I was becoming really nervous about my lack of preparation for a strategic planning retreat. The CEO, the senior executive team, and several physicians and board members were going to meet in three days to discuss a variety of important issues. One of my assignments was to present a 30 minute review of an important project. This would set the stage for selecting one of several possible approaches to the project. I would need to do some deep work for this presentation.
First, I had to create an outline of my presentation and complete some background research. Then, I would design my slides and organize and rehearse the presentation. Because I had not even formulated the overall message of the presentation, I was getting really anxious about it.
I had little uninterrupted time at the office to prepare because I had double-booked my usual meetings in anticipation of attending the retreat. At home, I was similarly unable to extract myself from the usual interruptions of phone calls, texts and other urgent problems.
Enabling Deep Work
I decided to use one of my time-tested tactics to help me focus and create some dedicated thinking time for this problem. On the following Saturday, my wife was planning to run a short errand. I informed her that when she left, I was going to go on a brisk walk, so not to worry if I wasn’t home when she returned.
I followed the plan and walked for about 45 minutes around our neighborhood. During that time, I was able to focus and mentally review the pros and cons that I wanted to present. I fashioned a short list of steps for the proposed project and a timeline in my mind. When I thought about a couple of background items that I needed to follow-up on, I dictated a reminder into my cell phone voice recording app.
It’s time for the VITAL Physician Executive’s Monthly Leadership Favorites – September 2017 Edition. In this feature I share inspiring and enlightening advice from respected leaders, generally from outside of healthcare (but not always).
The title of this month’s post is a misnomer (the Monthly part), given that I did not post a Favorites list in August. That was intentional.
Since I reduced my posting frequency from twice-weekly to weekly, I did not feel that it was appropriate to use the Favorites format for 25% of my posts. I feel that the Favorites don’t have the gravitas of my usual posts. I might be wrong on that – but that’s my thinking, so they may be a bit less frequent than before.
Leadership Favorites – September 2017 Edition
This month’s favorites follow…
Reading this post by The Productive Physician – Inbox Zero: The Ultimate Guide to Managing Your Email – I was reminded that this might be a good topic to revisit. Managing email can become a daunting task. Somehow, we find ourselves on dozens, if not hundreds, of email lists, and our Inbox may be perpetually clogged.
We may be in the habit of leaving email notifications on, and keeping our email services open during the day. This results in one of the most pervasive forms of distraction and shallow work imaginable. If we want to focus more on Deep Work, email is something we must get under control.
The first stop in our journey to explore possible solutions is Inbox Zero: The Ultimate Guide to Managing Your Email. It is a comprehensive review of every aspect of email management that can be improved, streamlined or eliminated, and includes the following steps:
- Be a Good Email Citizen, and,
I won’t explain them any further. Rather, I recommend you check out the article. Be prepared to spend a little time there, or review it in pieces, because it’s very detailed (the author is kind enough to provide a table of contents along the right margin).
Leadership Dyads have been touted as the solution to the challenge of executing complex initiatives in hospitals and health systems. Meaningful physician leadership has been found to be the missing component in some of these implementations. The thinking goes that partnering a strong executive with an engaged physician can overcome physician resistance to such new programs. But not all leadership dyads are created equal.
What Is Dyad Leadership?
As described in a 2015 Advisory Board Article, dyad leadership is “…a partnership where an administrative or nurse leader is paired with a physician leader, bringing together ‘the best of both worlds’ of skills and expertise.” According to that report, the use of dyads in health care has become more common over the past decade.
The purported benefits of a leadership dyad include:
- Two leaders with complementary skills can be more effective than any one leader;
- The dyad ensures optimal use of each leader’s time and effort; and,
- It improves engagement and reduces stress.
I don’t agree with all of these assumptions. Yes, complimentary skills are useful. But there is an equal risk that two leaders attending the same meetings and duplicating their work could result in wasting valuable resources.
Enhanced engagement of physicians seems more likely. But whose stress level is going to be reduced when working on these high priority projects under the usual budgetary constraints and tight deadlines?
The title of this post is intended to have two meanings. Any manager, leader, or executive generally finds that there is rarely growth without discomfort. Growth and discomfort (sometimes outright pain) are usually linked. It also indicates that this blog itself is due for some growth.
When I jumped in and took my first executive position as vice president for medical affairs, it began a period of growth that I had not experienced since medical school and residency.
During that time, I was constantly feeling a sense of discomfort. I was only partially prepared for my new role. The experiences that felt especially uncomfortable were:
- Being the outsider at meetings with the CEO and other members of the executive team, who had worked together and met weekly for years before I joined them;
- Learning to interact with, support, lead and inspire the directors who actually ran my division;
- Accepting full accountability for my own performance and that of my division; and,
- Understanding and embracing budgets.
When considering a career pivot, mentors and advisors often include an admonition to follow your passion as a key piece of advice. After all, following one’s passion means that you will stick with it. You won’t easily be swayed from working on something you’re passionate about, so you’ll see it through, even when there are big challenges. To do otherwise would seem to be unorthodox career advice.
Besides, numerous surveys of, and interviews with, successful business leaders and entrepreneurs report the importance of following one’s passion.
But there are two serious statistical concepts at play that place such advice on shaky ground.
The first is that correlation does not equal causation. To the contrary, it’s quite possible that success fosters passion. It’s perfectly logical to become passionate about a career that has brought fame and fortune.
The second is survivorship bias. Yes, a high percentage of successful persons declare that passion was responsible for their success. But for every successful business owner, there are often many unsuccessful business owners.
About 60% of new restaurants fail within 3 years. Most of the founders were probably passionate about starting a restaurant. But if they were all passionate when they started (including the failures), then the correlation with success is zero at best.
Yet we never hear from the unsuccessful business founders or career seekers. Who would interview someone about being a failure?
So, the presence of passion itself probably does not correlate with success, just as the TV show American Idol has demonstrated that passion for singing does not correlate with the ability to sing well.
LinkedIn is a social networking site designed for the business community. The site allows registered members to establish networks of people they know and trust professionally. To be LinkedIn is to be part of a business and professional network.
It was founded in 2002 and is now owned by Microsoft. With over 500 million users worldwide, it boasts about 130 million users in the United States. It currently posts about 10 million jobs.
The primary feature that defines LinkedIn is each member’s profile. Your profile can be thought of as a dynamic visual resume.
My LinkedIn Story
I updated my LinkedIn profile and submitted my name to the job listings page. An entrepreneur contacted me shortly thereafter looking for a physician with my skills to join him as a minority partner in a new venture: to open a brand new urgent care center.
He had spent two years researching the business opportunity. He had plans to open a clinic in a region north of Chicago that had a deficit of urgent care services, so he messaged me through LinkedIn and started an online conversation.
Click image to go to my LinkedIn profile.
About six months later, following some negotiation, I signed several agreements. I purchased stock in the new company, and gave notice to my then employer that I was leaving my job as chief medical officer.
Fast forward two and a half years. PromptMed Urgent Care has grown from nothing to a very active clinic, treating 40 to 50 patients per day on weekdays (a bit less on weekends).
To make some extra money, I worked as an internal medicine intern for a short while after graduating early from medical school, while waiting to start my family medicine residency. While covering the medical floors and ICU, one of the duties that I felt very unsure about was to deliver bad news to patients and their families.
On several occasions, I recall feeling totally unprepared to inform an elderly woman that her spouse did not survive the cardiopulmonary arrest that occurred while I was on call. Or the fact that the chest X-ray demonstrated a likely lung cancer in a patient admitted with a cough and bloody sputum.
Admittedly, I probably should not have been the one having those conversations, but it just worked out that way.
Over the years, I became more comfortable with delivering bad news. I watched others do it. I read about it. But I never did receive any formal training on how to do it.
Several decades later, I was asked by the Director of Graduate Medical Education at my hospital to present a series of lectures to the residents. This past month, I presented one of those lectures devoted to the topic of delivering bad news to patients. It gave me an opportunity to review the subject.
I developed my method of delivering bad news by observing my instructors as I completed medical school and family medicine residency training. I don’t recall being taught a consistent method or process to follow.
As I reviewed the subject matter and integrated what I learned with the approach that I had come to follow, I was pleased to find out that there has been an effort to study the subject and several processes have been described and tested.
It’s time for the VITAL Physician Executive’s Monthly Leadership Favorites – July 2017 Edition. In this feature I share inspiring and enlightening advice from respected leaders, generally from outside of healthcare (but not always).
Leadership Favorites – July 2017 Edition
This month’s favorites follow…
Accumulate More Wealth as an Administrator
Medscape recently presented the findings from its most recent salary survey. It included a list of factors that correlate with higher levels of accumulated wealth. The authors identified ten such reasons, beyond specialty and years in practice.
As I think back to my early experiences as a hospital executive, I recall a fairly steep learning curve. The AAPL management courses I attended helped. But it wasn’t until I saw the principles taught in those courses applied in the real world that they started to sink in. And that’s also when I began to see my greatest shortcoming as a leader.
Most financial, human resource and management concepts eventually became second-hand. With mentoring and experience, I became comfortable with most aspects of my job.
But there were several duties that I struggled with through much of my career. They remained my greatest shortcomings. But I developed strategies to overcome them.
About a year ago, I wrote about the need for a business degree. In my post, I listed Four Reasons to Seek a Business Degree. Since then, I have witnessed some of my colleagues enroll in MBA programs. All healthcare organizations benefit from owners or leaders with knowledge of business principles, including private practices. Is it time for you to pursue a business degree?
I am re-posting the material from my previous article. However, I am adding 6 additional benefits completing a business degree provides.
More physician leaders have recently acquired an MBA, MHA, MMM or MPH (an MPH is not actually a business degree, but a significant number of physician executives have one). A business or management degree is definitely not a requirement for a career as a physician executive.
There are many successful physician leaders without such a degree. There are numerous physician CEOs, working in hospitals, insurance companies, medical groups and nonprofit organizations who don’t have one.
However, if you have not already graduated from one of the 65 joint MD/MBA programs, then you will likely consider obtaining it or a similar degree after completing residency. Pursuing such a degree is a big commitment. The costs will run into the tens of thousands of dollars. It will require hundreds of hours of study and up to a three-year commitment to complete.