but essentials include 8 1/2" x 11" crisp classic white paper with name, home address, and phone number engraved at the top; monarch size (7 1/4" x 10 1/2") of same quality paper and engraving to write personal notes and to clip to your resume; and small White cards with a single monogram initial of your last name for personal thank-you notes.

Always, always, always send interviewers, their secretaries, receptionists, and any other persons involved with your interviewing trip a handwritten, personal thank-you note. Use a commemorative postage stamp, make sure you have names spelled correctly, include a middle initial and degrees if appropriate, and send the note right after your meeting. This small gesture will speak volumes about your thoughtfulness and integrity.[11]

References

[1.] Strunk, W., and White, E. The Elements of Style. New York, N.Y.: Macmillan Publishing, 1979. [2.] Baldrige, L. Letitia Baldrige's New Complete Guide to Executive Manners. New York, N.Y.: Rawson Associates, 1993. [3.] Lucht, J. The New Rites of Passage at 100,000+. New York, N.Y.: Viceroy Press, 1995.

Michael T. Myers Jr., MD, is Associate Medical Director of Medicare Programs, Blue Cross Blue Shield of Massachusetts, Hingham, Mass. He may be reached at P.O. Box 3333, Hingham, Mass. 02044-9194, 617/741-3026, FAX [phone].