You Dont Need A Title To Be A Leader

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You Dont Need A Title To Be A Leader

• Marc Borenstein, MD, FACEP, FACP
• Chairman and Residency Program Director
• Newark Beth Israel Medical Center
• St. Barnabas Health Care System

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Why Pursue Leadership?

• Get paid the big bucks?
• Less clinical time?
• Prestige?
• Big office?
• Fancy title?

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Why Pursue Leadership?

• Be in charge?
• Get everyone to head in your direction?
• Get anyone to head in your direction?
• Get everyone to change direction?
• Get anyone to change direction?
• Crazy?

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What Is Leadership?

• Someone who has followers
• Peter Drucker
• Leadership is influence
• John Maxwell
• Knowing yourself, having a vision that is
  well-communicated, building trust amongst
  colleagues
• Warren Bennis

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What Is Leadership?

• A person who can persuade people to do what they
  dont want to do, or what theyre too lazy to do
  and like it
• Harry S. Truman

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What Is Leadership?

• Go to the people, start with what they have,
  build on what they know, and of the best of
  leaders the people will say, we have done it
  ourselves
• Lao Tse

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What Is Leadership?

• Authority or power over others?
• Telling people to do their job
• Influencing others?
• Getting people to do their job
• Getting people to do your job

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What Is Leadership?

• Authority and power
• Quality of force, requirement, or intimidation
• Organizational and/or role hierarchy

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What Is Leadership?

• Influencing others
• Power without apparent force
• Insincere, disingenuous
• Promoting ones agenda or hidden agenda

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What Is Leadership?

• Directing and showing others what to do?
• Managing outcomes?

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What Is Leadership?

• Leadership ? Management
• Describing leadership ? Creating leadership
• ? Being a leader

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How is Leadership Communicated?

• How am I experienced by others?
• Being v. Doing
• Were aware of what were doing
• Other people are aware of who were being

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How is Leadership Communicated?

• Experiential qualities of life
• Satisfaction, fulfillment, purpose
• Affected by context and being
• Hospitals have a task-oriented culture
• Training in what to do v. how to be

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Why Pursue Leadership?

• You have a commitment
• You have a mission
• Your voice and contribution matter

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Why Pursue Leadership?

• Leadership creates the leverage needed to move
  the world
• Emergency physicians work in complex
  organizational structure

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The Power of Leverage

• 1 EM physician provides care to 3000
  patients/year
• Graduate 10 EM residents/year 30,000 patients
• 25 year career/graduate 750,000 patients
• 10 year RPD career 7,500,000 patients

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The Power of Leverage

• Never doubt that a small, group of thoughtful,
  committed citizens can change the world. Indeed,
  it is the only thing that ever has
• Margaret Mead

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Start From Where You Are Right Now

• Invent a purposeful context for what you are
  already doing
• Create mission and vision statements that
  articulate that purposeful context for you and
  what is possible for others

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Start From Where You Are Right Now

• Be sure your mission and vision are in alignment
  with your ED and institutional mission and vision
• Create a bold statement

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Why Invent a Purposeful Context?

• The story of the stone cutters

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Qualities of a Purposeful Context

• Must excite you
• Inclusive
• Leave others with the possibility of
  participation in and contribution to something
  bigger than the individual

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Qualities of a Purposeful Context

• If your actions inspire others to dream more,
  learn more, do more, and become more, you are a
  leader
• John Quincy Adams
• If you want money for people with minds that
  hate.brother youll have to wait
• John Lennon

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Mission

• To provide dignity, compassion and enhance the
  well-being of each and every person
• To have people leave with an experience of being
  valued

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Vision

• To create a ED that will serve as a model for
  whats possible for people a safe haven where
  excellent emergency care is delivered with
  compassion, timeliness, and a driving sense of
  honoring the individual

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Vision/Mission NBIMC

• Personal attention notable for its warmth and
  sincerity and inspired by a sympathetic
  recognition of the human element is the powerful
  but gentle handmaiden of science employed by
  doctors, nurses, and attendants at Beth Israel
  Hospital. Patients are people, not cases at this
  hospital.they are men, women, and children,
  human beings, and are treated as such

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Vision/Mission NBIMC

• The value of the human touch as a power for
  healing is never lost sight of at Beth Israel
  Hospital

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Create a Bold Statement

• The value of a bold statement
• A non-linear future not predicted by the past
• Simple, clear
• Immediately communicates to all
• Bold statements
• NASA
• Coca-Cola

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Bold Statement

• Putting Newark on the Map!

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Are You Playing By Yourself?

• If youre working on a project you can accomplish
  all by yourself its too small for who you are
  and what you can contribute
• At risk for resignation/burnout

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Are You Playing By Yourself?

• Symptoms
• Feeling bored, tired
• Not having much fun at work
• Same old, same old
• Been there, done that

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Are You Playing By Yourself?

• Solutions
• Reclaim your childhood vision/mission
• Invent a new vision/mission
• Consider taking a careful risk

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Are You Playing By Yourself?

• The important thing is this to be able at any
  moment to sacrifice what we are for what we could
  become
• Charles Dubois

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Trying To Do It All By Yourself?

• Your working on a big project but have
  insufficient time to get the job done and have a
  life outside work
• At risk for resentment/burnout

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Trying To Do It All By Yourself?

• The time you spend trying to do it all will be
  taken at the expense of ones personal and family
  life

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Trying To Do It All By Yourself?

• Symptoms
• Feeling angry
• Im working harder than they are
• No one around here cares as much as I do
• Tired/sleep deprived, working late at home
• Stress with spouse, family
• I need a time management class

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Leadership Reality 1

• There is insufficient time for you to get
  everything done

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How Can I Get the Job Done?

• You cant

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Leadership Reality 2

• All great projects require a team
• Many great projects are not accomplished in a
  single lifetime

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Leadership Reality 3

• Trying to do it all yourself
• Compensation for a failure to provide leadership
• Reliance on skills you already have
• Staying within your comfort zone

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Leadership Effects

• Creates an environment of scholarly inquiry
• Divergent thinking
• Empowered by uncertainty
• Safety to ask and explore

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Leadership Effects

• Changes paradigms
• Creates and changes context

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Paradigm Shifts

• Expanding the world
• Bigger, better boats v. traveling to a new world
• Expanding the world of business
• watches v. measuring time v. fashion

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Leadership Requirements

• Discipline to articulate and sustain a vision and
  sense of purpose
• New and/or expanded non-intellectual skills and
  responsibility

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Leadership Requirements

• Effective and disciplined communication
• Ownership of outcomes and the experience of
  others
• Creative v. descriptive language

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Measurements of Leadership Effectiveness

• Amount of individual participation
• Number of teams taking action
• Quantity and quality of results produced by
  others
• Number of new leaders created

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Can It be Taught?

• I can teach my wait staff to set the table
  correctly but I can not teach people to be
  interested in how their behavior affects
  others.Hire right
• Danny Meyer

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Great Leaders

• Build great teams that produce extraordinary
  results
• Do not all employ the same style
• Utilize coaching and coaching structures
• Evangelistic
• Embrace change

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Great Leaders

• Understand the marketplace from outside-in
• Customer (patient) focused
• Understand the critical role of organizational
  culture
• Implement the best ideas regardless of origin
• Advance the leadership body of knowledge

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Keys to Leadership

• 1 Willingness to take ownership
• 2 Creating the future through language
• 3 Prioritizing choices and taking action
• 4 Thinking from abundance

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Keys To Leadership

• 5 Mining for the gold
• 6 Listening for ones vision in what others say
• 7 Embracing change
• 8 Incorporating renewal
• 9 Seeking the inner journey

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Leadership Continuum

• Leadership
• Participation
• Complaint
• Skepticism
• Resignation, apathy
• Cynicism, despair

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Communication

• General competencies
• Communication and interpersonal skills
• Professionalism

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Components of Communication

• Speaking - Listening
• Thinking - Speaking - Hearing - Listening

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What is Communication Effectiveness?

• Having what I think I said
• what you think you heard

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Difficult People v. Difficult Airways

• Are you willing to settle for 67?

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Emotional Intelligence

• Self-awareness
• Self-regulation
• Motivation
• Empathy
• Social Skill

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Self-awareness

• Confidence
• Comfortable with divergent thinking, ambiguity
• Able to consider other points of view
• Accurate, realistic self-view
• Thirst for constructive critique
• Candor, without self-significance
• Self-deprecating sense of humor

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Self-regulation

• Reflective
• Not impulsive, reactive or emotionally driven
• Invites and considers all points of view before
  taking action
• Creates trustworthiness
• Builds integrity

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Motivation

• Innately driven to achieve
• Striving talents
• Strongly optimistic
• Organizational commitment

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Empathy

• Cultural sensitivity
• Appreciates and invites diversity
• Drives service to others
• Patient satisfaction
• Attraction/retention of talent

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Social Skills

• Talent for finding common ground
• Team-building
• Leading change
• Creating new and strengthening existing
  relationships
• Schmoozing

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Be A Coach For Others

• What is required for coaching?
• Commitment
• What creates mastery?
• Practice and training

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Be A Coach For Others

• What are characteristics of an effective coach?
• Remember the commitment
• Honor and interact based on the commitment
• See whats missing
• Acknowledgement

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Be A Coach For Others

• Know the rules for the game at work
• Play the game at work by the rules
• Know the outcomes that define winning
• Know the score

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Empower Others

• Dont offer agreement to complaints
• Find the commitment
• Move complaints to solutions
• Challenge people to put in whats missing
• Invite people work on what they love

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Giving Back/Generosity

• Annual hospital fundraiser
• Departmental gifts/activities
• Residency graduation
• Holiday parties, gifts
• Research/education fund

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Giving Back/Generosity

• Create an empowering context for some of you time
  at work
• Health fairs
• Community education
• Committees
• ED and non-ED conferences

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Practical Tips

• Schedule everything you intend to do
• Schedule time for yourself, family, and friends
• Frequently check your schedule with your family
• Head, heart, body Total well-being
• Schedule time for the mind, soul, and physical

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Practical Tips

• Learn to say no
• Empower and trust others to get the job done
• And let go
• Annual inventory of projects
• Give away the ones that no longer excite you,
  create income, or forward your career

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Practical Tips

• Make requests
• Let people know that you need help
• Communicate breakdowns early
• Know whats expected of you

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In Conclusion

• This is the true joy of life, the being used
  for a purpose recognized by yourself as a mighty
  one the being a force of nature instead of a
  feverish little clod of ailments and grievances
  complaining that the world will not devote itself
  to making you happy.
• I am of the opinion that my life belongs to
  the whole community and as long as I can live, it
  is

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In Conclusion

• my privilege to do for it whatever I can.
• I want to be thoroughly used up when I
  die.Life is no brief candle to me. It is a sort
  of splendid torch which I have got hold of for
  the moment, and I want to make it burn as
  brightly as possible before handing it on to the
  next generation.
• George Bernard Shaw

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Bibliography

• First, Break All the Rules. Buckingham M and
  Coffman C. Simon Schuster, 1999.
• Good to Great. Collins J. Harper Business, 2001.
• The 7 Habits of Highly Effective People. Covey
  SR. Simon Schuster, 1989.
• Principle-centered Leadership. Covey SR. Simon
  Schuster, 1991.

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Bibliography (contd)

• What the Best CEOs Know. Krames JA. McGraw Hill,
  2003.
• The Last Word on Power. Goss T. Doubleday, 1996.
• What They Dont Teach You At Harvard Business
  School. McComack, M. Bantam Books, 1984.

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Bibliography (contd)

• Organizing Genius. Bennis W. Persius Books, 1997.
• Its Not How Good You Are, Its How Good You Want
  To Be. Arden P. Phaidon, 2003.
• The 21 Irrefutable Laws of Leadership. Maxwell,
  J. Thomas Nelson Publishers, 1998.

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Bibliography (contd)

• Harvard Business Review on What Makes a Great
  Leader. Harvard Business School Press, 1998,
  1999, 2000, 2001.