MCH Working Conference: The Future of Maternal and Child Health Leadership

1. MCH Working Conference: The Future of Maternal and Child Health Leadership LEADERSHIP AND THE PUBLIC GOOD Dominick P. DePaola, D.D.S., Ph.D. The Forsyth Institute April 19, 2004

2. SUMMARY THOUGHTS • The true test of leadership is to ask: “Are those who would participate in leadership equipped to serve the common good?” • Leadership is the practice of helping people envision and then participate in creating a better world • Leadership is about creating a caring culture: People Come First! • Leadership is about exceeding expectations (Disney) • Influencing change is the business of leadership!

4. LEADERSHIP WORKING DEFINTION I “A leader is one who mobilizes others toward a goal shared by leader and follower” Willis, G., Certain Trumpets – The Call of Leaders, NY, Simon and Shuster, 1994

5. LEADERSHIP WORKING DEFINTION II “Leadership is a dynamic relationship based on mutual influence and common purpose between leaders and collaborators in which both are moved to higher levels of motivation and moral development as they effect real, intended change.” Roast, J, Leadership for the 21st Century New York, Praeger, 1991

6. INGREDIENTS FOR SUCCESSFUL AND EFFECTIVE LEADERSHIP COMMON GOOD (GOAL) LEADERSHIP FOLLOWERSHIP • Agreement on process of establishing common goal • Agreement on common good (goal) • Context • Environment • Agreement on outcomes (success) measures/intended change

9. ATTRIBUTES OF THE EFFECTIVE LEADER In order to achieve the common good, leadership must have definitive characteristics: • The ABILITY to • move multiple constituencies • be flexible and tolerant of disparate positions • be “savvy” about the political/social landscape • create coalitions, partnerships and collaborations • nurture interdisciplinary and cross-cultural approaches • The WILLINGNESS to • take risks and push the envelope • challenge traditional values and the status quo • exhibit sustained resolve

10. LEADERSHIP STYLES ARE JUDGED ON GOALS AND THEIR PURSUIT: +Arrogant - “our” goals are best +Confrontational - conflicting goals +Plodding - meeting perceived needs +Regressive - low level goals +Status quo - goals may be good but implementation is slow +Visionary - pushing the “envelope” – true shared vision

11. Leadership: Eight Steps to Rapid Change Equipped with the necessary attributes and passion, leaders spring into action: • Sound a Bugle • Give Them a Compass • Unleash Your Change Ninjas • Shake Up the Status Quo • Sing from the Same Songbook • Focus Your Workforce • Ignite Unbeatable Performance • Let Go of the Present McPherson, C., Wittemann, K., Inspiration or Desperation: Companies Change When People Care, Summerville, 2004

12. Do Thine Own Thing If Benjamin Franklin had tried to be a General and George Washington had tried to be an Inventor, we would probably be living in a British Colony without electricity!

13. Questions To Ponder I: • What kind of leadership do you practice? • • Simple • • Transformational • 2. Does the leadership you exhibit move both leader and collaborators to a higher level of moral development? • 3. Do you take public need and social responsibility seriously? • 4. Who is on the leadership team? • • Does the team have the appropriate mix of qualities? • • Is there attention paid to cross-sector partnering?

14. THE COMMON GOOD

15. What is the “Common Good”? • Increase access to care and effective use of access • Eliminate oral health disparities • Engage the community in expanding the community capacity for enhancing the wellness of its pediatric population • Expand community-based education and clinical care • Improve public schools • Improve science education and functional literacy • Engage in health care reform debate, including appropriate reimbursement models • Work toward a unified health system

17. Public Paradox Relative to Children’s Oral Health • Scientific and technological advancements are at all time high • Pediatric oral health care is in a crisis • high prevalence of disease • limited access to care • limited use of access • Perceived value of oral health is still problematic

18. A NATIONAL CALL TO ACTION TO PROMOTE ORAL HEALTH ACTIONS: • Change Perceptions of Oral Health • Overcome Barriers by Replicating Effective Programs and Proven Efforts • Build the Science Base and Accelerate Science Transfer • Increase Oral Health Workforce Diversity, Capacity, and Flexibility • Increase Collaborations SG, Call to Action 2003

20. TO ADDRESS THE PARADOX, AN EFFECTIVE LEADER NEEDS: • Legitimacy • Public Trust • 360 degree view • Communication and engagement skills • Flexibility • Courage • Unwavering commitment to realizing a vision

21. OBSTACLESare those frightful things you see when you take your eyes off yourGOAL. Henry Ford

22. These are some clips from real responses of students to exam questions (Jay Leno): • H2O is hot water; and Co2 is cold water • Water is composed of two gins, Oxygin and Hydrogin. Oxygin is pure gin and Hydrogin is water and gin • Vacuum: a large empty space where the Pope lives • The place where people speak Gaelic is San Francisco • For a nosebleed; put the nose much lower than the heart until the heart stops • Pyramids were built for shade

23. Gaining support and excitement from the community, the effective leader must: • Exhibit caring, passion and compassion about the common good • Communicate a shared vision for the common good • Engage the consumer in an advocacy role • This is where the rubber meets the sky!

25. EFFECTIVE LEADERSHIP UNFOLDS FROM THE COMMON GOOD!

26. Questions To Ponder II: • Who should define our priorities? • 2. Are your priorities connected to perceived and/or real public values and need? • 3. Is the apparent public paradox related to oral health a failure of leadership? • Are health disparities in general a leadership failure per se or a failure to create leadership in the public good? • 5. Is partnering with the community a critical approach to improve health outcomes?

27. LEADERSHIP AND THE PUBLIC GOOD A COMMUNITY-ORIENTED HEALTH MODEL

28. Model of Physician Responsibility in Relation to Influences on Health Individual Patient Care Direct Socioeconomic Influences Broad Socioeconomic Influences Global Health Influences Access to Care Domains of Professional Obligation Domains of Professional Aspiration JAMA, January 7, 2004, Vol. 292, No.1, Pg. 95

29. Community-Oriented Health Model HEALTH OUTCOMES Communications Health Professions Schools Community Needs Community Capacity Community Empowerment Partnership(s) Contracts Educators Practitioners Caregivers Citizens Determinants of Health Outcomes Higher Health Level • Safer environment • Decreased communicable diseases • Decrease chronic diseases • Improve immunization • Improve access to care • Decrease prevalence of oral disease • Higher level of self-care • Improved nutrition/food supply • Improved literacy • Reduced poverty • Improve specific health status measures • Improve utilization of health services

30. Based on an understanding that a public good is worth pursuing, leadership must: + Understand community need + Understand community capacity + Be willing to engage societal issues consonant with academic or public health mission + Be willing to establish shared goals and implementation strategies + Be willing to understand community expectations + Be willing to measure success outcomes + Be willing to be both flexible and persistent!

32. PRACTICAL LEADERSHIP: + Make work fun! + Use celebrations to create relationships + Equip people to make decisions + Become a “risk doctor” – help people recover from mistakes + Make your organization and personal mission, vision and values clear – then hold the reins loosely + Stamp out bureaucracy – make rules your servants + Deal with people, not positions + Train for skill – Hire for spirit, spunk and enthusiasm + Look for creative, unconventional ways to tell your story + When serving others (the community), make sure that “good enough” is never good enough Freiberg, K, Freiberg, J, Nuts, New York, Broadway Books, 1996

34. Questions To Ponder III: • Can you define your customers? • 2. Do you perceive leadership as a position of power? • Do you believe the “Lone Ranger” is an appropriate leadership metaphor? • Do you believe that leaders are servants by nature? • Do you believe people are born leaders?

35. MAKE VISION THE BOSS!

36. LEADERSHIP IS ALL ABOUT PEOPLE AND MAKING THINGS HAPPEN

37. There is a Special Place in Hell Reserved for the Morally Indifferent and Safely Neutral. - Dante