Want to Lead Others? Know Thyself

by Elizabeth Hofheinz, M.P.H., M.Ed., January 9, 2020 Have all the best leaders undergone psychotherapy? Perhaps…or at the very least they think like Greg Mundis, M.D., an orthopedic spine surgeon at Scripps Health in San Diego. “I am fond of quoting a master of leadership, John C. Maxwell, who said, “Leadership is influence, nothing more nothing less. Show you can lead a team to victory, and you will have shown you can positively influence your followers and organization.” But how to regularly attain such heights? How to draw forth such actionable wisdom from those you lead? Surgeon, know thyself… “Most of us have a solid grasp of the workings of the medical community, but we must also drill down and focus on our own specific goals. We as physicians obtain a medical degree that in itself inherently designates us as leaders. Even if you are not a department chair, you are leading a team whether you have a small private practice or a large group practice.” “In academic medicine you are leading on numerous levels; in committees, administrative duties, your research team, clinical practice, and the next generation of physicians (medical students, residents and fellows) and in local and national and international societies. There are multiple layers of leadership, all which point back to how well you yourself lead.” Dr. Mundis, CEO of Global Spine Outreach (GSO), an organization devoted to assisting children with spinal deformities who lack access to spine care, notes, “What every standout leader has in common is that they have a deep, broad understanding of who they are. The fact is that the more comfortable you are with yourself the more effective you will be as a leader.” “There are very real-life problems leaders can cause if they overcommit and underperform. This is particularly true in medicine. There is a tendency to overcommit in an effort to advance science, innovate, educate or simply treat patients. My ten years in practice have taught me the delicate nature of leadership in orthopedics. Realizing that every opportunity has an associated cost is essential to understanding the limits of what you can accomplish.” On a macro level, says Dr. Mundis, leading a practice isn’t too different from what it was years ago. “The funding and regulatory environments do change, but the constants are the people. This means that relationship and communication are the most critical. How do you become such an effective communicator that your entire team—nurses, physician assistants, everyone—has faith in your leadership?” Those being managed trust leaders who are involved. Dr. Mundis: “In my practice we have regular staff meetings where we go through current wins and challenges and then troubleshoot them. We also troubleshoot larger scale (systems level) changes that need to happen. Both of those processes keep us ‘on mission.’” But never be so driven to stay on track that you fail to hear the faintest utterances from someone in “the back row.” Dr. Mundis: “For goodness sake, talk less, listen more. Never make anyone on your team feel like his or her voice doesn’t matter. We as surgeons are looked upon to provide our opinions, but ours isn’t the only vantage point. And note that there is good data suggesting that people burn out in part because they feel that their opinions, i.e., they, do not matter. If you cannot sustain healthy relationships with your team then you cannot grow your practice, your surgical team, your research efforts or your academic involvement. Why? Because people will leave…and turnover will drastically set your goals back.” But what if you as a leader are struggling to be “heard” by the hospital? “Some will say, ‘I have voiced my concerns to the hospital administration, but no one is listening to me.’ My advice would be to commit to understanding who your administrators are—their nonwork lives, how they invest their time, their priorities, worldview, etc. If you can more clearly understand their perspective, then you can more effectively communicate your concerns and agenda. Sometimes there is a mismatch of professions…surgeons might automatically think that everyone around us shares the same world view as those of us with a medical background, but of course, this is not the case.” And what of leadership in orthopedic education? It’s “weird.” “Communication in the educational arm of academic medicine is a bit weird,” states Dr. Mundis. “You must convey the specifics of your research in a way that is accurately received. Not doing so means that inappropriate actions could result from such information dissemination. I once attended two meetings on minimally invasive spinal deformity surgery and heard quite different messages regarding treatment of the same condition. If you do not communicate your message in a distinct manner, then surgeons may go home and apply these techniques in the wrong way or to the wrong patients. Academic leaders have substantial influence on their peers via research and education, and have an obligation to maintain their integrity and authenticity in communicating with and teaching their peers.” “In general, it is important for surgeons who are looking to have more influence within academic circles to have a clear understanding of the challenges faced by surgeons around them. This requires you to talk to individual surgeons in order to understand their issues and practice environments. Not until you understand what others are going through will you be able to study and innovate to achieve better patient outcomes and delivery of care.” Communicate, communicate, communicate! “Ultimately John C. Maxwell got it right. ‘Leadership is influence, nothing more nothing less’. To influence you must communicate well. Failing to communicate is failing to lead. This is true for your clinical team as well as your academic team, the team in the operating room or among your peers. If you want to figure out how to be a stronger leader then you must take inventory of your communication skills and figure out how to make them better.” “As surgeons our influence or ‘leadership’ is critical to having a well-rounded and joyful life and practice. I would challenge us all to take time for introspection, to get to know yourself a little bit more every day, to understand your biases, and what truly motivates you. If you do not understand yourself then your leadership potential will max out. Learning to know yourself and finding genuine interest in those you have influence over, however, will make the depth and breadth or your leadership potential limitless. Your influence, or leadership, will be strengthened when you demonstrate the value you are able to create in the lives of those around you. At its very core, however, is the ability of the surgeon to know ‘thyself’. If you don’t understand or know yourself then how can you know what you have to ‘give’ to those around you? And you can’t be a leader if you have nothing to give.” “Global Spine Outreach has taught me this lesson on so many levels. Through this mission work I have found an ability to share my talents by: treating children who desperately need scoliosis care, sharing the rich education that has been given to me with other spine surgeons, using my influence to communicate the wholehearted and joyful experience with my peers, growing a team of influencers around me to raise financial support for this tremendous effort, and growing an organization whose potential is to change the delivery of spine care for a nation.” “We are all high functioning and are born leaders. Take the time to invest in yourself, to reflect on the gratitude that is built into our profession, and on the blessing of having the opportunity to influence those around us through surgery, education, research, innovation, or simply by being a sounding board. Create value by knowing yourself, giving your talents and just see how blessed you will be for giving of yourself.” As Nelson Mandela said, “One of the things I learned when I was negotiating was that until I changed myself, I could not change others.”

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