In my career, I have been very fortunate to have received mentorship from several amazing individuals across the disciplines of medicine, nursing, business, and law. As I recently reflected on those relationships and what they mean to me, I noted several common themes in the way these mentors approached their work with me.
First, they were unselfish in allowing me time to listen or to provide feedback. Second, they were highly committed to my success. Third, they were transparent and honest, and their feedback was always timely.
Sometimes I did not agree with the feedback, but I listened intently because I knew it was offered with a genuine interest in improving my performance. The feedback was often timely enough that I could remember the circumstance or situation that my mentor used as an example. These have become “life lessons” because I can remember the circumstances from which the feedback evolved.
Finally, my mentors never told me what to do, but they provided valuable and objective feedback that I could use to improve my thinking and make better decisions.
At various points in my career and in different roles, I was able to embrace mentors who had focused expertise based on where I was on my career journey, the role I filled, and the role to which I aspired. Importantly, these relationships were deeply personal; hence, I am fortunate, even today, to benefit from the ongoing feedback that several of my mentors provide. Here, I want to share some of the most memorable pieces of advice I have received in the hope that you may find them useful to you or those you mentor in leadership.
Lesson 1. Providers own the practice of their discipline, but administrators own the processes of care.
This advice was offered by one of my most memorable mentors. A nurse by background, she taught me many things when I was a young medical director. This advice came as I worked with a team struggling to improve care for a specific group of hospitalized patients. Week after week, I continued to default to my comfort zone: to engage in conversations about the clinical care being delivered.
She reminded me that I was not responsible for the practice of medicine, which she defined as the relationship between the providers and their patients. This provider group was outstanding in their knowledge and expertise; they knew how to care for patients and did not need our assistance. Rather, our responsibility was to ensure they had the tools and resources they needed to provide the quality of care to which they aspired.
By listening and offering support through data with reports, process analysis techniques, eliminating administrative burdens, and facilitating efficiencies, the group improved care, and we were perceived as valuable partners to this team and its patients. Through this experience, I learned to value the expertise of our team members and to recognize that my role was to complement their expertise by providing resources and a different lens for the work that they were doing.
Lesson 2. There is nothing that can’t be solved with a good old conversation.
In another mentorship moment, my mentor asked me how a physician responded to my calls. My response was that we had exchanged a series of emails and were clearly not seeing the problem in the same way. My mentor asked me to pause to consider how I communicated my concerns. We both knew this physician to be a bright, honest, good partner and team member. Perhaps he and I each had a different mental configuration of the problem.
Healthcare leadership depends on effective bidirectional communication. As an industry, we have become heavily dependent on email and its advantages; however, we must admit that email management consumes a large part of our day and has a few pitfalls that can get in the way of effective communication. All too often, email has replaced a much-needed conversation.
Email is asynchronous, so there may be time lapses between sending a message and receiving a response. The words and tone of an email can be misconstrued. An email is “static” in that it does not allow for clarification or details beyond what is offered at the moment. Unfortunately, because much of email is handled within the context of the day, we’ll often click off a quick response to a problem that needs a different form of communication simply to clear our inbox.
I learned from this example that people benefit from different forms of communication. Email may work much of the time, but by using the cell phone as a point-to-point communication device, we can reach a colleague directly and have a brief conversation that eliminates ambiguity, contributes to solving problems, and promotes meaningful relationships. The time invested in this type of communication is often more efficient for complex topics and goes a long way toward engaging partners in the work. Email can be an effective follow-up after the parties have had a conversation and shared the intricacies of the problem.
Lesson 3. Leadership is a lot like politics: The work requires that you caucus.
When this advice was first offered, I did not fully appreciate or understand it. One of the major responsibilities of leadership is to influence and persuade diverse constituent groups to move in a singular direction. This may involve advancing a particular strategy or moving a specific priority forward.
Creating the background and series of talking points that suggest a particular direction is important but insufficient. The real work is to take that body of work and meet individually or in small groups to share it and get feedback from others. This achieves three major goals. First, you hear feedback that can improve the final product. Second, people become invested because you thought enough of them to ask their opinion. Third, when you are sharing with a broader audience, some of the audience will have heard it before and be able to offer their support.
This experience taught me that most of my leadership work was done behind the scenes, engaging with others, listening to feedback, and gathering consensus. When you walk into a room for a vote, you want to be confident that you know which direction the vote will go.
Lesson 4. There is no better operational experience in healthcare than improving quality for patients.
Physician leaders who aspire to advance their leadership careers may ask how to acquire additional operational experience. As a new vice president, I asked my then mentor, who was a physician chief executive officer, similar questions. His response was not what I expected. He said, “You oversee a quality program for a large health system and are trying to figure out how to stop people from getting infections during hospitalization, not get injured by the medications we give them, and to live when we thought they might die. It doesn’t get any more operational than that in healthcare.”
This observation, which was so straightforward to him, made me realize that I was focused on the wrong work. All too often, physician leaders focus on acquiring the next appropriate competency in areas like finance, human resources, and operations, which are all important areas that require proficiency; however, as physician leaders, we must also realize the unique strengths and contributions that come from our daily work in areas beyond traditional business. We must not feel vulnerable or undervalued; we are experts in good patient care, and as a good team, we will benefit from experts from various backgrounds.
Physician leaders must be competent in the key concepts derived from these other disciplines so that we can understand the language they use and effectively communicate with them. Still, we must realize the unique contributions of being a physician leader.
I learned from this memory to focus on the work before me and ensure that I was learning from other disciplines to the degree that I could. Years later, during an interview for a leadership role, a board member questioned my financial experience, and my response came directly from this example. I said there are 40 certified public accountants in finance and four on the leadership team. If I have a financial question, I can always ask one of the experts, just like I would expect them to ask me a clinical question.
Lesson 5. We should never run the organization on the backs of our employees.
Of all the mentorship lessons I have learned over the years, this example has retained its prominence. I enjoy moving quickly and am stimulated by change, but this is not the case for all team members. As leaders, we know the challenges confronting our teams as they work daily to do a good job. The work is stressful; the processes are complex and inefficient. We sometimes assign more work than our teams can reasonably accomplish in a given time period. Yet, the business of healthcare is dynamic and fast-moving, and we rely on those we work with to help us understand the other areas of focus.
Context always matters. Too often, as physician leaders, we look for solutions that can address a priority problem; however, we fail to recognize the challenges facing those we ask to implement the solutions. I remember a great member of my team who made me a better leader through his thoughts and responses. He was a hard worker and a good person, and although he had a different leadership style from mine, he was a solid leader who knew how to get things done.
When I shared another priority that needed to be addressed, he respectfully laid out the five other top priorities I had him working on and asked for feedback on how he should organize the list to achieve what I thought was in the best interest of our organization. This simple reflection reminded me of the important advice my mentor had given me many years ago. Healthcare differs from any other industry because we work with and for people. Leaders need to be aware of our style, work, and priorities and ensure we are not sending indirect messages that cause our teams and employees to feel distressed.
Conclusion
Mentorship matters. My hope for each of you is that you are fortunate enough to find a mentor in your career who is selfless and can provide the kind of honest feedback that you need to grow. Also, consider what a difference you might make to someone else by serving as a mentor.
If you have been fortunate enough to have had a mentor, you know how important that was to you. Pay it forward. One of our biggest responsibilities as leaders is to empower the next generation of leaders with the skills and tools they need to lead healthcare into the future. Our lives may depend upon it.