All physicians are leaders in their organizations because of their clinical expertise and authority. Even those who do not have a formal leadership position are viewed as leaders of their care teams. Physician leadership matters, particularly in uncertain and challenging times such as the COVID-19 pandemic. Good leaders can help provide clarity, calm, and cohesion when there is complexity, stress, and low morale.

I recently completed a year as chief resident, which forced me to hone my leadership skills quickly. Along with a few dozen gray hairs, here are seven tips I've gathered about how to be an effective leader.

1. Be proactive. Being proactive involves setting goals, planning, and frequently reassessing so you aren't just reacting to situations. Look at the schedule and identify potential issues ahead of time. Check in with your team frequently to ensure small problems don't turn into big problems. Plan for what's coming so you can avoid frustration later on.

2. Listen. Successful leaders amplify the needs and views of those they represent. Resist the urge to give your opinion at every opportunity and make a point to listen and observe. Study how your organization works and pay attention to what your team needs.

3. Develop an organized system and prioritize. Leaders have dozens of tasks to complete at any given time. Because others look to you for guidance and to get things done, the amount of work can become overwhelming. Developing an organized system allows you to prioritize, delegate, and complete tasks on time. I used Google Keep (https://keep.google.com), an online note-taking service, and kept multiple checklists with varying degrees of urgency. I also tried to keep my inbox clean by responding to items promptly or moving tasks to my “Keep” task list.

4. Communicate well and transparently. What you say as a leader will be valued, so being an effective communicator is critical. When speaking in person, be concise and focused, and allow adequate time for questions. Know what you're talking about, but don't be afraid to say, “I'm not sure. I'll ask and get back to you.” When communicating via email, be even more concise and highlight key action items. As things change in the workplace, especially during a crisis, be as transparent as you can be. I did this by compiling all the important information for the week into a weekly update email.

5. Be flexible. No matter how much planning or organizing you do, there will be times of chaos. For example, the end of my chief year was during the COVID-19 pandemic. There was nothing I could have done at the beginning of the year to prepare for such an event. I quickly learned that I had to be adaptable as new challenges arose, and be flexible about requests from others.

6. Learn to say no and delegate. Those under your leadership will come to you with requests or ideas, and those above you will come to you with projects. It is impossible to do everything. Most physicians (myself included) are awful at saying no and delegating. To improve, you need to do two things: 1) know what you are passionate about so you can engage in these projects while saying no to other projects, and 2) know your weaknesses and identify others who excel in these areas so you can delegate specific tasks. If a project or request does not align with your responsibilities, kindly but firmly explain that it is outside your role.

7. Take care of yourself. Being a leader can be emotionally draining. When tasks pile up, it is easy to forgo exercise, healthy eating, and mental well-being. However, you cannot be an effective leader if you are not operating at full capacity. It is critical to set aside personal time every week and prioritize a few weeks of vacation during which you can unplug.

I'm sure there are lessons veteran physician leaders could add to this list, but these seven tips are a good start. I hope they are useful to other physicians as they lead their teams through uncertain times.