Empowering Physicians to Become Leaders

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1 Empowering Physicians to Become Leaders Roger Wong, BMSc, MD, FRCPC, FACP Associate Dean, Postgraduate Medical Education Clinical Professor, Division of Geriatric Medicine UBC Faculty of Medicine

2 Disclosure No competing interests in regards to the content of this presentation.

3 Objectives Upon completion, you will be able to: Understand the interactions between leadership and management in healthcare. Select common leadership styles. Apply the pearls of effective leadership in the healthcare setting.

4 Features of Physician Leaders Medical expertise Front line service provider Health advocacy Ethics code Influence

5 Evolution of Leadership From great leaders to contextual leaders From leader as hero to servant/steward From command-control to participative leadership From individual focus to team collaboration From conformity to diversity From predictability to dynamic renewal Neufeld et al. Leadership for Change in the Education of Health Professionals. Maastricht: The Network,1995.

6 Physician Leadership Process of influencing group or organization to achieve vision for better future Any member of group can influence behavior of members and become leader Many contexts: individual practices, clinical/academic institutions, medical associations, public policy, etc. Kotter JP. Leading Change. Boston, MA: Harvard Business School Press, Collins-Nikai R. Leadership in medicine. MJM. 2006;9:68-73.

7 Management and Leadership Role Management Leadership Power Base Appointment Authority power Anointment People power Function Consistency: Follows old reliable path Stays the course Provides the road map Innovation: Forges a new path Alters the course Provides the roadster Requirements IQ: Policies, procedures, rules, regulations Focus on immediate results EQ: Envisioning, inspiring, relationship building, recruiting, retaining Focus on future possibilities Zaleznik A. Managers and Leaders: Are They Different?

8 Management and Leadership Multiple interactions and not mutually exclusive. Analogy of two sides of the same coin.

9 Leadership Styles Continuum Most effective leaders use a collection of distinct leadership styles. Leaders who have mastered 4 or more styles have the best climate/performance. Authoritative Democratic Affiliative Coaching Goleman D. What Makes a Leader?

10 Authoritative Leadership Come with me. Mobilize people towards vision. Most strongly positive impact on climate. Consider when changes require new vision, or clear direction is needed. Goleman D. What Makes a Leader?

11 Democratic Leadership What do you think? Forge consensus through participation. Positive impact on climate. Consider when building buy-in/consensus, or getting input from team members. Goleman D. What Makes a Leader?

12 Affiliative Leadership People come first. Create harmony and builds emotional bonds. Positive impact on climate. Consider when healing rifts in split team, or motivating people at stressful times. Goleman D. What Makes a Leader?

13 Coaching Leadership Try this. Develop people for future. Positive impact on climate. Consider when helping a team member improve performance, or developing long term strengths. Goleman D. What Makes a Leader?

14 Pitfalls of Leadership Styles Pacesetting leadership: Do as I do, now. Set high standard for performance. Negative impact on climate. Coercive leadership: Do what I tell you. Demand immediate compliance. Negative impact on climate. Goleman D. What Makes a Leader?

15 Infectious Leadership Leaders behaviours tend to be transmitted to their direct reports, who pass them on to the next level, and so on down through their organizations. Over time, they permeate the organization from top to bottom, influencing activity at all levels. Eventually they become embodied in the organizational culture, influencing the types of people who get promoted and hired into the organization, creating a self-reinforcing feedback loop either positive or negative. Watkins M. Infectious Leadership. Harvard Business Review

16 Emotional Intelligence Goleman D. What Makes a Leader?

17 Meditation & Leadership Simple meditation can improve self awareness and leadership. 4 key questions: What am I trying to achieve? What am I doing that is working? What am I doing that is slowing me down? What can I do to change? Tjan AK. Five Ways to Become More Self-Aware. Harvard Business Review

18 Social Skills & Leadership Visionary leadership Influence Developing others Communication Change catalyst Building bonds Teamwork and collaboration Goleman D. What Makes a Leader?

19 Communication Techniques

20 Healthcare Examples Inform: This is the process for submitting weekend on call requests. It is due the second Friday of the month. Here are the steps Entertain: I remember the first time I did not do well in the in-training exam it was awful because here s what I learned

21 Healthcare Examples Direct: You are responsible for getting the admission history and physical exam done for the emergency patient. Get it to me in the next hour so we can review together. Inspire: Someone in Surgery once proposed using simulation to teach this procedure, we tried and it worked out. This is something I see you being able to do.

22 Pearls of Inspiring Leadership Selectively reveal some weaknesses (not fatal flaws). Use intuition to decide when and how to act. Tough empathy give people what they need, not what they want. Capitalize on own unique features to motivate people. Mix and match based on situational requirements. Goffee R, Gareth J. Why Should Anyone Be Led by You?

23 How Leaders Make Decisions Variable cluster analysis: Before making a decision at a critical time, I invested time and effort to explore multiple perspectives, needs, and ideas through a proactive dialogue with experts and stakeholders. During the decision-making act, I weighed a variety of options. Then, after making the decision, I explained it fully to all stakeholders to reduce the stress of change among those affected. Minsky L, Tang Peters J. How You Make Decisions Is as Important as What You Decide. Harvard Business Review

24 Leadership and Uncertainty Leaders should be honest about feeling uncertain. Research has shown that overconfident leaders make overly risky decisions. Being open about what you are unsure of helps you avoid bad decisions and allows others to trust you. Next time you are facing a moment of uncertainty, instead of focusing on the best, worst, or even most likely possibility, provide a range of possible outcomes. Moore D. Smart Leaders Are OK with Seeming Uncertain. Harvard Business Review

25 Change Management

26 How Leaders Survive Adversity Adaptive capacity: ability to transcend adversity, with all its attendant stresses, and to emerge stronger than before. It comprises of 2 qualities: Ability to grasp context: putting a situation in perspective. Hardiness: perseverance/toughness that enables people to emerge from devastating circumstances without losing hope. Bennis W, Thomas RJ. Crucibles of Leadership. Harvard Business Review

27 The Seven Ages of the Leader Infant Student Lover Soldier General Statesperson Sage Bennis W. The Seven Ages of the Leader.

28 The Infant One mark of a future leader is the ability to identify, woo, and win the mentors who will change his or her life. It may feel strange to seek a mentor even before you have the job, but it is a good habit to develop early on. Recruit a team to back you up; you may feel lonely in your first top job, but you won t be totally unsupported. Bennis W. The Seven Ages of the Leader.

29 The Student It is almost always best for the novice to make a low-key entry. Major changes in the first six months will inevitably be perceived as arbitrary, autocratic, and unfair, as much for their timing as for their content. Events that predate your arrival will also shape followers view of you. Bennis W. The Seven Ages of the Leader.

30 The Lover For the leader who has come up through the ranks, one of the toughest is how to relate to former peers who now report to you. The challenge for the newcomer is knowing who to listen to/trust, and what to pay attention to. Bennis W. The Seven Ages of the Leader.

31 The Soldier Be careful with your words and actions. The more effective the leader is the more careful he or she must be, because followers may implement an idea that was little more than a passing thought. Authentic leaders are generous. They are always willing (even anxious) to hire people who are better than they are, in part because they know that highly talented followers can help them shine. Bennis W. The Seven Ages of the Leader.

32 The General One of the greatest challenges a leader faces at the height of his or her career is not simply allowing people to speak the truth but actually being able to hear it. It remains important for the leader to understand the context they work in and get the support of their followers. Bennis W. The Seven Ages of the Leader.

33 The Statesperson The leader in this stage is often hard at work preparing to pass on his or her wisdom in the interest of the organization. The leader may also be called upon to play important interim roles, bolstered by the knowledge and perception that come with age and experience and without the sometimes distracting ambition that characterizes early career. Bennis W. The Seven Ages of the Leader.

34 The Sage Mentoring is one of the great joys of a mature career. Mentoring can start early. When you mentor, you know that what you have achieved will not be lost, that you are leaving a professional legacy for future generations. Bennis W. The Seven Ages of the Leader.

35 Summary Leadership and management are two sides of same coin. Use a variety of leadership styles based on situational needs. Apply the pearls of effective leadership. Be yourself, more, with skill.

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