Leadership

by Allen Weiss, MD, MBA, FACP, FACR
President and CEO, NCH Healthcare System

Leadership is essential for progress in any arena be it healthcare, government, education, business, or any other endeavor involving two or more people. Many different types of leaders with a myriad of characteristics have been catalogued in a multitude of books, essays, tips, and other “how to” documents.

Nonetheless, reviewing some basic principles illustrated with examples and communicating transparently to folks and the community who are directly affected by the success or failure of the institutions’ leadership is always worthwhile.

Many good leaders have developed teams which have helped society in countless ways. Last year I was privileged to listen to former New York City Mayor Rudy Giuliani review his principles of leadership in which he used personal examples drawn from his distinguished career. In general, these successful leaders and teams have common characteristics which are shared below.

NUMBER 1: VISION AND BELIEFS

“If you don’t know where you are going, any road will take you there,” is from Lewis Carroll’s Alice in Wonderland. Equally important is you will never know when you have arrived. Having a destination is the essential first step in effective leadership. The goals can range from simple and short to complex and long. From successfully getting through the holidays without gaining too much weight to helping an entire community live longer happier and healthier lives via a sustainable decade-long project are just two examples of projects, widely different in length and complexity, which have similar favorable goals.

Stating the goal publically when appropriate or writing the goal on a piece of paper and keeping it on your bureau or desk helps define the vision. We all need to know where we are going. Whether you are the captain of your own ship or the captain for a team, defining the vision— having a publically stated goal with guiding principles—is quintessential leadership.

NUMBER 2: OPTIMISM

Optimism is key and not just for silly fools. We all bring our own weather. What we think will happen usually does happen. Obviously, one needs to be practical. Certain goals might not be realistic, but starting with green light thinking as to what might be possible is better than limiting oneself right from the beginning. Locally, who would have ever believed Collier County would have the longest life expectancy and be the healthiest and happiest place in the nation? Our Metropolitan Statistical Area (MSA) this past year was first by a hundredth of point of 190 MSAs according to the most recent Gallops-Healthways Survey. http://www.well-beingindex.com/2015-community-rankings

In August, 2016 Kiplinger Letter named Naples as the best place to retire—another example of optimism. This recognition is amazing, especially considering that it wasn’t long ago when our part of southwest Florida was known as a small and sleepy fishing village. Our local leaders have been optimistic with their green-light thinking as Naples has evolved to be the jewel it is.

NUMBER 3: COURAGE

No one ever said it was going to be easy, but if you do the right thing often enough, you get the right result. Being around altruistic and self-motivated people and having these two characteristics yourself will reinforce your will to stay the course and do the right thing for long-term success. Getting caught up in the day to-day drama and noise associated with people who are short sighted, egocentric, and selfish is not only deleterious for innocent bystanders but also harmful for these negative folks.

Courage is doing the right thing, and grit is the ability to stay the course even when the going gets tough. Taking a chance on a new service or group when a longstanding anachronistic group becomes too mercenary, unconcerned enough with quality, or inflexible is the correct course even when the short-term consequences are costly in terms of resistance or loss of reputation and income. Don’t be afraid to be innovative. After the initial “hit,” everyone is much better off as new best practices are developed and shared across the nation.

NUMBER 4: RELENTLESS PREPARATION

“If you fail to plan, you are planning to fail!” is a saying attributed to Benjamin Franklin as well as a few other notables. Even though the originator is uncertain, the message is strong and important. Learning new ways to care for patients—be it infection prevention, placement of central intravenous lines, or response to a mass casualty event such as a fire, flood, or hurricane—all proceed better when everyone has practiced in a mock drill.

As an institution, NCH practices for all of these unwelcome events knowing that sometime we will be stressed with the real emergency. For the non-emergency patient care therapeutic procedures, we train on life-like manikins in a simulation lab. These manikins, computer controlled and able to mimic real patients with tears, grimaces, short bursts of words, heart beats, EKG rhythms, and other human-like responses, engage the care team as if they were in a real life situation. After the clinical scenario is over, the team debriefs with the coach, learning what they did well and where they can improve. Again, relentless preparation makes the difference.

NUMBER 5: TEAMWORK

No one is as smart as all of us. Surrounding oneself with good people and using everyone’s good attributes will give a much better result than trying to be the Lone Ranger even though he had his faithful Tonto. Knowing yourself, both good and bad qualities, is a good starting point. And if you can’t identify any weaknesses in your own personality, just ask your wife or significant other. If your mate doesn’t have some suggestions for you to improve, then you have a co-dependent relationship and an even bigger opportunity for change.

Many exercises show how well functioning teams communicating within themselves out perform groups which are in dysfunction. MBA students are typically aggregated into teams at the beginning of the program because in most real businesses, teams rather than individuals are more functional and productive.

NUMBER 6: COMMUNICATION

You cannot assume people know what is going on. Most people need to hear something seven times before they can remember the message. Jack Welch, the famous former CEO of GE, said you have to deliver the message until you are sick of it, and then you have just started. Think how often advertisers try to get in front of you to get a message across.

Having everyone on the team agree with the goal and understand the plan, as well as participate at the correct time and in the appropriate manner, makes for success. The opposite is so true. Asking folks to repeat a message back takes a little more energy and time initially but is well worth the effort. Even summarizing a conversation, ending a meeting or engagement with a quick wrap-up, and enumerating a list of “to dos” are much more effective than just assuming that everyone is on the same page.

NUMBER 7: CELEBRATION AND FEEDBACK

Positive feedback is very important and too rare in today’s society. Three or four wins combined with one not-so-good outcome turns out to be the best mix to foster progress. All wins or all defeats are not as good as having a therapeutic blend. Children who are successful in elementary school are best served by the combination of mostly positive feedback with some opportunities fo rimprovement.

Having day-to-day constructive criticism is part of our socialization process. Isolation and lack of feedback at any age is deleterious for development and progress. Celebration is part of the socialization process that gets people together by doing good for each other. People who live well into advanced age typically have a group of friends who socialize daily at mealtime or by taking walks together. At the opposite extreme, isolation is very painful and among the worse punishments created—exactly why it is reserved for particularly bad behavior in prisons.

Many books on leadership with additional and different comments employ some of the seven elements enumerated above. Many different styles of leadership also have special places in specific situations. In general, even top-down to participatory to servant leadership all use some of the seven attributes in different amounts to yield successful outcomes.

Leadership is not a mystery. Explore, see what works for you, and become a leader.

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