The Leader Within A Core Leadership Attribute Seminar on Self-Assessment

1. The Leader WithinA Core Leadership Attribute Seminar on Self-Assessment Created By: Brian J. Zink, MD, FACEP Professor and Chair, Department of Emergency Medicine, The Alpert Medical School of Brown University, Providence, RI Tenet Editor: Jeffrey Druck, MD, FACEP Associate Director, Denver Health Residency in Emergency Medicine University of Colorado School of Medicine

2. The American Dream • Honey, one day • you too could • be President!

3. Outline • Background & Barriers • Levels of Leadership • Leading from the Middle • Physicians as Leaders • Self-Assessment & Growth

4. Background & Barriers- We Have All Been Leaders • Early lives filled with accomplishment and distinguished achievements • Pushed to the front, asked to lead and set an example

5. Background & Barriers- Where Did the Leader Go? • Medicine’s buffering effect • Serve the patient • Conform to systems • Demanding hours • Complex hierarchies • Current air of resignation and defeatism

6. Background & Barriers- The ABC’s Energy-Drain • A ctivity Without Direction • Doing things that don’t seem to matter • B urden Without Action • Not being able to do things that matter • C onflict Without Resolution • Not being able to deal with the ‘matter’ • John Maxwell, The 360 Leader, 2005, Nelson Business

7. Background & Barriers- Why Do Some Excel Where Others Don’t • Overcoming barriers • Modern healthcare, USA • Declining reimbursement • Increasing uninsured • Increasing constraints and expectations • Reduced NIH funding • But given very similar circumstances, some academic medical centers are very successful

8. Background & Barriers- The Leader Within • Every day you have the chance to demonstrate leadership • Clinical teams • Bed-side teachers • Role models • Research • Committee work • Other Service

9. Background & Barriers- The Leader Within You can accomplish anything in life, provided that you do not mind who gets the credit. - Harry S. Truman

10. Background & Barriers- Why Become a Leader • Breaking the ‘Glass Ceiling’ • Personal achievement • Personal satisfaction • Career satisfaction • Affecting change • Overcoming the Senescence factor

11. Personal Humility Level 5 Leader Professional Will Effective Leader Competent Manager Contributing Team Member Highly Capable Individual Levels of Leadership- Good to Great

12. Levels of Leadership- Qualities of a Level 5 Leader • Personal humility • Channel their ambition • Demonstrate modesty • Professional will • Unwavering resolve • Set the standard • Goal and result oriented Jim Collin, Good to Great

13. Modest but powerful Connected to employees Take responsibility for problems or failure Deflect praise downward Excellent mentors Plans for succession Levels of Leadership- Qualities of a Level 5 Leader

14. Levels of Leadership- Qualities of a Level 5 Leader • More Plow Horse than Show Horse

15. Levels of Leadership- Qualities of a Level 5 Leader • The Window… … and the Mirror

16. Leading From The Middle- A Unique Leadership Position • 360° management • The right mindset • Process over position • Influence over demand *Adapted from Maxwell, 360 Leader

17. Leadership Demands Academic Physician Patient Expectations Staff Expectations Trainee & Subordinate Demands Leading From The Middle- 360° Management *Adapted from Maxwell, 360 Leader

18. Leading From The Middle- 360° Management • Managing your boss • Assess yourself • Strengths & weaknesses • Level of confidence • Communication style • Response to authority • Response to criticism Modified from Kotter JP: On what leaders really do. Harvard Business Review Book; 1999, p. 136

19. Leading From The Middle- 360° Management • Managing your boss • Understand your boss • Personal history • Goals & objectives • Pressures & triggers • Strengths & weaknesses • Blind spots • Communication & work style Modified from Kotter JP: On what leaders really do. Harvard Business Review Book; 1999, p. 136

20. Leading From The Middle- 360° Management • Managing your boss • Develop/maintain a relationship that: • Fits both your needs and styles • Is characterized by mutual expectations • Keeps your boss properly informed • Is based on dependability and honesty • Selectively uses your boss’s time and resources Modified from Kotter JP: On what leaders really do. Harvard Business Review Book; 1999, p. 136

21. Leading From The Middle- 360° Management • Managing vs. Leading • Pushing the boundaries • Asking the question: “Why do we do it this way?” • And then suggesting: “Let’s try it this way.”

22. Leading From The Middle- The Right Mindset • Team player • Can carry out the vision • Values role • Sense of purpose • Highly reliable Leonard Bernstein and the 2nd Fiddle

23. Leading From The Middle- The Right Mindset True heroism is remarkably sober, very un-dramatic. It is not the urge to surpass all others at whatever cost, but the urge to serve others at whatever the cost. - Arthur Ashe

24. Leading From The Middle– A Process, Not a Position • Leadership is not a title/position • The characteristics come BEFORE the position • Developing/learning how to influence others in a positive way is a process

25. Leading From The Middle- Influencing Over Demand I ntegrity N urturing F aith L istening U nderstanding E nlarging N avigating C onnecting E mpowering The Influence Acrostic *From John Maxwell, Becoming a Person of Influence

26. Leading From The Middle- Influencing Over Demand Show me what you can do; don’t just tell me what you can do. Don’t let what you cannot do interfere with what you can do. - John Wooden

27. Leading from the Middle- Mission, Vision, & Values (MVV) • Acknowledge the institutional MVV • Align your activities appropriately • Mirror the MVV with your actions • Exhibit compatible leadership

28. Leading from the Middle- Mission, Vision, & Values (MVV) • Realize/transfer the MVV: • How do I fit in to my area in the Department? • How does my Department fit with other Departments in the medical school/center? • How does our Department fit in, compete, fare with the local and regional competition? • How does our Department fit in on a national level?

29. Leading from the Middle – Three Simple Steps • Do your own work first • Identify problems • Work on solutions

30. Leading from the Middle – Three Simple Steps Don’t find a fault, find a remedy. - Henry Ford

31. Physicians as Leaders- Ten Tips for Success • Show up • Prepare well • Possess and present key data • Learn the language • When asked to speak – Don’t wing it

32. Physicians as Leaders- Ten Tips for Success • Learn when to push vs. compromise • Good questions lead to solutions • Give a return on your leader’s investment • Be better tomorrow than today • Be a go to player, unafraid to fail

33. Doctors as Leaders – Special Considerations • In general, doctors are: • Very competitive • Unsophisticated when it comes to playing politics in organizations and systems • Perfectionist • Independent-minded • Critical and skeptical

34. Doctors as Leaders - Controlling the Competitor Within Competing Scarcity mind-set Me first Destroys trust Thinks win-lose Single thinking Excludes others Completing Abundance mind-set Organization first Develops trust Thinks win-win Shared thinking Includes others From John Maxwell, the 360 Leader

35. Doctors as Leaders- Focus on production not politics Production Growth What they do well Becoming better What’s necessary Principled decisions Achieving the next level Controlling their destiny Politics Who they know What they say Appearing better Minimal needed Popular decisions Being given the next level Others dictate their destiny From John Maxwell, the 360 Leader

36. Doctors as Leaders - Perfection is not realistic

37. Academic medicine A collaborative discipline Medical teams approach Group learning Group research e.g., CTSI Emergency medicine The pinnacle of interdependence in medicine Independence is a fading virtue – becoming obsolete. Doctors as Leaders - Aim for Collaboration not Independence

38. Doctors as Leaders - Avoid being overly skeptical/critical Be a positive leader When you need criticize offer a constructive solution When you exhibit skepticism keep it healthy, reasoned, diplomatic, not harsh or demeaning

39. Self-Assessment & Growth Be more concerned with your character than your reputation… Your character is what you really are, while your reputation is merely what others think you are. - John Wooden

40. Self-Assessment & Growth • Manage Yourself • Build Character • Ask Yourself Questions • Have a Leadership Plan • Learn to Lead • Be in a Fundamental State • Get outside of ‘The Box’

41. Self-Assessment & Growth- Manage Yourself Emotions and impulses Time Priorities Thinking Personal Life

42. Self-Assessment & Growth - Building Character Gain Real world experience Learn from foibles/mistakes Strong mentorship Associate with quality

43. Self-Assessment & Growth- Questions to Answer • What is my niche, role, realm, position – now and desired? • Who will I lead? • Students, residents, peer physicians, others? • What are my leadership skills? • What do I need to improve as a leader? • Who and what can best teach me what I need to know as a leader?

44. Self Assessment & Growth- Have a Leadership Plan Starts with your mission statement – the tap root of your existence Components: professional & personal Short term and long term goals Five and ten year plans Once these elements are in place, a leadership plan can evolve

45. Self Assessment & Growth- Learn to Lead • Stand in for your boss • Stand up for your boss • Volunteer to take on a hard job – or something that isn’t “your job”. • Place the stones to pave the path to leadership

46. Normal State Self-focused - Ego driven Externally directed Internally closed Comfort-centered Fundamental State Other-focused Internally directed Externally open Purpose-centered Self Assessment & Growth- The Fundamental State of Leadership Quinn, RE. Building the bridge as you walk on it. Jossey-Bass, 2004

47. Self-Assessment & Growth- Self-deception & ‘The Box’ Self-deception is a process of denying or rationalizing away the relevance, significance, or importance of opposing evidence and logical argument. Leadership and Self- Deception: Getting Out of the Box, The Arbinger Institute, 2002

48. Self-Assessment & Growth- Self-deception & ‘The Box’ • ‘The Box’ • Self and comfort-centered behavior • Lack of understanding of others’ points of view • Failure to act on core beliefs or values • Conformity, accepting dysfunction Leadership and Self- Deception: Getting Out of the Box, The Arbinger Institute, 2002

49. Self-Assessment & Growth- Self-deception & ‘The Box’ Get out of the Box Cease resisting others Be free of self-betrayal Help others succeed and achieve Create environment of openness Leadership and Self- Deception: Getting Out of the Box, The Arbinger Institute, 2002

50. Summary Know your barriers Start now Do your work, find solutions to problems, volunteer to help Communicate, collaborate, & care Work towards a Fundamental State of Leadership Be outside the Box