Leadership Lessons for Physicians from Ted Lasso

Apple TV+ launched “Ted Lasso” in the fall of 2020. The series focuses on an American football coach (played by Jason Sudeikis) who is hired to coach an English soccer team. But Ted Lasso is less about sports and more about leadership. A Golden Globe, a Screen Actors Guild, and a Critics Choice Award later, along with charming an ever-growing audience, we are ready for the second season. In this episode of SoundPractice we will talk with Gary Schwartz, MD, MHA, President, Associated Eye Care, about his LinkedIn article, “Leadership Lessons from Season One of Ted Lasso.” Dr. Schwartz found ten crucial leadership lessons woven into the Ted Lasso series. This episode serves proof that SoundPractice can be hip, socially relevant, and educational -- simultaneously.

View the LinkedIn article here .

Mike Sacopulos: My guest today is Dr. Gary Schwartz. He's a practicing ophthalmologist in Stillwater, Minnesota, and is president of the Associated Eye Care. Dr. Schwartz, welcome to Sound Practice.

Dr. Gary Schwartz: Thank you. I'm happy to be here.

Mike Sacopulos: We're going to be talking about Ted Lasso. For those unfamiliar. Could you give me a plot summary?

Gary Schwartz: Sure. Ted Lasso was a show that season one aired on Apple TV. Season two airs this Friday, so we're recording this prior to the dropping of the new season. Ted lasso is an American college level football coach who, for reasons that are plot devices, ends up taking a job in England and becoming a Premier League soccer coach. It follows his story of a fish out of water who goes from college level to the highest professional level and goes from American football to European football or soccer.

Mike Sacopulos: Maybe we should just get this out in the open right now. Would Ted Lasso be a good physician, or is he lacking some skills critical to being a physician?

Dr. Gary Schwartz: The audience for this podcast is mostly physician leaders, so the question is would Ted make a good physician? Would he make a good leader? His skill set is mostly in leadership. He's a leader of men. He's a coach of a team who values development of his players above all else. He would likely not make a good physician because his weakness is the mastery of fundamental facts. Part of the joke of the show is he's coaching this soccer team, but he really doesn't know much about soccer. He's coaching in England, and he doesn't know much about England. To be a physician, you must have a skill set to be able to diagnose and manage and treat. And that's where Ted Lasso would fall short. Although he makes a great leader, he would not necessarily make a great physician.

Mike Sacopulos: Now you've written a great article that you posted on LinkedIn. Through analysis and insight, you've been able to drive 10 leadership lessons from Ted Lasso. The first lesson you describe is the importance of culture. How does the series convey culture? Perhaps you can talk a little bit about that as it might apply to healthcare.

Dr. Gary Schwartz: Sure. Let me start off by describing the article I wrote. For something to do this winter, while we were all shut in, I watched the show Ted Lasso. I made some connections there that regarding interesting leadership lessons. I just wrote this fun, started off as a one- or two-page throwaway that turned out to be a seven- or eight-page essay, and I posted it on my LinkedIn. As a member of the American Association for Physician Leadership, I also posted it in the AAPL Community forum. It got traction there so that is why we are talking about it today!

On the question of culture, culture is central to everything. The way we see culture play out in the show is mainly in the locker room and on the practice field. It also shows how the players treat one another and how the players treat the character, Nathan, who's the “Kit Man.” He’s a low-level employee, the guy who does the laundry and makes sure the lockers are stocked up and things like that. Starting with Episode one, the Ted Lasso character played by Jason Sudeikis, can see that there’s trouble in his locker room.

There are different camps. There's the leader of the team, the team captain, the character named Roy Kent. He really sits back, and he is complicit in bad behavior because he doesn't step in to stop it. Then there's an unofficial leader, the younger star player named Jamie Tartt. He’s the informal leader and he's a bully. He has a group of followers who are also bullies. What Ted Lasso determines is this is a culture that needs improvement and that he’s going to work to improve this culture.

Now what's interesting is they're not necessarily a losing team. The reason Ted Lasso is brought in isn't to make the team better. The reason he's brought in, and unbeknownst to Ted, (in this plot device) is because the new owner of the team is a divorced woman who got the team in a divorce settlement. She hires inexperienced Ted Lasso to spite her husband and to cause the team to lose. She wants the team to become an embarrassment, because the team was so important to the husband. But the football team is a winning team. We don't know how good their record is, but they're winning enough that they stay at the Premier League level. Premier League soccer in England is different than American sports, whereas the bottom few teams get relegated and that is something that happens during the season. This and means they move down to a lower league, and the top few teams of the lower league move up the next season.

Mike Sacopulos: Interesting. Lesson number two that you came up with is you do not have to know everything. I have to say, that is reassuring to me, Doctor Schwartz. What can you tell us about lesson number two?

Dr. Gary Schwartz: As far as the Ted Lasso character is concerned, he comes to England from America, and he seems to really make very little effort to learn the sport of soccer and to learn English culture in general. There's a repeated joke where he's about to cross the street in England and he looks to the left, which is the way you would look in the United States, and then he's about to step off the curb and somebody puts their arm out and stops him because the car's come from the right, because it is England. He hates tea. There is another running joke where every time he drinks tea, he, in a very colorful Jason Sudeikis way, he describes what tea tastes like, and just cannot believe that the English people really drink this. He thinks it's a joke that the English are playing on him.

He comes into the job not knowing much about the sport of soccer, but what does he know? He knows how to coach. He knows how to get the best from his players. He knows how to develop young men. He knows how to create a good culture in the locker room, so that's what he does know and that carries. The analogy for your AAPL physician audience is if you are a physician, yes, you need to know everything to be a good physician, but if you're a physician leader, things change.

Let's look at me. I'm an ophthalmologist, and I'm the president of a 15 doctor, 160 employee group. That's what I know; that's my space. But let's say I get courted away. Let's say a healthcare system or major hospital says, "Hey Gary, instead of being the president of a midsize ophthalmology group, how would you like to be the CMO of our hospital? Or how would you like to be in charge of ambulatory services of our hospital?" Many physicians, who spend their time as physicians thinking they must know everything, a job like that would cause analysis paralysis. It is impossible to learn everything for a new job.

As a physician leader, you need to be comfortable with the idea of knowing “everything.” You must focus on what carries over. I understand how a clinical practice works. I understand ophthalmology, but ENT is probably similar in a lot of ways. Primary care medicine is probably similar in a lot of ways. The similarities probably outweigh the differences. I know how to lead. I've led a company of 150 people, so I should be able to lead a department, or I should be able to lead a medical staff. I do not need to know everything about the hospital or everything about all the subspecialties that will be under me in my new position.

That's the analogy for the physician leader. I would not be a good ear, nose, and throat doctor. I don't have the education for that, but I might be a good CMO, or I might be a good head of clinical services.

Mike Sacopulos: For what it's worth. You've got my vote.

Dr. Gary Schwartz: I'm not applying. Ha!

Mike Sacopulos: Lesson four is one of my favorites. Call people by their name. It seems to me that this applies in a wide variety of arenas, but in healthcare, maybe this is part of the art of medicine over the science of medicine.

Dr. Gary Schwartz: Yeah, there's a personal touch using people's names. It's the art of building a practice. What do I mean by that? When I was still a resident at the University of Minnesota, we used to have this lecture from a sage ophthalmologist, who would tell us how to be in practice. You've been a resident, you've been a student, how do you be in practice? One of the things he told us was, this was in the age of paper charts, if you learn something about a patient that is interesting, write it on the chart cover, so next time you see them a year later, when you really don't remember them from the 15 minutes from the prior year, you will see the note you jotted down and then you bring it up.

I practiced and trained in Minnesota, but I'm from Boston, so any Boston connection at all is interesting to me. If a patient tells me their kid was in Boston, that his daughter goes to school in Boston, their son did military service in Boston, I always jot that down. In our electronic health record, we have a place to set that up. It works. And I'll say to them, "Oh, is your daughter still in Boston?" They'll say, "Oh my goodness, Dr. Schwartz, you always remember that. Yeah, she still is." "You get out to see her at all?" If I bump into them in the grocery store, I won't remember that, but if it's in the chart, I remember that.

That's like using people's names. If you make some sort of association to them that's deeper than just yeah, your eyes look great today ma'am, your vision is 20-20, there's some sort of connection. And you want that patient choose to come back to see me next year, rather than choose to see the guy who's in this office on Tuesdays because that works best for the patient’s schedule.

It works well with staff too. If I have staff members who I know, that work closely with me and I called them by their names, but I have other staff members who I don't know as well or they're lower in the pecking order, or they're newer and I don't call them by their name, then they see that. They say, "Huh. How come he's calling that employee by her name, but he's not calling me by my name?" It may make them feel unvalued. But if I start calling them by their name, that raises, in their mind, that I value them.

Mike Sacopulos: It certainly makes them feel less fungible, right? With a name, you are individualizing the interaction. It is a great lesson.

Dr. Gary Schwartz: Yes. Here is another trick. Mike, you are an attorney so if you write many letters. If it is a formal letter, Dear Dr. Schwartz…and at the bottom, you would say, Thank you and sincerely. But what if you wrote instead, Thank you, Gary. When I get to the bottom of the letter and I see my name there, I'm like wow, there's a nice little surprise. He's considering me. By using my name there, you're humanizing that whole letter.

Mike Sacopulos: And suggesting a degree of intimacy, right? Yes. That is a good lesson. Onto number six in your list, which is seek input from others. How does Lasso do this?

Dr. Gary Schwartz: Ted Lasso seeks input from a lot of characters throughout the series, at all different levels of the organization. Some involve decisions, plays, who to start, who to bench, things like that. Some of it's personal. How do I deal with this character that's hurting the culture of my locker room? Famously, there's one character, Nathan, who we mentioned. He's the locker room guy, that famously, in the first episode, right at the end of the opening credits of the first episode, he asks Nathan his name. Nathan's response is he looks at Ted like he's joking. He doesn't answer, and then Ted Lasso says, "What is your name?" Nathan's response is, "No one's ever asked my name before."

Nathan has pictured himself so low in the team hierarchy that it is not even worth knowing his name. Then Ted convinces him, "No, I want to know your name," and then he tells him his name. Then he learns that Nathan knows a fair amount of soccer, so Ted will ask him about plays and he asks him to do a pep talk before one of the games. It is way above any of anything that Nathan would ever expect. All the previous coaches have totally ignored him. He presents some plays to Ted for consideration. Since Ted doesn’t know much about soccer, he considers them. And it works.

For me personally, I'm an ophthalmologist, I do surgery, and we learn a lot of surgery in residency, but you also perfect your surgery over the years of practice. I remember being in surgery a couple of years out, struggling with a certain part of a procedure. When you are in private practice, you don't really have anyone you can go to. I remember looking over to the scrub nurse at the time, the scrub nurse, (now scrub tech) and I said to her, "How do other doctors manage this part? There's got to be an easier way to do it than what I'm trying to do." I said this in the middle of a surgery. I just whispered to her, I was like, "How do other doctors do this?" She said, "A lot of doctors will use this," and she handed me an instrument. I looked and I said, "What do they do with this?" She responded, "They bend it around the side." "Oh yeah. I'll try it. What the heck. It's not that much different than what I'm doing, but it's different enough." I tried and I was like, "Huh. That is better."

Now this nurse then knew, down the road, if she saw me struggling with something that I didn't even realize I was struggling with, she could say to me, "Dr. So and so, he does it a little differently than you. He does this." But by soliciting that advice the first time, she knew that door was open from then on. I'm not patting myself on the back, but it's not often that a scrub nurse or a scrub tech feels empowered to say to a surgeon, "I think I know a better way you can do that," but by opening that door early in my career, I picked up some things from her that I never would've come up with on my own.

Mike Sacopulos: Or it would have taken you a long time to come up with on your own.

Dr. Gary Schwartz: Yeah. I would have had to watch videos or go to meetings and figure it out on my own eventually. But by having this relationship where the nurse knew she could volunteer that type of information to me, it made me a better surgeon at the end of the day, and it made better, safer surgery for the patients that we were taking care of together.

Mike Sacopulos: Makes a lot of sense. You were speaking of Nathan in the series, and your next lesson, number seven was to look for diamonds in the rough. That seems to be Nathan, am I right?

Dr. Gary Schwartz: Right. When we first meet Nathan, he is shy, he feels unvalued, and in a comic way. It's a comedy show after all. But he has tremendous pride. When we first meet him, he's running at Coach Lasso and the other coach, Coach Beard, who have just arrived in the UK and they're standing on the field, on the pitch. Nathan doesn't know who they are, so he runs at them saying, "Get off the grass, get off the grass, get off the grass!" He is so proud of this grass, and he's not a groundskeeper, he's the locker room guy. Then when he learns it's the new coaches, then he's like, "Oh my, I'm sorry. You're the new manager. Here, you can go back on the grass. You can back on the grass." They say, "No, no, no.” We've got to go see the president of the company, the president of the team," and so he takes them in there. Then they have the deal with, "What's your name?" Because no one in the President’s office knows who he is.

He's a diamond in the rough. He has knowledge, but it's buried so deep in there because nobody's asked him for it and he's too shy to present it. Ted must gain his trust, has to allow him to develop as a character in the show, but as a useful participant of the organization. But he grooms him. Episode by episode by episode, he does a little something to bring him out a little more. It's not just something he does once and then you have the Nathan character, it's if you watch Nathan's development over the 10-episode series, you can see, each episode, there's a little bit more, until the final episode where he's made a coach. It's a surprise ceremony where they have the whole team there, the president, the other coaches, and they do this funny thing where they have a new Kit Man in there, so Nathan thinks he's going to lose his job, and instead they're like, "No, no, no, we're promoting you to coach." Now Nathan is part of the coaching staff, which is where he belongs based on his skill set, but without Ted's development over the season, he never would have gotten there.

Mike Sacopulos: What a nice storyline. Now, your lesson number eight, I must tell you, on a personal level, I struggle with, and certainly anyone who's a parent will relate to this. Lesson number eight, about when to get involved and when not to. Tell us a little bit about that.

Dr. Gary Schwartz: Sure. Some of these, they're, well-known, just with different names. The first one was a culture. We all know Peter Drucker's, "Culture eats strategy for breakfast," so this is it. Don’t micromanage. Know where you need to be involved and know where not too.

This is a great scene early in the season where Ted Lasso is trying to affect the culture of the locker room, and the formal leader, Roy Kent, he's toward the end of his career and he's a great character. As an aside, the actor who plays him, Brett Goldstein, is one of the writers the show runner for the series. Roy Kent is angry, he's really repressed, he's this old English soccer player. He's the one person who has won a championship in his career, but now he's on this not winning team and he's on the end of his career. He's the formal leader. He's the captain of the team, and he watches this informal leader, this young Jamie Tartt, and his followers, pick on Nathan. They tease him and they throw dirty jockstraps at him and things like that. Roy just shakes his head and is like, "I can't believe these guys get away with it."

Roy goes to coach and says, because he knows coach Lasso likes Nathan, "Did you see what they're doing to Nathan in there?" Coach says, "I do. I see it." "Aren't you going to do anything about it?” Lasso says, "It's not my fight. If two kids are fighting in the playground, the teacher can't be the one to break up that fight. The kids have to settle this on their own." Roy can't believe it and it takes the rest of the episode for him to figure out what that means. Then he, through this lesson, he steps up and he ends up taking on the reigns of the leader again, and that helps bring this divided locker room together.

But that works in real life too. We're facing something like this in my practice right now. We work very hard on culture in our practice, and one thing you learn is you have micro-cultures within your organization. You have the front desk has their culture, the nurses have their culture, the techs have their culture, the call center has their culture. With one of our groups, we survey our groups on culture every fall, we found out with one of these groups, their survey levels showed problems with the culture. We knew we had a problem, so where is the problem? We resurveyed them again in a different way to try to figure out where the problems are, and it's a common response. They're not satisfied with the communication they're getting; they have some problems with the leadership and the management, and there's some bullying and gossiping. The old established workers are not treating the new workers very nicely.

From a leadership perspective, what do we do? The communication we sent out explained what we're doing and what we're going to do. The message was, "Look, we can fix the communication. We can fix the management, but this intra-departmental bullying stuff -- that's on you guys. There's no way we're going to fix this. You guys have to fix this from within." We communicated that to them directly in those words. I don't want to put too much on Ted Lasso, but if I didn't watch the series and write that essay, I don't know if I would have figured that out. I think I would have tried to solve that from leadership, and I think that would have been problematic.

Mike Sacopulos: Excellent. Let’s get to lesson number 10. Be curious and not judgmental. In your article, you have Lasso quoting Walt Whitman. Is curiosity necessary for being a good physician leader?

Dr. Gary Schwartz: Yes, I think it is. This is not a new concept, but don't jump to conclusions. The way I word it with my teenage son is, "You can usually tell what someone did, but you almost never know why someone did it," but all of us make these assumptions. We're like, "Oh, he did that because," blah, blah, blah. You don't know why he did it, you just know that he did it. Half the time, you're not even sure that he did it.

With Ted Lasso, it's the concept to be curious, not judgmental. If you see somebody doing something that you don't like or don't understand, don't jump to a conclusion that they're doing it because A, B and C. They don't like you or they're lazy, or they don't care or they're stupid, or the usual reasons. Ask them, "Why are you doing it? Why did you not do this? Or why did you do this?" Oftentimes they'll give you an answer that you haven't thought of and you're like, "Huh. That makes sense. Now I can see why you did that. That's fair. Now I have a better understanding."

The audience here are physician leaders, so as physicians, we're used to reading peer review literature and studies. The study is the purpose, the method, the results, the conclusions. Well, what is jump to conclusions? It means you don't read the methods and the results and the purpose, you just jump to the conclusions. Well, don't just jump to the conclusion, we read the other detail because that tells you why they're doing the study, how they did the study. If you just jump to the conclusion, then you skipped all the work.

Mike Sacopulos: Absolutely. Our time's almost done together. I recommend your article, and this podcast is specifically being designed to drop right at the beginning of season two. It seems like I should ask you for predictions of what you expect Ted Lasso to encounter in season two of the Apple TV series.

Dr. Gary Schwartz: I've intentionally not read anything about it because some detail is already coming out, so I've intentionally stayed naive on the subject. My hope is we continue to focus on Ted Lasso’s struggles and his successes and his failures in leading the team. Some of the main plot devices that were evident in season one, notably, the reason why he was hired was because the owner was trying to spite her ex-husband, well -- and that got resolved at the end. I think a lot of season two is going to be more player driven, for example, how does Roy Kent deal with his retirement? How does he like being an ex-player rather than a player? His now girlfriend Keeley is going to be tied up in that as well.

The one thing I do know is there's a sports psychologist who's brought in. I've seen by one of the commercials that one of the players keeps kicking the ball over the net instead of into the net, so the sports psychologist is going to be brought in for that. But I think the team must deal with not being in the Premier League anymore. They will be in the second-tier league, their identities are tied in with being professional soccer players. What does that mean now? That's the battle that I think Ted Lasso is going to have to get into. The cultural issue of last year (Roy's camp versus Jamie's camp) will likely turn into how we survive in being second best as a team. If one of Ted's coaching philosophies, is in trying to develop men to be the best that they can be, what does that mean when you're playing in the second-best league? But this is all just a guess.

Mike Sacopulos: That sounds like a good prediction. My guest on Sound Practice has been Dr. Gary Schwartz. Dr. Schwartz, thank you so much for your time. This has been so much fun.

Dr. Gary Schwartz: You're welcome. I've really enjoyed this. Let’s all look forward to Season Two!

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