Wednesday, November 29, 2017

Critical Mass

Today I woke up to a "Breaking News" text message that NBC had fired "The Today Show" anchor, Matt Lauer due to accusations of "inappropriate sexual behavior" from multiple women.  At the same time, Minnesota Public Radio fired long-time radio personality Garrison Keillor (creator of the show, "A Prairie Home Companion") for similar allegations.    There have been a number of famous men in the last few weeks whose careers have ended due to allegations of sexual harassment or improper conduct.  I suspect that there will be more to come.  We seemed to have reached a "tipping point" where this kind of behavior is no longer tolerated - it is about time.

I read a very interesting article in Time magazine by Jay Newton-Small entitled, "What happens when women reach a critical mass of influence" based on her recently published book, "Broad Influence."  I would encourage all of you to take a look - it really is quite amazing.  Newton-Small claims (and she provides a number of examples to back her point) that an organization's tolerance for sexual harassment ends abruptly when women comprise between 20% to 30% of the organization (i.e., there is a "tipping point" at about 20-30%).  For example, when there were at least 20 female Senators, the U.S. Senate reformed the Pentagon's sexual harassment policies.  When 25% of Hollywood producers were women, the so-called "casting-couch culture" of Harvey Weinstein was brought to an unceremonious end.  When one-third of the White House press corps were women, a number of media moguls were accused of sexual harassment (see Fox's Roger Ailes, among others).  The 20% to 30% tipping point appears to apply to racial and ethnic diversity as well.  Shortly after the U.S. Supreme Court's landmark decision to desegregate schools in the 1954 Brown v. Board of Education, sociologists recommended that a "critical mass" of minority students should be introduced into schools.   

If 20% of the workforce is a "critical mass", we have a long way to go, especially with regards to racial and ethnic diversity.  There is no question that we are better and stronger through diversity.  As former President George H.W. Bush (who, incidentally, was also recently accused of inappropriate behavior) said:

We are a nation of communities...a brilliant diversity spread like stars, like a thousand points of light in a broad and peaceful sky.

It really is a beautiful metaphor.  We are a "nation of communities" but unfortunately, we don't always act that way.  Perhaps we can only become like the "thousand points of light" when we reach that "critical mass" of 20-30% diversity in positions of leadership.  We will only reach that "critical mass" when we are deliberate and explicit with our diversity goals.  As leaders, we need to place individuals from different backgrounds in positions where they have the opportunity to grow and develop.  We need to provide the mentorship to assure their success.  It has to start somewhere, and now seems to be an opportune moment.  Please help build that "critical mass" so that we can all reach our greatest potential.

Sunday, November 26, 2017

"You're fired!"

I know what you are thinking - and you are wrong!  I am not writing a blog that has anything to do with the television show "The Apprentice" or any of its stars.  Nope, this post is about something completely different.

I was sitting in front of the television yesterday watching my alma mater, Purdue University, win the Old Oaken Bucket by beating our rivals from Indiana University in the last football game of the season.  The win meant that Purdue is now "bowl eligible" with a 6-6 win-loss record (unfortunately, Indiana is not "bowl eligible" since the loss gave them a 5-7 record).  It was a great win for Purdue's first year coach, Jeff Brohm.  What is even more impressive is that just last year, with almost the same group of players, Purdue finished the season with a 3-9 record.  In fact, the last time Purdue went to a bowl game was in 2013.  Basically, Purdue has had a long string of very unimpressive football teams coached by a succession of not so impressive (at least based on their win-loss records at Purdue) head football coaches.  It got me thinking - what is so special about Coach Brohm that he seems to have turned the Purdue football program around?  Okay, I know.  One season does not make a successful program, but there is hope.  Does a head football coach really mean that much?  Can a new head football coach really have that much of an impact?

Consider this point even further.  Most college football programs ended their seasons this past weekend, and just like every year at about this time, several head football coaches were fired because of their lack of success.  Some of the notable ones include the head football  coaches at Texas A&M, Tennessee, Arkansas, and Florida - pretty impressive list given the fact that most of these colleges have historically had strong, competitive football programs (Tennessee and Florida have even won multiple national championships).  Keep your eye on the sports world, there will be a succession of firings and hirings over the course of the next couple of weeks in what has become affectionately termed, the "annual college football head coaching carousel."

So back to my original question - what can all of these colleges expect from a brand new head football coach?  Will a change in head coach bring back the glory days of old for the likes of Tennessee, Florida, Texas A&M, and Arkansas?  Believe it or not, this particular issue has been studied fairly extensively.  And, the results of the studies that have been done will likely disappoint all of you rabid Volunteer, Gator, Aggie, and Razorback fans.  E. Scott Adler, Michael Berry, and David Doherty conducted an analysis of coaching changes from 1997 to 2010, the results of which were published in the journal, Social Science Quarterly (see the link here).  The performance (in terms of wins and losses) of football programs that replaced their head coach were compared directly with programs who retained their head coach.  Surprisingly (maybe), changing the head coach of historically poorly performing teams (think Purdue's football team last year) had little, if any, effect on the program's win-loss record.  Football programs with a little more success (think Tennessee, Florida, Texas A&M, and Arkansas) actually did worse after a head coaching change.  As it turns out, the results of this study have been replicated in other sports too (for a summary, see the link here), including professional football, soccer, basketball, and hockey.  Even more important (unless you love sports!), studies in the business world, where a CEO is replaced instead of the head coach, have similar results too!

So what gives?  As Josh Bersin writes in a post for Forbes magazine, it's not all about the CEO (or in our previous examples, it's not all about the head coach).  At least in the business world, a focus on leadership strategy is infinitely more important to the overall success of the organization than any one individual CEO.  Bersin offers the following best practices from his analysis of multiple organizations:

1. High-performing organizations directly link leadership strategy to business strategy.  In other words, successful organizations link their leadership development strategy with the overall mission, vision, and values of the organization.  Developing a strong team of leaders at multiple levels throughout the organization is really the key to success here.

2. High-performers develop leaders at all levels.  Again, successful organizations foster leaders at all levels through talent management, succession planning, and leadership training.  Interestingly enough, successful organizations empower their front-line leaders to make decisions that are in the best interest of the organization as a whole (this is a great example of the High Reliability Organization principle of "deference to expertise").

3. High-performers invest in leadership development.  Here, the most successful CEO's focus on developing front-line leaders.  If it's important to the CEO, it's important for the CEO's direct reports, and so on.  The CEO that is fully engaged with leadership development will build a strong group of leaders that will assure the organization's success.

Would these best practices translate to success on the football field or basketball court?  I don't know.  But they are definitely what can make or break just about any other kind of organization.  So next time you are ready to call for your favorite football team's head coach to be fired, or for that matter, the CEO at your organization, remember that leadership transitions at the top of the organization don't always work out for the best.  However, if the new CEO follows these leadership best practices, maybe he or she will be successful in taking the organization to new heights.

Saturday, November 25, 2017

By request...

I thought long and hard about what to write about this weekend.  There were several great topics with a lot of potential that came to mind - Thanksgiving and gratitude, rivalry week in college football, transitions of power (see the recent transition in leadership in the country of Zimbabwe or all the college football head coaching changes announced this week), Presidential leadership (or in our case, the lack of Presidential leadership).  My wife, our youngest daughter, and I drove down South this past Wednesday for Thanksgiving (we met our other three kids in Atlanta - they all flew!).  Along the way, we stopped at a fast food restaurant right off the interstate.  There was a long line at the drive-through window (actually, they had two lines going side by side).  There were two workers taking orders on iPads and collecting payment by credit card.  They took my name down, so when it was our turn to drive up to the window, the worker in the restaurant confirmed my name and handed us our order.  Great efficiency and a really strong example of process improvement.  I thought about writing more on that episode.  However, I received a tweet on this same Wednesday afternoon that "requested" a post on a memo that the hospital administrators at Parkland Memorial Hospital sent out to their employees shortly after President John F. Kennedy died.  So here it goes, by request!

Both President Kennedy and Texas Governor John Connelly were brought to the Emergency Department of Parkland Memorial Hospital on the afternoon of Friday, November 22, 1963 (fifty-four years ago this past Wednesday).  Two days later, Kennedy's accused assassin, Lee Harvey Oswald, was brought to Parkland after being shot as well.  While Governor Connelly survived, as everyone knows, both Kennedy and Oswald died.  While hospitals like Parkland Memorial Hospital deal with trauma victims every single day, very few are forced to deal with such high-profile trauma victims as a Governor, U.S. President, and assassin, all in the span of two days.  In response, the hospital administration sent out this letter:
The letter is very well written and acknowledges the unique situation that the employees at Parkland Memorial Hospital dealt with in just the short span of two days.  We see here a great example of crisis leadership, and I think there are probably three takeaway lessons for health care leaders today.

First, point #7 above is critically important.  Even during a crisis, hospitals have to function as they normally do - patients still come and go, families and visitors still come and go.  The rest of the world does not stop, just because one particular health care organization is in the middle of a crisis.  I remember my own personal experience of a mass casualty emergency when I was in the Navy.  Our hospital was dealing with a mass influx of trauma patients as a result of a airplane crash.  But even while our emergency department and operating room suites were dealing with the trauma victims, our labor and delivery unit was still delivering babies, and our nursery was still dealing with a sick newborn.  Life goes on - even during a crisis.

Second, and even more important, health care leaders must show gratitude.  When?  The best answer is "all of the time."  However, showing gratitude with a public acknowledgement of thanks is absolutely essential after a crisis (ideally as soon as possible after the crisis has started to subside - though some would say that gratitude is important throughout the crisis).  Here, the administration of Parkland Memorial Hospital acknowledged the very unique situation that their teams of physicians and nurses experienced during those two long days in November, 1963.  Remember that the nation was mourning the death of a very much beloved President.  Parkland employees were dealing with more than that - the assassination of a U.S. President was the most important news of the day, so they also had to contend with the news media from around the world.  Gratitude, even a simple "Thank you", tells the entire organization that the leadership understands and acknowledges what their teams are dealing with.  The display of gratitude should be meaningful and from the heart.  The display of gratitude should be personal and public. 

Third, as soon as possible after the crisis has passed, organizations absolutely must gather the facts and conduct a thorough After Action Report of their experience.  No matter what the cause, there is a lot to learn from how an organization functions during a crisis.  Leaders should never let an opportunity to learn from a crisis go to waste.  I suspect that Parkland Memorial learned a lot about how their hospital functioned with two very high profile trauma victims.  They likely learned a lot about how their media relations team functioned with an extremely stressful set of circumstances.  The key for any organization is to leverage what is learned in a crisis and improve upon their response for the next time.

Sunday, November 19, 2017

"Sometimes the hardest thing and the right thing are the same..."

One of the toughest things that I have experienced in my professional career as I have transitioned into leadership roles is that I can no longer leave some of the most difficult decisions to someone else.  It is a fact of life, leaders frequently are called upon to make really tough, and at times unpopular, decisions.  There is absolutely no getting around the fact that you can't please everyone all the time - at times, making the tough decision, even if it's the right decision, can make members of your organization very angry and frustrated (usually their anger is directed towards the leader who made the decision!).  Major Richard Winters, one of the main characters in one of my favorite television series, "Band of Brothers" once said, "If you're a leader, you lead the way.  Not just on the easy ones, you take the tough ones too."


Dan Rockwell, who writes a blog called "Leadership Freak"", says "The way you make unpopular decisions is as important as the decisions themselves."  Leadership is more about humility, transparency, and integrity than it is about making decisions.  He goes on to list several tips on how to be respected, even when making a difficult and unpopular decision.  Here are some of my favorite ones:


1. Adopt a relaxed, gentle, welcoming demeanor.  Breathe deep.  Smile.  Gentle eye-contact.
2. Be a learn-it-all, not a know-it-all.
3. Reject the trappings of position and authority.  When you pull rank, they close down.
4. Include others as early and as often as possible.
5. Share information prolifically - secrets lead to fear and manipulation.
6. When you can't share information, explain why.
7. Answer public concerns quickly, directly, and publicly.


One additional caveat, even when you follow these tips, you as the leader will still be subject to criticism.  Here, I have found that the Stoic philosopher, Epictetus was exactly right.  Whenever he was criticized, he said, "If that person really knew me and my flaws, they'd have said something much, much worse."  In other words, take the criticism for what it really is - feedback on how to improve the next time you have to make a difficult and potentially unpopular decision.





Tuesday, November 14, 2017

Clear the deck

I have been very lucky to have great mentors throughout every stage of my career, and with great mentorship always comes with great advice.  What was the best advice that I ever received?  Well, it's hard to say exactly, but "Don't overcommit yourself - learn to say No" immediately comes to mind.  Unfortunately, I didn't really learn to say No until much later in my career.  I ended up okay, but I do think that things would have been much easier for me if I had politely said No a little more often.

As it turns out, "learning to say No" is actually an important skill!  Camille Preston wrote a fantastic article for Fortune magazine in 2014 called "Why saying no gets you ahead".  The key message is that overcommitting yourself will decrease your productivity, prevent you from reaching your actual goals, and increase the risk of professional burn-out.  Preston offers seven tips to help you learn to say No:

1. Implement a 24-hour pause period.  In other words, wait 24 hours before you say Yes.  Think it over carefully - if you still want to accept that invitation to write a textbook chapter or serve as the project leader on that major quality improvement initiative, then go ahead and say Yes.  The 24 hours will give you the necessary time to think things over carefully.  And just about every decision can afford to wait for 24 hours.

2. Say no with grace and authority.  Be polite, but firm.  Don't beat around the proverbial bush.  If you don't want to do something, kindly thank the individual for the invitation but say no (and mean it). 

3. Simplify your commitments.  If your commitments don't help you ultimately attain your professional goals, then give them up (see more below).  As Preston states, "If you don't enjoy it, aren't fulfilled by it, or it doesn't help you personally or professionally, stop doing it."

4. Create white spaces on your calendar.  There are always going to be lunch dates, after hours presentations, or conferences that you don't want to attend.  Do yourself a favor - don't go to them.

5. Minimize the meetings.  Too many meetings are not helpful.  Most meetings are not productive anyway.  If it doesn't come with an agenda and pre-work, it probably isn't worth the investment of your time.

6. Notice the "should".  Volunteer and service activities are great opportunities - but you should be doing them because you want to do them and NOT because you think it will help your career if you do.

7. Set your boundaries, and stick to them.  Don't answer e-mails, text messages, or telephone calls after work or on the weekends.  More importantly, don't ask the members of your team to do so either. 

Preston's third tip reminds me of a wonderful story about Warren Buffet (Warren Buffet's three-step strategy).  Apparently, Warren Buffet was giving some career advice to his personal pilot, Mike Flint.  He told Flint to write down his top 25 career goals.  Next, he asked Flint to look over his goals and circle the 5 most important ones.  At this point, Flint had two separate and distinct lists - the first one listed his top 5 most important career goals, and the second one listed 20 other goals that weren't as important to him.  Buffet asked his pilot to explain what the two lists meant to him.  Flint replied that the top 5 goals were the ones that he would focus most of his time on achieving, while the next 20 were the ones that he would keep on the backburner and get to them as soon as he could.  Buffet emphatically said that he should forget about the next 20 goals and "avoid them at all costs."  These goals would only distract him from achieving his top 5 most important ones.

Learning to say No is one of the most important things that a leader can do to "clear the deck."  As Steve Jobs once said, "It's only by saying No that you can concentrate on the things that are really important."  So, do yourself (and your team) a HUGE favor - clear the deck by learning to say No.




Saturday, November 11, 2017

Courage, Honor, and Commitment


We celebrated Veteran's Day yesterday at the hospital.  The annual Veteran's Day Recognition Ceremony is one of my favorite events of the year.  I was honored this year to give the keynote address.  The text of my address follows below: 

My friends and colleagues, I have never been comfortable being called a veteran.  I never served in combat.  And in all of my time in the Navy, I never once set foot on a ship that was more than 100 yards from shore.  But please don’t misunderstand me – I have NEVER been more proud to have served in our nation’s military.  If I am reluctant to call myself a veteran, it is because I place an infinitely greater value on the contributions of those men and women who either put themselves in harm’s way or were willing to do so.  If I am slightly uncomfortable standing before all of you on Veteran’s Day, it is because I gave less to our nation than I received in return.

Our time in the Navy lasted only 9 years – six years on active duty and three years in the Reserves.  It all started at the Naval Reserve Center in Indianapolis, Indiana, where I received my commission and took my oath.  I spent 6 weeks in Newport, Rhode Island between my first and second year of medical school at Officer Indoctrination School (affectionately known as “knife and fork” school – if you don’t believe me, please consider that during my free time there, I became a certified PADI Open Water Scuba Diver and learned how to sail).  During my third year of medical school, I worked in the Neonatal Intensive Care Unit at Naval Hospital San Diego.  I loved it there so much that I spent three additional years there after finishing medical school completing my residency training in pediatrics.  I spent the next three years as a general pediatrician at the Naval Hospital Guam and the Naval Hospital Camp Lejeune, with several short stints as a general medical officer and advisor to the U.S. Army Corps of Engineers on the island of Kosrae, in the Federated States of Micronesia.    I came to Cincinnati as a Pediatric Critical Care Medicine Fellow and remained in the Reserves, so it was back to the Naval Reserve Center in Indianapolis for my last 3 years before my honorable discharge.  The highlight of my time in the reserves, aside from working at Cincinnati Children’s Hospital, was a medical humanitarian mission trip to El Salvador. 

Aside from all of the great memories that we shared and all of the close friendships we made, my time in the Navy taught me the meaning of duty and service.  I carry in my pocket a coin marked with three words – Courage, Honor, and Commitment – the three Core Values of the United States Navy.  But in actual truth, I do not need a coin to remind me of these words, for they are imprinted in my memory and etched in my heart.  They have remained with me all of these years and will be there until the end of my days.  General Douglas Macarthur once said, in a farewell speech that he gave at West Point shortly before he died, “Unhappily, I possess neither that eloquence of diction, that poetry of imagination, nor that brilliance of metaphor to tell you all that they mean.”  And here I paraphrase – but I will try now.

Courage
The legend of LT John F. Kennedy and PT-109 during World War II is well-known.  Perhaps less well-known is that Senator Kennedy won the 1957 Pulitzer Prize for his book, Profiles in Courage.  The book provides 8 examples of Senators throughout history (at least up until 1957) who defied both the opinions of their political party as well as their constituents to do what they thought was right.  In many cases, these Senators were greatly criticized and lost their reputations as a result.  That, ladies and gentlemen, is Courage.  Standing up for what you think is right, even when what you think is right isn’t necessarily what everyone around you thinks is right.  It is a rare thing to see this kind of courage in the political world today. 

Perhaps one exception.  I don’t care whether you were for or against the Affordable Care Act, but for most of Barack Obama’s presidency, the Republicans in the Senate were waiting for the chance to repeal it.  They recently had their chance – the odds were greatly in their favor.  It came down to one final vote.  And Senator John McCain, a former US POW and Navy war hero, cast his vote against the wishes of his party.  While a number of government officials, members of the press, and his constituents praised him for standing up for what he believed in, individuals in his own political party, including the President of the United States, publicly condemned him.  Courage.  Doing what you think is right, even when you may suffer criticism or loss of reputation as a result. 

Honor
When I think of the word, “Honor” I think of men and women like Vice Admiral James Stockdale.  You may remember Admiral Stockdale as the Vice Presidential running mate for Ross Perot during the 1992 Presidential election.  In my opinion, Admiral Stockdale is better remembered for what he did much earlier in his career.  Stockdale’s A-4 Skyhawk was shot down during a combat mission over North Vietnam on September 9, 1965.  He was captured and spent over 7 1/2 years as a Prisoner of War as the senior naval officer at the famous Hanoi Hilton (incidentally, Senator John McCain was also held there).  Stockdale was routinely tortured and denied medical care.  Stockdale created a code of conduct for all of his fellow prisoners (which is still taught today) that established secret communications and rules of engagement while being tortured.  Once, when he was told that he would be paraded in public, he slit his own scalp and face with a razor to purposely disfigure himself so that he would not be used as a tool of propaganda.  Stockdale was awarded the Congressional Medal of Honor for his extraordinary leadership, courage, and honor.  He said of his time as a POW, “I never lost faith in the end of the story, I never doubted not only that I would get out, but also that I would prevail in the end and turn the experience into the defining event of my life, which, in retrospect, I would not trade.”  I will say it again, “I would not trade.”  Honor means doing the right thing, “even if it means dying like a dog when no one’s there to see you do it.” 
Commitment
If you ever get a chance to do so, I highly recommend the movie, “Men of Honor” starring Cuba Gooding, Jr and Robert DeNiro.  The movie tells the story of Master Chief Petty Officer Carl Brashear – the first African American to attend AND GRADUATE from the US Navy Diving and Salvage School.  Now remember that President Harry Truman desegregated the Navy in 1948 – Brashear graduated from Dive School in 1954.  He routinely faced hostile prejudice and overt racism – and on a number of occasions, he received death threats if he tried to finish dive training.  But he persisted, and he graduated.  His career was distinguished, and he eventually rose to the rank of Chief Petty Officer.  In January 1966, while salvaging a nuclear bomb that was lost in the ocean following a mid-air collision between a B52 bomber and KC-135 tanker, Chief Brashear sustained serious injuries to his left leg, which was later amputated.  Despite being an amputee, he returned to full active duty and diving and became the first African American (and the first amputee) to become a US Navy Master Diver.

To say that Master Chief Brashear was committed to the Navy is a vast understatement.  Despite all of the odds against him (prejudice, racism, and even the loss of his leg), he never gave up his dream of becoming a US Navy Master Diver.  Commitment means never, ever giving up.  It means staying true to a cause that is bigger than you.  It means being like Master Chief Carl Brashear.

So.  Courage.  Honor.  Commitment.  If you live by these core values, or really any of the core values of our Armed Forces - no matter what you do in your life, you will be successful.

Before I close, I hope that you will indulge me for a couple of more minutes.  Every year on Veteran’s Day, I read a letter to myself that was written a very long time ago to a Mrs. Bixby.  The contents of the letter perfectly summarize what it means to serve your country – what it means to have courage, honor, and commitment.  The letter reminds me of why we do what we do, so I would like to read it now.  You may have heard it before – there’s actually a famous scene in the movie “Saving Private Ryan” in which General George Marshall reads the same letter:

Dear Madam,

I have been shown in the files of the War Department a statement of the Adjutant General of Massachusetts that you are the mother of five sons who have died gloriously on the field of battle.

I feel how weak and fruitless must be any word of mine which should attempt to beguile you from the grief of a loss so overwhelming.  But I cannot refrain from tendering to you the consolation that may be found in the thanks of the Republic they died to save. 

I pray that our Heavenly Father may assuage the anguish of your bereavement, and leave you only the cherished memory of the loved and lost, and the solemn pride that must be yours to have laid so costly a sacrifice upon the altar of Freedom.

Yours, very sincerely and respectfully,
Abraham Lincoln.

Thank you for indulging my annual Veteran's Day tradition.  Thank you for allowing me to speak to you all today.  And most of all, thank you for your service.  God bless you all.  And God bless the United States of America.

Wednesday, November 8, 2017

We are only human

I took an oath (both literally and figuratively) on the day that I graduated from medical school.  On that day, I became a physician.  I learned, as many of my colleagues have learned, that being a physician is not just something that you do - it is who you are every hour, every day, every year.  Being a physician doesn't stop when I leave the hospital and come home. 

I will admit that over the years, I have missed some important events at home.  I remember one particular year that I promised my son that I would be home in time to take him and his sisters out trick-or-treating on Halloween.  I specifically remember breaking a few speed limits on the way home so that I would be able to keep my promise.  My wife remembers that moment too.  Fortunately, on that particular occasion, I made it home in time from the hospital, and I was able to keep my promise.  But there were other moments that I wasn't able to do so.  Being a physician doesn’t stop when you go home.

I recently read a post on LinkedIn that really bothered me.  The individual who wrote the post was telling of an episode in which one of her family members was sick and in the hospital.  She asked her boss for some time off, and in this case, her boss said no.  I know what you are thinking - and you are absolutely right.  Could a boss really be that callous?  Would someone really do that? 

As it turns out, there was a similar story in my past too.  My son spent a little over three weeks in the Newborn Intensive Care Unit when he was born - he was very sick.  I was about five months into my third year of medical school.  As fate would have it, I was actually rotating in the same Newborn Intensive Care Unit where my son ended up being a patient.  My son's physicians and nurses were incredible.  They took great care of him - indeed, they saved his life - and they took great care of my wife and I.  To this day, we still keep in touch with my son's physician every Christmas.  I particularly remember the physician I worked with that month (who ended up being my son's attending physician too) telling me to take the rest of the month off.  He would make sure that things would be okay.  However, once the end of the month came, I was scheduled to start a three month rotation in Internal Medicine.  I remember going to the Dean's office of the medical school to ask for some time off.  We still weren't sure how long our son was going to be in the hospital, so I wanted to at least ask for one month off (remember, this was before there was any such thing as family leave, and medical students didn't have vacation time).  Regrettably, the Dean of Student Affairs was not very understanding.  He really couldn't understand why I would want to take some time off - he even asked if my son was really that sick.  I remember telling him that we were told that my son was sick enough that the odds of him surviving were only about 20-30%.  I remember telling him that I wanted to be with my son and my wife, so that I would be there with them at the bedside in case he didn't make it.  He eventually agreed to let me have some time off. 

So yes, there are people out there who are really that callous.  Some of them are even physicians.  You don't have to tell me that we are only human.  We make mistakes - even the best physicians.  But I hope that I will never make the mistake of being so callous to those on my team.  As leaders, we need to take care of our people.  We all have personal lives.  We all have things that are important to each and every one of us.  Our job as leaders is to make sure that we give the individuals on our teams the time that they deserve to take care of all the things that happen in their professional lives, as well as their personal ones. 

We are physicians - every minute, every hour, every day.  But we must remember that we are humans too.

Saturday, November 4, 2017

Classic rookie manager mistakes

I know I usually don't post anything on Saturdays (especially during college football season!), but I came across an interesting post on my Twitter feed earlier today.  Dushka Zapata confessed to making "8 classic mistakes" of a first time manager (many of which I have made too, as I explain further below each mistake);

1. "I felt I needed to know everything."  There is absolutely no way that a new leader can know everything about his or her job.  Leadership consultant, writer, and former Navy officer David Marquet made a similar mistake when he was assigned command of the USS Olympia, a Los Angeles class attack submarine (as told in his book, Turn the Ship Around).  Before taking command, he studies all of the blueprints on the USS Olympia until he knew every wire, every control switch, and every piece of equipment on the entire ship.  He reviewed the personnel files of every one of his officers and crew members, until he felt like he knew enough to predict how they would perform under stress.  He felt confident that he knew more about his new command than anyone else on the ship.  The only problem - a few days before he was scheduled to assume command of the Olympia, his superior officers told him that he would be taking command of another submarine, the USS Santa Fe, instead.  It was only after he gave an order for the helmsman to do something that was not possible for the USS Santa Fe to do (but something the USS Olympia could have easily done) that he figured out that he could never hope to know every facet of every crew member's job on the ship.  It was only after learning the lesson that he could not know everything - indeed, it was better for the ship that he didn't know everything - that he achieved success.

2. "I gave more work to employees who were already good."  Superstar team members are perhaps a new leader's greatest asset.  Unfortunately, new leaders often have the tendency to give the most difficult assignments to their superstars.  Even worse, these same leaders keep giving assignments to their superstars.  The result?  The superstars are overloaded and fail to live up to their potential and the new leader's expectations.  More importantly, the other members of the team fail to develop to their potentials as well.  Spread the wealth!  Give assignments to your superstars, your high potentials, and the members on the team who need "stretch assignments" so that they can develop their skills, knowledge, and expertise.

3. "I didn't adapt my style to the needs of people who reported to me."  There are a number of leadership styles (known by a seemingly infinite number of names, depending upon the author) - the best leaders "flex" their styles to the individual needs of the situation and their team members.  Some members of the team will need more encouragement and assistance than others.  Some team members will respond better to a "top-down" or "authoritative" leadership style, while others may respond better to a "bottom-up" or "coaching" leadership style.  The important point is that there is no such thing as a "one-size fits all" approach.   

4. "I felt betrayed when people left."  There will always be turnover when a leader begins a new position.  More importantly, if a new leader is doing a good job, his or her team members will be heavily recruited to become leaders themselves!  Don't be offended by team members who depart - it's not always about loyalty, and it should not be viewed as a personal affront to your leadership.

5. "I felt like the happiness of people who reported into me was my responsibility."  Leaders are responsible for making sure that their employees are engaged, motivated, and inspired to give their best performance.  But leaders need to understand and appreciate that there is more to happiness than employee engagement and work-life balance. 

6. "I was bad at delegating."  Of all of the rookie manager mistakes discussed so far, this one is probably the worst!  Our CEO pulled me aside after one of our leadership team meetings and asked if there was anything wrong - he thought that I seemed less engaged.  In truth, there had been a lot going on in the hospital, and I was texting back and forth with one of my team members.  When I discussed this particular incident with my coach, she asked why I didn't just delegate my responsibilities during the leadership team meetings to one of my associates.  I realized that she was absolutely right!  Delegating most of my responsibilities to one of my associates serves two purposes.  First, I can be fully engaged during our leadership team meeting.  Second, and perhaps more important, my associates now have a development opportunity (and an opportunity where I am not far away to provide assistance, if necessary).

7. "I made the company a priority over the person." I just finished reading Simon Sinek's book, Leaders Eat Last.  There is a tradition (actually, it's an expectation) in the military that the officers eat after the enlisted - in other words, leaders place the needs of their team members above their own.  It's a cliché that an organization's greatest asset is its people - cliché or not, it's the absolute truth.  Never, never, NEVER place your own needs above those of your team members.  More importantly, the company doesn't come first.  The people do.

8. "I wanted everyone to be the same." There is strength in our diversity.  Each and every member on our team brings a different set of skills, knowledge, and expertise to the job.  Each and every member on our team brings a different and unique personality and life experience to the team.  New leaders should embrace this diversity.  Don't expect everyone to be the same.  More importantly, don't hope that everyone will be the same. 

Wednesday, November 1, 2017

"United we stand..."

You have probably heard most of the teamwork clichés that I am about to recite.  Perhaps some of their power lies in the fact that they are so easily remembered.  Most of these have been repeated so many times that it is almost impossible to know who said them first.  Here are some of my favorites:

Teamwork makes the dream work (author unknown).

If you want to go fast, go alone.  If you want to go far, go together (apparently an old African proverb).

You can do what I cannot do.  I can do what you cannot do.  Together we can do great things (maybe not as well known, but a great quote from Mother Teresa).

TEAM.  me (author unknown, but often frequently used as a slogan on the practice jerseys of basketball teams).

There's no 'I' in 'Team' (author unknown, but this quote is particularly interesting - during his Hall of Fame induction speech, legendary basketball player, Michael Jordan, famously quipped that while there was no "I" in "Team", there was an "I" in "Win."  Interestingly enough, earlier during his playing career, Jordan reportedly once said, Talent wins games, but teamwork and intelligence wins championships).

United we stand, divided we fall (this quote is often erroneously attributed to Abraham Lincoln, who actually said in a famous speech during his first Presidential election campaign, A house divided against itself cannot stand.).

The last quote is actually from a famous story from ancient Greece (one of Aesop's Fables) called the "Four Oxen and the Lion" that provides an important lesson on teamwork.  Aesop tells how a lion used to hunt in a field where there also lived four oxen.  The lion had tried, on a number of occasions, to attack the four oxen, but whenever he attacked, they would flick their tails to warn each other and then form a circle, head (and horns) out.  One day, after the lion had attacked several times unsuccessfully, the oxen started quarreling with each other, and each walked away into separate corners of the field.  The lion, in turn, attacked them one by one and ate them all.  United we stand, divided we fall.

There is a similar story, again one of Aesop's Fables, of a man who had three sons who often quarreled with each other.  The man decided to teach his sons a lesson, so he brought them a bundle of sticks.  He asked them to break the sticks in half.  Each of his sons tried unsuccessfully - the bundle of sticks was too strong to break.  The last son threw the bundle to the ground in disgust and said, We can't do it.  The father picked up the bundle of sticks, separated the sticks, and easily broke them in half, one by one.  He then looked at his sons and said, My sons, if you work together - if you are united, you will be as this bundle.  Nothing can ever break you.  However, if you keep working alone and are divided, you will be broken as easily as one of these sticks.  In other words, United we stand, divided we fall. 

There is one final example.  The ancient Spartans were some of the strongest warriors (for a great illustration, see the movie, 300 about the Battle of Thermopylae between King Leonidas of Sparta and Xerxes I of Persia).  Apparently, one of the most revered weapons that a Spartan warrior carried was his shield.  Shields were often passed down from one generation to the next as family heirlooms.  Soldiers who lost their shields in battle were dishonored and often punished severely, even by their own families.  The ancient Greek historian, Plutarch, famously tells a story of a Spartan mother who tells her son as he is leaving for war to return home either with your shield or on it (there is a scene in the movie 300 that uses this quote - the wife of King Leonidas tells him, Come back with your shield or on it).  Why was the shield so important?  The shield was fundamental to the battlefield tactics of the Spartan army.  The Spartans would group together and use their shields defensively to form a tight, impenetrable phalanx from which they could use their spears to kill their attackers.  The shield was fundamental to their teamwork.  In other words, together they would be impossible to defeat.  United we stand, divided we fall.

The message from all of these quotes and stories is the same.  Indeed, it is a universal truth - teamwork is critical to the success of any organization.  Leaders can't be successful on their own, and in reality, without the team, there is no such thing as a leader.    There are countless examples of professional sports teams who have gone out to acquire free agent superstars - on paper, these teams look like they would be unstoppable.  The truth?  Many times these teams have resulted in losing seasons.  Why?  The superstars could not work together as a team.  The same is true for any organization - if your top talent can't work together, your organization will fail.  Leadership turns teams of superstars into winning organizations.  United we stand, divided we fall.