Healthcare Leadership for Introverts

Leadership does not need to be a dramatic, fist in the air and trumpets blaring activity.

—Scott Berkun(1)

Healthcare leaders often are described in terms that we associate with extroverts, such as forceful, dynamic, outgoing, high-spirited, exuberant, and social. It’s no surprise, then, that many people assume that extroverts make the best leaders. This belief is reinforced by the many successful extroverted leaders we’ve witnessed in action, but also by a sweeping cultural shift that began in the 1920s and 1930s. Back then, Dale Carnegie’s courses and his book How to Win Friends and Influence People soared in popularity and became a catalyst for what Cain(2) has dubbed a new “Culture of Personality.” Cain explains, “Americans started to focus on how others perceived them. They became captivated by people who were bold and entertaining.” Americans were increasingly drawn to matinee idols, politicians, business leaders, religious leaders, friends, and neighbors who were outgoing, charismatic, and extroverted. Our love affair with extroversion flourished throughout the remainder of the 20th century and continues to thrive in our culture today.

Throughout history and even during and after our cultural shift toward extroversion, however, some of our most effective, successful, and famous leaders have been introverts. For example, Monych(3) writes, Bill Gates, Warren Buffett, Mark Zuckerberg, Elon Musk, Abraham Lincoln, and Mahatma Gandhi are/were introverts. The Harvard Division of Continuing Education(4) adds Oprah Winfrey, Ruth Bader Ginsberg, and Michael Jordan to the list of introverted leaders. Rampton(5) reports that Steven Spielberg, Al Gore, Hillary Clinton, and Barack Obama are introverts. And Kahnweiler(6) says that Nelson Mandela, Mother Theresa, and Martin Luther King Jr. were introverts too.

Oprah and President Obama aside, most introverts choose to keep out of the limelight, and many people think that that’s where they should stay. Belknap(7) explains, “The world is full of loud sports events, loud parties, and loud traffic. It’s full of open office layouts, big-gathering holiday parties, and more meetings than you can shake a stick at.” In many healthcare organizations, group brainstorming, in-person networking, board meetings, community outreach programs, and splashy fundraisers and events for donors are the norm. Leaders often find themselves having to work a room or to perform in front of large numbers of people with all eyes upon them. It would seem that introverts would be ill-suited to these leadership tasks. But if that’s the case, how can we explain why there have been so many examples of introverts who have been great leaders? Are they flukes? Are introverts better suited to the challenges of leadership than a lot of people think, and if so, how? And what exactly do effective introverted leaders do to thrive in what Belknap describes as an “extroverted world”?

What Is Introversion?

Imagine that you can store your energy in a rechargeable battery. Extroverts charge their batteries by being with people, whereas introverts charge their batteries by going within and taking time alone. Most people are not extreme introverts or extroverts but fall somewhere toward the middle range of the introvert/extrovert spectrum. According to Kahlweiler, quoted in Inam,(8) “Where you fall [on the spectrum] can often be determined by how important it is for you to have a break after being with people. If you must have a break, you may be more introverted. If taking a break from people is nice, but not necessary, you may fall on the extroverted side.” Kahlweiler reports that an estimated 40% to 60% of people fall on the introverted side of the spectrum and that they share many of the same patterns of behavior. For example, Ellis(9) says that introverts:

• Need quiet to concentrate;

• Are reflective;

• Are self-aware;

• Take time making decisions;

• Feel comfortable being alone;

• Don’t like group work;

• Prefer to write rather than talk;

• Feel tired after being in a crowd;

• Have few friendships but are very close with these friends;

• Daydream or use their imaginations to work out problems; and

• Retreat into their own minds to rest.

Scientists don’t know for sure if there’s a cause for introversion or extroversion. What they do know is that the brains of the two personality types work differently from one other. Ellis reports, “Researchers have found that introverts have a higher blood flow to their frontal lobe than extroverts do. This part of the brain helps you remember things, solve problems, and plan ahead.” Introvert brains also react differently to dopamine than extrovert brains do. Introverts and extroverts have the same amount of the chemical, but extrovert brains get an excited buzz from their reward center. Introverts, on the other hand, tend to feel “run-down by it,” Ellis says.

Introverts are often more misunderstood and undervalued than extroverts, especially in highly extroverted workplaces and cultures. Inam explains, “Their [introverts’] lack of seeking attention is often misconstrued as lack of ambition, lack of ability to connect with people, or lack of being able to influence and lead others.” Often, introverts are more reserved and calmer than extroverts, express their thoughts after reflection, are private (especially at first), and have a low-key or neutral facial expression. They typically prefer small group or one-on-one discussions and often are humble. These characteristics are sometimes misconstrued for weakness, especially when compared with the behaviors we see in gregarious, highly social extroverts. Ellis says that other misconceptions about introverts are that they are unfriendly and hard to get to know and that they don’t make good leaders. However, the opposite is often true. Being an introvert doesn’t affect how friendly you may be, Ellis says, and introverts often develop very deep friendships. As well, Ellis says, “Some of their [introvert’s] qualities make them effective leaders.”

Another area of misunderstanding is that it is not as easy to spot an introvert as many people think. Belknap explains, “Extroverts would be surprised at how many people are introverts because we have learned to act at being extroverts.” Extroversion is expected in the United States and in most of the western world, Belknap says. In fact, introverts who are attuned to this expectation and who have the desire and strength to succeed will usually develop their extroverted tendencies and bring them to the forefront when the situation calls for it. That can explain why introverts may behave more in a more extroverted fashion in the workplace, at social events, and when they go on a dating app than they do in other parts of their lives.

The Advantages of Being an Introverted Leader

The job of healthcare leaders is not only to rally the troops, talk, and push their followers forward. Leaders also must be able to adjust their strategies based on new data, input, and analysis. They must be active listeners and astute observers who are able to summarize and synthesize key points for their followers. Often, leaders must recognize what others do not see and anticipate what others do not anticipate. Belknap says, “Yes, extroverts can do that, but introverts were born to do it.”

Furthermore, the ability to pay careful attention to others generally goes hand in hand with introversion. Miller suggests, “An extrovert will speak a lot when placed in any group, thus making them the center of attention.” Introverts, on the other hand, are less often the focus of attention. Their introverted traits—listening to others, paying attention to details, quiet reflection, critical outside-the-box-thinking, and problem solving—are what often help them to excel as leaders. Monych explains, “After all, it takes a listener to gather customer feedback and employee observations, and a critical thinker to put together common elements that may result in a new business opportunity.” An introverted leader is likely to listen actively and to think critically before rushing to judgment and speaking. In today’s complex workplace, Monych says, a well-thought-out response may be the better option than quick action (depending upon the urgency of the circumstances, of course).

Introverts can also be excellent communicators and tend to excel particularly at writing. Kahlweiler (interviewed by Inam) says, “They prefer writing to speaking and will clarify their points through carefully thought-out emails.” Introverts tend also to be very well-prepared speakers. They usually take less airtime at meetings than extroverts and let others do more of the talking. By listening and not speaking, they set the stage for people to “step into their own strengths,” Kahlweiler says. As well, when introverts do speak, people generally pay close attention precisely because they don’t talk all the time. As Miller(10) explains, “There is power in silence.”

Introverted leaders may have an edge over extroverts when communicating with younger employees.

Additionally, introverted leaders may have an edge over extroverts when communicating with younger employees. Monych explains, “Extroverts, brace yourselves. Today’s all-digital, all-the-time environment means that young people entering the workforce tend to communicate in a more introverted fashion.” They’re accustomed to highly individualized social interaction and communicating by text, social media, and email to access and share information, Monych says. This change, already seen in workplaces that hire millennials, points to training and development opportunities for extroverted employees so they can learn how to succeed in today’s more introverted work environments. Introverts will probably find it easy to adjust to this workplace culture shift, Monych suggests.

Finally, introverts tend to be humble, and it is their quiet humility that has pushed many of them up the chain of authority. Miller says, “They [introverts] don’t boast about their accomplishments” and are quick and happy to give credit to others. Introverts usually acknowledge their mistakes and accept their limitations. Being naturally and genuinely humble, introverts welcome new ideas and suggestions without feeling threatened. “It is this trait [humility] that makes introverts quietly confident,” Miller says.

The Challenges of Being an Introverted Leader

Any overused strength becomes a weakness, and this is as true for introverted leaders as anyone else. Introverted leaders face several challenges. For example, they may:

• Miss opportunities to build relationships: Kahlweiler (interviewed by Inam) suggests that introverted leaders can become too comfortable in their solitude and avoid building key relationships.

• Miss opportunities for new projects and promotions: Introverted leaders don’t like to toot their own horns and, as a result, may stay under the radar and be passed over for new projects and promotions. Kahlweiler explains, “If you inform people about what you are accomplishing, they will better understand your value and consider you for opportunities.”

• Be too empathetic: Introverted leaders are keen observers and prone to being more empathetic than extroverted leaders. Wakowski(11) explains, “This trait [empathy] is not always welcome in leaders because it restricts them from being tough enough when the situation so requires.”

• Lack small talk skills: Introverted leaders may not be the best at small talk, which Wakowski describes as “an important factor in developing relationships between colleagues.”

• Find interruptions draining: Introverted leaders are easily distracted and challenged by external stimuli. Cornes(12) says, “While they might be too nice to say anything, they get very frustrated with constant interruptions when they are trying to concentrate.” Workplaces where people are constantly striking up conversations or breaking up the day with meetings make it almost impossible for introverts to engage in deep thought, Cornes says.

• Have smaller networks: While extroverts collect contacts easily, introverts are likely to have smaller networks. They may not have the breadth of relationships that extroverts do. Therefore, they may not know as many people who can help them or who have faced the leadership challenges they’re facing.

• Encourage others to invent things about them: Introverts are more likely to be labeled as weird or snobbish than extroverts because they don’t interact as much. Elkins(13) explains, “In almost every real-life situation, folks are going to be suspicious of the person who keeps to themselves.” Others may invent things about an introverted leader in the absence of personal experience, and they may assign a lot of negative traits to them. For example, Elkins says, others may think, “She’s aloof. Snobby. Has something to hide. Strange. Selfish.” Occasionally, people may invent something good about an introverted leader, but 80% of the time the introvert is going to be a “shady character,” Elkins says.

• Need time to recharge: Introverts need time away from others to regain their energy, especially after highly social events, and there will be consequences if they don’t get that time. For instance, they may become frustrated, irritable, and fatigued. They may also lose focus and experience headaches or other physical symptoms of stress. Cornes(12) explains, “If they are forced to sacrifice this [down time], they won’t be operating at full capacity until they have had a break.”

Ten Strategies for Introverted Healthcare Leaders

Extroverts stepping into leadership often do so with a lot of advantages. They find their energy from being with others and do not need as much time to themselves. They are usually accepted and embraced quickly by their followers because they act the way most people expect leaders to act. What you see with extroverts is typically what you get. Introverted leaders, on the other hand, often have a harder row to hoe. They may have to overcome strong misconceptions and cultural biases against them. Crockett,(14) citing various research studies, reports several concerning findings for introverted leaders. For example, Crockett says:

• 96% of high-level executives self-identify as extroverts.

• There is a strong, scientifically proven bias against leadership candidates who fall on the introverted end of the spectrum.

• Extroversion is consistently ranked by research participants as the most important trait a leader can have.

• 65% of senior executives see introversion as a “barrier to leadership.”

• Only 6% of research participants think introverts have the people skills required to oversee a successful team.

• 71% of research participants said that they believed that there was a stigma against hiring introverts into a leadership role.

Many businesses have a singular vision for what a good leader should be—outgoing, gregarious, and an expert networker. They write off introversion as a form of social “pathology,” Crockett says. Nonetheless, introverts can, do, and must overcome the misconceptions and biases against them when they aspire to leadership. Here are 10 strategies that will help introverted healthcare leaders thrive in an extroverted, often biased world.

1. Describe yourself in positive terms. Don’t label yourself as an introvert. Tekeli(15) warns that labeling is “dangerous territory” and brings with it a lot of baggage that isn’t necessarily your truth. Focus instead on describing your introverted characteristics and tendencies as strengths. For example, are you detail-oriented, analytical, and a quick study with strong strategic skills? Are you an astute observer, an active listener, and a reflective and thoughtful speaker? These positive traits are less likely to elicit bias than the label “introvert” will.

2. Actionize your observations. Introverted leaders usually are keen observers who notice things that others miss. However, your observations alone may leave others in a quandary about what you want or expect them to do. Crockett says, “Turn all your listening and observing into actionable suggestions.”

3. Be brave and push yourself. Miller-Merrill(15) suggests, “We all must learn to push ourselves if we want to grow personally and professionally.” That means that introverted leaders may at times have to push themselves into conversations and into social situations where they feel vulnerable. Keep in mind, though, that there is a big difference between needing time alone and hiding from challenges. Do not use your preference for solitude to shrink from challenges, avoid risk, or miss difficult conversations that you should be part of.

4. Be genuine. An introverted leader does not need to play act at being highly extroverted to be successful. Therefore, don’t force yourself to be the bubbly, back-slapping, joke-telling life of the party. Push yourself, yes, but only within reason. As Crockett says, “Be unapologetically genuine.”

5. Communicate what you are thinking. Introverts can be hard to read, which sometimes leaves others feeling uncertain and uncomfortable. They will fill in any blanks that you leave for them. Therefore, clearly describe what is in your head so people can stop guessing or jumping to the wrong conclusions. Lederman(15) suggests, “Provide your team with information in multiple ways. Make them feel in the loop and watch productivity soar.”

6. Schedule and prioritize alone time. Time to oneself is a key to success for introverts. Carve time for yourself away from draining stimuli, both at work and at home. For example, Garnett(15) suggests, introverts may find that being alone for the first hour of the day can be very helpful and worthwhile, even if that means that they must wake up an hour earlier. Guthrie(15) suggests that the most successful introverted leaders find ways to carve 10- or 15-minute intervals out of the workday for quiet decompression time to recharge their empty “social/people tank.” In addition, they leave one or two evenings a week free from work or social obligations to recharge, Guthrie says. Crockett suggests that ideally, “For every 1-hour meeting, make sure to plan at least 30 minutes to yourself.” While that may not always be possible, you get the point. Introverted leaders cannot go to meeting after meeting all day every day without a break, without suffering the consequences. Schedule alone time as you plan your calendar.

7. Ask more questions. Of course, introverted leaders can say what’s on their minds whenever they choose. However, they may find it uncomfortable to speak or difficult to be heard over the most extroverted voices in the room. Ma(16) suggests, “A simple way to fix this is to ask if you can lead the agenda, which gives you the opportunity to talk first.” Then, “depersonalize” your ideas, Ma says, by turning them into questions. For example, Ma suggests, ask, “Should we consider researching the topic further as the takeaway from today’s meeting?”

8. Create an introvert-friendly work environment. Think about the work environment that would allow you to do your best work. Then create a work culture that supports that environment. For example, Ma suggests, introverted leaders will shine when they can mull things over before they must render their opinions. Therefore, create opportunities and time for research, reflection, and preparation before meetings. Or, Markow(17) suggests, “Make one-on-one meetings part of your leadership style.” Although large group meetings are inevitable, plan your meetings when you can so you can communicate individually or in smaller groups. Space your big meetings and limit your open-door office hours. As well, use electronic communication rather than face-to-face when you can do so without sacrificing work quality.

9. Build a strong team. Every leader has strengths and weaknesses, and no one person can be expected to excel in every skill area. That’s why astute healthcare leaders, whether introverts or extroverts, create teams of diverse individuals who complement one another and fill in the skill gaps. For example, Friedman(18) says, “For me, I wanted at least one person with team/industry experience, at least one with deep technical expertise, and most importantly, at least one extroverted ‘people person’ who could strike up conversations and develop connections.”

10. Step up during times of crisis. There will be moments when everyone is going to look to you for leadership, so be sure that you give it to them. Take the strong stand, be decisive and reassuring, speak up, and put yourself front and center when that is what is best for you to do your job.

Create an Introvert Affinity Group

Many healthcare organizations form affinity groups for their employees. Kalish(19) explains that an affinity group is “a group of people having a common interest or goal.” In the workplace, an affinity group can be a sports league, a book club, or a club focusing on a hobby or recreational activity. However, in most organizations, the most powerful affinity groups will be those that focus on creating a diverse and inclusive workplace, Kalish says.

For example, many organizations form affinity groups for LGBTQ employees, employees with disabilities, women in leadership, Hispanic employees, and employees who are veterans. In addition, Friedman argues employers should form affinity groups for their introverted employees. Such groups can provide a safe space for introverts to talk about their challenges at work and to learn effective coping strategies, Friedman says. In a much larger context, leadership’s support for an introvert affinity group (or multiple groups at all levels within the organization) can become a powerful statement to all employees. Top-down support for introverts can change the culture of the organization while providing an opportunity for introverted employees to “bring voice to the table,” Friedman says.

References

1. Ho L. Interview with Scott Berkun. Lifehack. www.lifehack.org/articles/lifehack/interview-with-scott-berkun.html . Accessed March 24, 2022.

2. Cain S. Quiet: The Power of Introverts in a World that Can’t Stop Talking. New York: Crown Publishers; 2012.

3. Monych B. The surprising reasons why introverts make exceptional leaders. Insperity. www.insperity.com/blog/the-surprising-reasons-why-introverts-make-exceptional-leaders/ . Accessed March 21, 2022.

4. Harvard Division of Continuing Education. Introverts as leaders: quiet power as a leadership strength. Professional Development Program. https://professional.dce.harvard.edu/programs/introverts-as-leaders-quiet-power-as-a-leadership-strength/#outcomes . Accessed March 21, 2022.

5. Rampton J. 23 of the most amazingly successful introverts in history. Inc. July 20, 2015. www.inc.com/hannah-hall/radio-flyer-hero-wagon-design-innovation.html . Accessed March 21, 2022.

6. Kahlweiler JB. The Introverted Leader: Building on Your Quiet Strength. 2nd ed. Oakland, CA: Berrett-Kohler Publishers; 2018.

7. Belknap T. Leadership for Introverts: The Power of Quiet Influence. Takoma, WA: Port Bell; 2018.

8. Inam H. The good news for introverted leaders. Forbes. April 15, 2018. www.forbes.com/sites/hennainam/2018/04/15/the-good-news-for-introverted-leaders/?sh=160a244c192f . Accessed March 22, 2022.

9. Ellis RR. Introvert personality. WebMD. June 24, 2020. www.webmd.com/balance/introvert-personality-overview . Accessed March 22, 2022.

10. Miller B. 7 reasons why introverts make great leaders. About Leaders. https://aboutleaders.com/introverts-great-leaders/ . Accessed March 24, 2022.

11. Wakowski A. 4 weaknesses introverted leaders can turn into strengths. Healthline. https://aboutleaders.com/introverted-leaders/ . Accessed March 25, 2022.

12. Cornes J. The strengths and weaknesses of being an introvert. Jason Cornes. www.jasoncornes.co.uk/blog/the-strengths-and-weaknesses-of-being-an-introvert . Accessed March 28, 2022.

13. Elkins K. 7 disadvantages of being an introvert. Insider. May 7, 2015. www.businessinsider.com/disadvantages-of-being-an-introvert-2015-5 . Accessed March 25, 2022.

14. Crockett Z. 65% of execs think introverts are bad leaders. Here’s why that’s BS. Hustle. May 16, 2022. https://thehustle.co/65-of-execs-think-introverts-are-bad-leaders-heres-why-thats-bs/ . Accessed March 28, 2021.

15. Tekeli C, Miller-Merril J, Lederman M, Garnett L, Guthrie L, Forbes Coaches Council. 12 challenges introverted leaders face and how to overcome them. Forbes Coaches Council. https://www.forbes.com/sites/forbescoachescouncil/2016/03/08/12-challenges-introverted-leaders-face-and-how-to-overcome-them/?sh=352739cf57bb . Accessed March 28, 2022.

16. Ma S. How I’ve used these 4 “flaws” to my advantage as an introverted leader. Fast Company. September 6, 2018. www.fastcompany.com/90232320/how-ive-used-these-4-flaws-to-my-advantage-as-an-introverted-leader . Accessed March 28, 2022.

17. Markow J. Nine tips to help introverted leaders succeed in the workplace. Forbes Coaches Council. www.forbes.com/sites/forbescoachescouncil/2018/03/02/nine-tips-to-help-introverted-leaders-succeed-in-the-workplace/?sh=30d145a24300 . Accessed March 28, 2022.

18. Friedman S. 10 survival tips for introverted leaders. Introvert, Dear. May 7, 2021. https://introvertdear.com/news/10-survival-tips-for-introverted-leaders/ . Accessed March 28, 2022.

19. Kalish A. How to start an affinity group at work, according to real people who did it. The Muse. www.themuse.com/advice/how-to-start-an-employee-resource-affinity-group-in-the-workplace . Accessed March 29, 2022.

20. Bainbridge C. The difference between being shy and introverted. Very Well Family. February 25, 2021. www.verywellfamily.com/the-difference-between-being-shy-and-being-introverted-1448616 . Accessed March 22, 2022.

21. Curtin M. Are you shy or are you introverted? Science says this is the difference between them. Inc. May 31, 2018. www.inc.com/melanie-curtin/are-you-shy-or-introverted-science-says-this-is-1-primary-difference.html . Accessed March 22, 2022.

22. What you should know about shyness. Healthline. www.healthline.com/health/shyness#signs . Accessed March 26, 2022.

Introverted or Shy? Who Makes the Better Leader?

Being introverted and being shy are not the same thing, even though a shared preference for alone time may look the same to a casual observer. Bainbridge(20) explains, “An introvert enjoys time alone and gets emotionally drained after spending a lot of time with others. A shy person doesn’t necessarily want to be alone but is afraid to interact with others.” Not all introverts are shy, and many have excellent social skills. However, after engaging in social activities, introverts tend to feel emotionally drained and need time alone to recharge their emotional batteries.

Introversion is a personally type; shyness is an emotion. Bainbridge explains, “People can get therapy for shyness, but not for introversion.” Introverts are not weak, damaged, or sick. As Cain suggests, “Don’t think of introversion as something that needs to be cured.” Introverts can and often do learn how to succeed in more extroverted environments. Nonetheless, they will always be true to their stripes. Bainbridge explains, “Introverts can learn coping strategies to help them deal with social situations, but they will always be introverts.” Shy people, on the other hand, can learn to overcome or at least reduce their shyness, usually with therapy and practice.

A key distinction between shy and introverted people can be found in the ways that their anxiety plays out. Curtin(21) explains, “Introverts can choose to be social and interact with others; they often just don’t want to. Shy people—depending on the level of shyness—can’t make that same choice without a high cost.” For them, a party isn’t just a drain (as it can be for an introvert); it’s a struggle. Ellis(8) suggests that people who are shy tend to feel awkward or uncomfortable when they’re in social situations, especially when they’re around strangers. Their discomfort can manifest physically and become intense. According to Ellis, “They [shy people] may feel so nervous, they become sweaty. Their heart may beat quicker, and they may get a stomachache.” Shy people may be inclined to skip social events because they don’t like the negative feelings that take over their thoughts and bodies when they go to parties, big meetings, or other social activities. People who are introverted may also prefer to skip social events, but for a different reason. They probably know that they will feel more energized or comfortable doing things on their own or with one or two other people. Ellis explains, “Introverts don’t choose to skip social events because they have strong negative reactions to larger gatherings the way that shy people do; they just prefer being alone or in very small groups.”

Shy people will find it challenging to be thrust time and again into the social requirements of leadership. Healthline (22) suggests that relaxation techniques such as deep breathing can help shy people to cope with their anxiety. Group therapy can also be helpful in adults experiencing shyness. Healthline adds, “In rare instances, medication can provide temporary relief for shyness.” But left untreated, very shy people would be unlikely to succeed in a conventional leadership role without experiencing significant anxiety that would take an enormous toll on them emotionally and physically. Introverts, on the other hand, can and often do become great leaders.