MCH Working Conference:

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MCH Working Conference The Future of Maternal
and Child Health Leadership
LEADERSHIP AND THE PUBLIC GOOD
Dominick P. DePaola, D.D.S., Ph.D. The Forsyth
Institute April 19, 2004
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SUMMARY THOUGHTS

• The true test of leadership is to ask Are those
  who would participate in leadership equipped to
  serve the common good?
• Leadership is the practice of helping people
  envision and then participate in creating a
  better world
• Leadership is about creating a caring culture
  People Come First!
• Leadership is about exceeding expectations
  (Disney)
• Influencing change is the business of leadership!

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LEADERSHIP WORKING DEFINTION I
A leader is one who mobilizes others toward a
goal shared by leader and follower
Willis, G., Certain Trumpets The Call of
Leaders, NY, Simon and Shuster, 1994
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LEADERSHIP WORKING DEFINTION II
Leadership is a dynamic relationship based on
mutual influence and common purpose between
leaders and collaborators in which both are moved
to higher levels of motivation and moral
development as they effect real, intended change.
Roast, J, Leadership for the 21st Century New
York, Praeger, 1991
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INGREDIENTS FOR SUCCESSFUL AND EFFECTIVE
LEADERSHIP
COMMON GOOD (GOAL)
LEADERSHIP
FOLLOWERSHIP

• Agreement on process of establishing common goal
• Agreement on common good (goal)
• Context
• Environment
• Agreement on outcomes (success)
  measures/intended change

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ATTRIBUTES OF THE EFFECTIVE LEADER
In order to achieve the common good, leadership
must have definitive characteristics

• The ABILITY to
• move multiple constituencies
• be flexible and tolerant of disparate positions
• be savvy about the political/social landscape
• create coalitions, partnerships and
  collaborations
• nurture interdisciplinary and cross-cultural
  approaches
• The WILLINGNESS to
• take risks and push the envelope
• challenge traditional values and the status quo
• exhibit sustained resolve

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LEADERSHIP STYLES ARE JUDGED ON GOALS AND THEIR
PURSUIT
Arrogant - our goals are best
Confrontational - conflicting goals Plodding -
meeting perceived needs Regressive - low level
goals Status quo - goals may be good but
implementation is slow Visionary - pushing
the envelope true shared vision
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Leadership Eight Steps to Rapid Change
Equipped with the necessary attributes and
passion, leaders spring into action

• Sound a Bugle
• Give Them a Compass
• Unleash Your Change Ninjas
• Shake Up the Status Quo
• Sing from the Same Songbook
• Focus Your Workforce
• Ignite Unbeatable Performance
• Let Go of the Present

McPherson, C., Wittemann, K., Inspiration or
Desperation Companies Change When People Care,
Summerville, 2004
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Do Thine Own Thing
If Benjamin Franklin had tried to be a General
and George Washington had tried to be an
Inventor, we would probably be living in a
British Colony without electricity!
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Questions To Ponder I

• What kind of leadership do you practice?
• Simple
• Transformational
• 2. Does the leadership you exhibit move both
  leader and collaborators to a higher level of
  moral development?
• 3. Do you take public need and social
  responsibility seriously?
• 4. Who is on the leadership team?
• Does the team have the appropriate mix of
  qualities?
• Is there attention paid to cross-sector
  partnering?

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THE COMMON GOOD
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What is the Common Good?

• Increase access to care and effective use of
  access
• Eliminate oral health disparities
• Engage the community in expanding the community
  capacity for enhancing the wellness of its
  pediatric population
• Expand community-based education and clinical
  care
• Improve public schools
• Improve science education and functional literacy
  
• Engage in health care reform debate, including
  appropriate reimbursement models
• Work toward a unified health system

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Public Paradox Relative to Childrens Oral Health

• Scientific and technological advancements are at
  all time high
• Pediatric oral health care is in a crisis
• high prevalence of disease
• limited access to care
• limited use of access
• Perceived value of oral health is still
  problematic

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A NATIONAL CALL TO ACTION TO PROMOTE ORAL HEALTH
ACTIONS

• Change Perceptions of Oral Health
• Overcome Barriers by Replicating Effective
  Programs and Proven Efforts
• Build the Science Base and Accelerate Science
  Transfer
• Increase Oral Health Workforce Diversity,
  Capacity, and Flexibility
• Increase Collaborations

SG, Call to Action 2003
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TO ADDRESS THE PARADOX, AN EFFECTIVE LEADER
NEEDS

• Legitimacy
• Public Trust
• 360 degree view
• Communication and engagement skills
• Flexibility
• Courage
• Unwavering commitment to realizing a vision

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OBSTACLES are those frightful things you see when
you take your eyes off your GOAL. Henry
Ford
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These are some clips from real responses of
students to exam questions (Jay Leno)

• H2O is hot water and Co2 is cold water
• Water is composed of two gins, Oxygin and
  Hydrogin. Oxygin is pure gin and Hydrogin is
  water and gin
• Vacuum a large empty space where the Pope lives
• The place where people speak Gaelic is San
  Francisco
• For a nosebleed put the nose much lower than the
  heart until the heart stops
• Pyramids were built for shade

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Gaining support and excitement from the
community, the effective leader must

• Exhibit caring, passion and compassion about the
  common good
• Communicate a shared vision for the common good
• Engage the consumer in an advocacy role
• This is where the rubber meets the sky!

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EFFECTIVE LEADERSHIP UNFOLDS FROM THE COMMON GOOD!
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Questions To Ponder II

• Who should define our priorities?
• 2. Are your priorities connected to perceived
  and/or real public values and need?
• 3. Is the apparent public paradox related to
  oral health a failure of leadership?
• Are health disparities in general a leadership
  failure per se or a failure to create leadership
  in the public good?
• 5. Is partnering with the community a critical
  approach to improve health outcomes?

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LEADERSHIP AND THE PUBLIC GOOD
A COMMUNITY-ORIENTED HEALTH MODEL
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Model of Physician Responsibility in Relation to
Influences on Health
Individual Patient Care
Direct Socioeconomic Influences
Broad Socioeconomic Influences
Global Health Influences
Access to Care
Domains of Professional Obligation
Domains of Professional Aspiration
JAMA, January 7, 2004, Vol. 292, No.1, Pg. 95
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Community-Oriented Health Model
HEALTH OUTCOMES
Communications
Health Professions Schools
Community Needs Community Capacity
Community Empowerment
Partnership(s)
Contracts
Educators Practitioners Caregivers
Citizens
Determinants of Health
Outcomes Higher Health Level

• Safer environment
• Decreased communicable diseases
• Decrease chronic diseases
• Improve immunization
• Improve access to care
• Decrease prevalence of oral disease

• Higher level of self-care
• Improved nutrition/food supply
• Improved literacy
• Reduced poverty
• Improve specific health status measures
• Improve utilization of health services

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Based on an understanding that a public good is
worth pursuing, leadership must
Understand community need Understand
community capacity Be willing to engage
societal issues consonant with academic or
public health mission Be willing to establish
shared goals and implementation
strategies Be willing to understand community
expectations Be willing to measure success
outcomes Be willing to be both flexible and
persistent!
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PRACTICAL LEADERSHIP
Make work fun! Use celebrations to create
relationships Equip people to make decisions
Become a risk doctor help people recover
from mistakes Make your organization and
personal mission, vision and values clear then
hold the reins loosely Stamp out bureaucracy
make rules your servants Deal with people, not
positions Train for skill Hire for spirit,
spunk and enthusiasm Look for creative,
unconventional ways to tell your story When
serving others (the community), make sure that
good enough is never good enough
Freiberg, K, Freiberg, J, Nuts, New York,
Broadway Books, 1996
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Questions To Ponder III

• Can you define your customers?
• 2. Do you perceive leadership as a position of
  power?
• Do you believe the Lone Ranger is an
  appropriate leadership metaphor?
• Do you believe that leaders are servants by
  nature?
• Do you believe people are born leaders?

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MAKE VISION THE BOSS!
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LEADERSHIP IS ALL ABOUT PEOPLE AND MAKING THINGS
HAPPEN
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There is a Special Place in Hell Reserved for the
Morally Indifferent and Safely Neutral.
- Dante