I am often asked today if I am a doctor or an administrator, my response is both, always! You might ask, can a physician really be both? The answer is yes, BUT not every physician. If you take the group of all physicians, the first cut is those that are interested, then it is narrowed by those that are prepared: either through formal education, life experience or both, and the final cut is those that have the demonstrated ability to lead by inspiring a diverse team and operationalizing a vision. Today this represents a rather narrow playing field.

It is important to remember that doctors are different; many have dreamed of being a physician since childhood, and rank among the best and brightest, with often only the top 0.5% of high school students eventually being accepted into medical school.

Physician Executives are wired differently; they are decisive, based on an unwavering priority hierarchy:

• Patients
• Mission of the Organization
• Personal Needs

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HIGHLIGHTS SHARED AT THE TELEMED IQ SUMMIT 2019, NASHVILLE, TN

Attaining most any goal or dream requires us to do something different, which goes against the natural human tendency to stay in our comfort zone. Transformation has to start with change, but we resist change until the pain of staying the same exceeds the pain of change...yes, PAIN is the catalyst and friend of transformation.

Understanding the difference between change and transformation is important. Transformation requires a change of culture. A change of culture requires strong leadership, the kind of leadership comfortable with creative disruption. To simplify the difference between change and transformation remember that checking off items on a “To Do” list can bring change, but transformation requires completing items on a “To Be” list.

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Over 145 million patients come to US Emergency Departments every year; it takes over 167,000 emergency nurses to provide compassionate care to these patients: whether a child with a fever or a senior struggling to breathe, they are America’s frontline for care.

Many people outside of emergency medicine may not realize that our nation’s EDs provide an accurate and unfiltered view of society. This slice of reality shows humanity at its best and worst. In addition to the joy of saving a life, the occasional thank you and smile that an ED nurse will receive, they may be yelled at, unappreciated, subjected to unpleasant comments, and even assaulted…. by people they are just trying to help.

Yet, 24/7, 365 days per year - days, nights, weekends, holidays, sunny days, stormy days, natural disasters— these dedicated professionals put their personal needs and those of their families aside and dedicate themselves to caring for all types of strangers.

As an emergency physician, I can personally affirm that I could not do my job without them: they are my right hand (and my left), my eyes, my ears, my conscience, and sometimes even my kinder, gentler voice!

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Too much of a good thing can sometimes be a problem; there is a risk that caring too much can result in burnout. Even a profession that is literally and figuratively built on it, as is healthcare, there is not immunity to an overdose of caring.

You might be thinking: “What healthcare leader would ever tell a member of their team to care less?” Self-reflect and visualize your peers and the people you are leading. Do any of these characteristics seem familiar?

• Constantly worries about what people think
• Always feels obligated to fix things
• Has a hard time letting things go
• Starts the day with a list of worries
• Ends the day with a list of worries
• Stresses about staff turnover
• Stresses about staff happiness

I’m sure you can identify with some of these tendencies personally or amongst your team. The answer is not to stop caring about patients, staffing, getting through your “to do” list, or about being liked; the answer is to care just the right amount! Think of care as sugar; in the words of Mary Poppins it takes “Just a spoonful of sugar…!”

Care enough to progress toward your goals, being visible and open, maintaining control while knowing when to let go, and earning respect. Care about being liked, but do not rest your self-worth on it. Sound advice you might say, but easier said than done. Try this CARE PLAN:

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Recently, I had the opportunity to share the joy and intense emotions of giving away my daughter in marriage. At this extraordinary event, I had the fatherly privilege of making the welcome toast. Reflecting on these thoughts in the days that have passed, I realize that these principles and practices that guide us toward happy and healthier relationships are key traits that great leaders exhibit. Please indulge me in the following excerpt from that toast I gave at the wedding of my daughter Francesca to her husband Matthew.

One of the privileges of being the Dad of a little girl is that she sits on your lap and you have little talks from time to time. One I remember in particular is when her mother was out shopping, because that’s what she did when Daddy and daughter spent time together, Francesca looks me in the eyes and says: “Daddy when I grow up I want to marry you” ….. I had to politely explain to her that Mommy wouldn’t like that too much! She then went on to say: “How will I ever find the right person to marry?” I said: “Honey, when you fall in love and if that person treats you as well as I do, then he’s the one.” Matthew you’ve passed that test.

So I can’t leave without a little advice for Francesca and Matthew…..You are starting your life together, what’s the most important thing? The most important thing is LOVE….that’s a great word but there are a lot of things that go into it. For my colleagues in medicine, you know we have to make acronyms out of everything to help us remember….

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A mentor of mine is often quoted: "Hope is not a strategy!"

Indeed, there is a world of difference between hoping things will improve and implementing a well thought out plan. However, nothing can ever change or improve unless we can imagine it as such. Once it is imagined, there must be some belief or "hope" that this vision can be realized. Now that's where strategy comes in, making the vision a reality.

As leaders, we must start by inspiring hope, not by asking for the action plan. When your team believes they can make a difference, they will. It is very obvious in healthcare: patients would never come to us without the hope that we can make them better. Hope is not just for our patients, it is for every member of our team.

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The human body is the most brilliant machine ever created and the quintessential work of art. The headline above is not referring to your creativity and accomplishments in your clothing optional private abode; it is taking literary license from 19th century Danish author, Hans Christian Andersen.

Reflect on the fairy tale, The Emperor’s New Clothes. The Emperor (leader) was a vain man, concerned more with appearances, accolades, and maintaining his current position than the harsh realities that others faced. His subjects were afraid to express their honest opinions to him, fearing they might be deemed unfit for their position or even stupid. The climax of this tale occurs when he is fooled by some weavers into wearing a “spectacular new suit” that, in fact, doesn’t exist at all. The Emperor is allowed to parade through the town naked. Finally, a mere child blurts out in honesty that the Emperor is wearing nothing at all.

Leaders at all levels of an organization run the risk of being caught naked at work, but this risk increases as one ascends the ranks. People see pleasing their boss as important, essential to keeping their jobs. Most leaders would proclaim they are wise enough to detect blatant deception, but it is often more subtle than that. Very often what happens is filtering; direct reports present the info that makes them look good and their boss is expecting. This filtering of information is equivalent to a slight degree of course variation which becomes obvious 100 miles or more into the journey.

What would Mr. Andersen say to leaders today?

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Long term success in life is rarely achieved by perpetual crisis management and the ability to work around the clock to meet a deadline…not that great leaders and successful individuals don’t have that ability and need to deploy it from time to time! One of the keys to sustained success is balance. Balance should not be viewed as a goal that is attained; rather a dynamic state in need of frequent adjustment…like a see-saw.

Plenty has been written about time management and work life balance, each method with its own merits. If you have taken some of this published advice and it has brought you success, don’t change a thing. If you continue to struggle, I urge you to read on.

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Focusing on joy, especially in work, is gaining momentum. It has my attention! It is clear to me that the mindset and habits are exactly what great leaders have and do and what developing leaders should concentrate on.

It is very tempting for any leader, especially those in healthcare, to focus on what’s wrong, what needs to be fixed. It’s time to view the situation through a different lens…we need to focus on the meaning and purpose of our work. This is a distinct advantage for those of us in healthcare, our mission is making peoples lives better. Joy is not in things, it is in US. IHI describes pride in workmanship as a fundamental right; having the connection to meaning and purpose promotes such pride and is the basis of joy.

Take the Joy Quiz.

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All leaders will openly admit that they could not do their job without their team. However, as humans, I’d bet that most of them, in a moment of frustration, have thought “it would be easier if I just did it myself.” Why? Because influencing people is a gradual process, not simply a decision with immediate results.

Accepting the reality that no matter how brilliant or hard-working you are, you will always need your team which means you need to learn how to influence them.

Master the following attributes and you will be well on your way.

10 Leadership Traits that Drive the Ability to Influence Teams

Grateful Attitude - As a leader you are always on stage and therefore need to possess and portray a grateful attitude. Start your day with a ritual that grounds you; whether this is prayer, meditation, exercises, reflecting on loved ones, etc. When your day gets tough, reflect on, or re-enact your gratitude ritual.

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Enhancing our own leadership development along with the novice and advanced leaders on our teams is mission critical in healthcare today. The environment that we are challenged to be successful in is very harsh — increasing the cost of technology and pharmaceuticals, the ever-increasing cost of labor, on top of declining reimbursement.

The formula for success appears simple enough, but the challenge (as always) is the execution. Clearly, educating leaders and enhancing their skills will yield great outcomes; yet the material that must be mastered is not intuitive, and the skills must be practiced over and over to be mastered.

One of the first lessons to be mastered is abandoning time-tested strategy, focusing on maintaining current productivity and volume levels, and being content with the fundamental processes currently in place. In other words, leaders must be comfortable being uncomfortable, embracing the feeling of being unsettled. Read Full Article.

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