Chapters Transcript My Five Principles of Effective Leadership Course: Inspired MD Summit: A Professional Growth and Leadership Development CME Event for Physicians Well, it's so great to hear how the talks overlap and kind of accentuate the key points we're talking about. I started talking about self and to Asma's point, anyone who's taken a lot of leadership training kind of takes their own pieces. You'll all find certain things that are more relevant to you, certain things you'll talk about when you leave here, and certain things hopefully you'll pay forward. So. It is hard to distill down to 5, but I call this the 5 key components that I like to bring to every group that I meet that I try and teach some type of leadership training. And remember, when we talk about leadership, it doesn't mean that you have to be responsible for other people to be a leader. You start by leading yourself, and every one of these points is appropriate, starting just with our own leadership of our own behaviors and hopefully extending out. So, number 1, problems and solutions. It's a very simple one. I teach this to the students. I try to teach it to my fellows, but I do it every 3 years. I found out that I may have missed a year. I was talking to my fellows the other day. The concept being that all of us encounter problems, and we need to identify those problems and address them. And as you heard from Fritz, by identifying problems, we can come up with ways of fixing them. But if all you do is identify the problems, no matter how real those problems might be. If that's the only thing that you are bringing forward. You could be looked at as a complainer. Now, the problems may be very real. But the same person who identifies the same problems then says, and here's a recommendation for how we can fix it. Here's a potential solution. How is that person looked at? That person is no longer looked at as a complainer, but they're a problem solver. So who do you want on your team? Do you want the complainer, or do you want the problem solver? So the rec, the idea is that people get labels, unfortunately, and sometimes we can't help it. But the key here is that whenever you identify a problem, follow it by saying, here's what I recommend to fix it. Even if you don't have the ability to fix it, meaning you don't have the resources, you don't have, because you could build that or that's the next problem. How do we get that? But think about anybody who reports to you or anybody who you deal with. Imagine if they said to you, Here's a problem I've noticed, and here's my recommendation. And by the way, The person who identifies the problem is probably most knowledgeable with that problem and best able to recommend the solution. They probably are in the best position. And one of the tricks I could tell you for any of you who run meetings when someone says, well, here's an issue that keeps coming up over and over again, and they don't recommend a solution, you say, guess what? Let's put a group together and you're gonna be in charge now of fixing that solution, that problem, coming up with a solution. And sometimes like, oh, what did I say? But then it empowers people to take ownership, always trying to say how we can do better. So we want to be a problem solver, not a complainer. Now, when you go outside, and we don't have too many of these in New York City, we learn a lot from grass and trees. A lot more than you can realize. There's a lot of complexity to them. So first, let me ask the question. You've all heard this expression, I know, so let me ask the question, where's the grass greener? Anybody wanna tell me where the grass is greener? On the other side, it's always greener on the other side, right? That's human nature. Right? We'll hear about happiness. Our happiness doctors laughing because that's one of the reasons why we feel unhappy. We, we see social media, everybody has these amazing lives and amazing vacation. They're perfect. They have perfect kids and families and relationships. Everybody's perfect. And we feel awful because the grass is greener on the other side. Actually, where is the grass really greenest? It's not on the other side. It's greener where you water it. That's where it's greenest. And if someone's grass really is greener, they're doing a lot more watering, and we better figure out how we water our own grass. And the problem is when you're in the idea mindset of growth. We wanna look for opportunities of how we can water our own grass. Watering our own grass generally means that we're trying to come up with means for self-improvement. That's what you're doing right now. All of you sitting here, believe it or not, are watering your own grass. So how do we develop this healthy growth? And by the way, we don't want weeds, we want nice green beautiful grass that can grow, that can thrive, that we can feel good about when we look at it and say we put a lot of work into making this grass green, so we have to change. The only way we can do better is changing, and Doctor Oxenteno mentioned this, how we're afraid sometimes to change and sometimes we're on such a straight path. Maybe there are other paths that we could take. I love the jungle gym idea. But the only way we can do better tomorrow is changing what we do today. And the change means we have to look inside and say, how can we do better. This was, um, a concept that I think. is not just in medicine. In fact, we're the worst to embrace it. This is a concept that technology embraces. Now, for example, uh, everybody has a phone. I look at this iPhone and I look at it, it is a marvel of modern technology. It's amazing what it does. This is an iPhone 15. I didn't even get the most recent one. But is Apple saying, oh, this is a great phone. We're done. You've had enough. No, they're working on the 16. They already came out as a 17. But what happens when you don't change? Well, it didn't show up there, but anybody know, anybody use a BlackBerry? How many of you were addicted to BlackBerries? They call them crackberries. They had a little keyboard on them, right? They were amazing. But where's the black, how many of you have BlackBerry today? It's gone because what BlackBerry said was, no, no one's gonna use a phone without little keys on it. That's not gonna happen, and it just disappeared. When you don't change, you may actually cease to exist, professionally, metaphorically, and in the world of technology, physically. Change is part of what we do, but change happens really fast. And actually in medicine we have a tough time changing. A new guideline comes out. How hard is it? Asma, you deal with guidelines all the time. How hard is it we put out a new guideline to actually get people to follow it. It's hard to change your medicine. We learned to do it one way. It's very hard to change. Change is difficult, but the only way we can do better today is changing about what we're gonna do tomorrow. Now, let's talk about trees. Talked about grass, let's talk about trees. So, trees are pretty amazing, and for some reason, my trees pictures and all aren't coming up, so I'm just gonna tell you about them. How many of you know about aspen trees that are out in the west? Anybody see the beautiful white trees, a um, They're numerous, they're gorgeous. They really, they're, they're stunning. Well, what's interesting about an aspen tree is they're not a single entity. How many of you know this about aspen trees? They're actually a single organism because every tree is connected by the same root system. The root system is actually a single organism. The trees themselves are individual manifestations of a wider complex of roots, and it's all the same. So actually, the aspen tree or trees is one of the largest organisms on the planet because it's a single root system. Think about that for a minute. Think about what that actually means. That we're all part of the same root system. Now you could say your institution, you could say, um, our, uh, our profession as physicians, that's our aspen tree, that's our single entity, our roots. Now let's talk about the other type of tree. How many of you actually gone out west and see these giant redwoods? Show of hands. They're incredible. They, I mean, they're huge and you see 10 people getting around trying to get around these trees. They go hundreds of feet up. Does anybody know how far the roots go down? You would think it probably has to be at least, I mean, a building is almost bigger below than above. Sometimes we have these massive structures and and that the skyscrapers have. 4 to 5 ft. Think about that. A tree hundreds of feet high has 4 to 5 ft below a root. How is it possible that it could stay up? Anybody know how it works? The roots intertwine and connect when you look under. You see fully integrated intertwined root systems. Now, not like the aspen trees where they're the same root system, they're different. The aspen tree represents what we're part of as a whole. But the redwoods recognize we start as an individual. Remember I showed you that baby who doesn't even know he or she is looking at another baby that themselves? We start as individuals and we start learning. We become dependent on each other. We are absolutely dependent. We're like the redwoods. Our roots are locked together so that we can support each other. The metaphor is really strong. And networking is absolutely critical to what we do by meeting people in this room, by meeting some of the people who are talking to you today, by meeting people who may have not only similarities but differences, the diversity of your network may actually expand your interest, may expose you to new things, may actually become your future mentors and sponsors. You heard Doctor Oxentenko saying, well, if I don't. I feel like this is for me, how will I know who else is out there that this opportunity might be a great way for me to sponsor if I have a networked with them before? Don't be afraid to reach out to people who might help you. That if I could give myself, we're gonna do a whole panel here, but if I could give myself one advice when I was a resident or a fellow, it's not to be afraid to reach out to people who you think might actually help your career. Even if they're department heads, division chiefs, uh, section chairs, whatever it is, reach out to people who you think might be doing something interesting that could help you either personally or professionally. All right. Number 3 Leadership We thought, think about leader and we think about great leaders. Think about people who've inspired you. Think about people who run organizations, companies. It could be even a little section that you're a part of, that you felt like they were an amazing leader. We talked about authenticity and enthusiasm. What's the metric that we use? This is a great leader because you heard Fritz talking about metrics we use now for exceptionalism and believe me, NYU is incredibly metric driven. This organization, just don't rub someone on the back and say great job. You say great job because these metrics were achieved and then. Here's what we're gonna do next year. How are we gonna do better? We're gonna set the bar higher, OK? But how do we measure the actual metric of effective leadership? It actually starts with you. We talked about knowing who you are, but the metric is not about you. It's about how others do. Under your supervision, under your responsibility. So the metric of effective leadership is the accomplishments of those you're responsible for, and that means it starts with your accomplishments. If you're charged with a task and you're an end of one. Your metric of success is gonna be how you do it, OK. But if you're responsible for a group and that group is tasked with the product, your metric as a leader is not how you did, it's how everybody achieved in your group, meaning that the metrics of leadership actually have to do with your ability for others to reach their great potential. Well, I think the same holds true in medicine. Our metrics of how we do as physicians is how our patients do. And that doesn't mean we cure them of every disease. Do we give them hope? Do we give them the ability to feel like they're better than they were when they came to see us? The metrics of successful leadership is in the actual achievements of those around us that those we're responsible for. Can you imagine if every leader felt that way? What an incredible world we live in, and it's not that difficult, but if we recognize it's not about us, it's about the people we're with, we're all intertwined in those roots. Number 4. Now I love this. Um, this is, it was a whole talk. For those of you, I don't know how many of you were here last year. I gave a whole talk on this. How many of you. I have seen the original Wizard of Oz. I mean, the original with Dorothy and, OK, great. I'm not talking about Wicked now. Wicked has evil, good and evil upside down, and it's awesome. I love Wicked, but I'm going back to the originals Wizard of Oz. I want you to think of the Wizard of Oz as a leadership journey. And I want you to see how this can be something that you can help follow your own yellow brick road. OK. So what happens here? Oh boy, OK. For what some reason all my slides aren't coming through, and I'm not exactly sure why that is. OK. So let me walk you through the Wizard of Oz. We have Dorothy, she's on a journey. She ends up in Oz by a fluke of a horrible storm. And she needs to meet the wizard because her goal, her journey is to get home. How is she gonna get back to Kansas where she's from? So who does she meet? She meets the scarecrow first, the Tin Man. And the lion. Each of them are on their own journeys looking for something. What did the scarecrow need? Does anybody remember? Brain. And there's a great song which Doctor Schlechter sings really well, by the way. And when he gives his keynote lecture, maybe we'll have him sing it. But he, he needs a brain. Well, what does a brain represent? It represents our training, our Um, our ability to reason, our creativity, our ability to actually produce the cognitive components that allow us to achieve even better than we do. So think of all the training we've had. That's the brain piece, that's the metaphor that the brain represents. What's the heart? Kindness, compassion, empathy. And when we take care of patients, boy, do we need that component as well. We need the best training, but we also need the absolute best in terms of our ability to bring forward compassion and kindness. And we're gonna, Doctor Lau's gonna talk about how we can bring more empathy into our, uh, to our training. OK, so we have the brain, the heart. What about the lion? Do you guys remember what the lion? Courage. You know, true story, absolute true story. When my son Steven was a little boy, and we were watching this for the first time, he turns to me and he says, Daddy, the, uh, scarecrow needs a brain. The steel man needs a heart. But what does the lion need? An esophagus? It's a True story. That's what happens when you grow up and, and I guess maybe courage lives in the chest somehow. I'm not exactly sure he made that leap. He's a computer scientist now, so, uh, he's not a physician. But the line brings courage. That always bothered me. Like, what courage, really? That's the thing that she needs, but truthfully, courage is one of the most important attributes. Maya Angelou says, without courage, you can't do any other attributes. Without courage, you can't stand up for what's right. Identify with what's wrong. Try something new, change what we're doing today. So courage is key. These are the three attributes, the brain and the training, the heart and the compassion and the courage to move forward. And who represents authenticity? Remember I told you about an authentic leader, what authenticity represents? So let's look at this clip. Hopefully this will run. Oh, but I want to go home You've had plenty of time already. Do not arouse the wrath of the great and powerful Oz. I said come back tomorrow. If you are really great and powerful, you'll keep your promises. Do you presume to criticize the great Oz? You ungrateful creatures, think yourselves lucky that I'm giving you audience tomorrow instead of 20 years. Oh. The great Oz has spoken. Pay no attention to that man behind the curtain. The great Oz has spoken. Who are you? Oh, I am the great and powerful wizard of Oz. You are. I don't believe you. No, I'm afraid it's true. There's no other wizard except me. You humbug. Yes, it's exactly so. I'm a humbug. Oh, you're a very bad man. Oh, no, my dear, I'm a very good man. I'm just a very bad wizard. The reason I love this, and when I watched The Wizard of Oz again, I missed that last piece. Let's talk a little bit about it. So, the wizard is this projection, this fearful projection. Don't pay attention to the man behind the curtain. Can you have a worse leader than someone hiding behind a curtain? We know leaders like that. And what does Toto represent? Toto pulls back the curtain, Toto the dog. And we see the actual wizard. The authentic wizard. Pay no attention to that man behind the curtain, and then what happens? They said, you're a humbug. And Dorothy says, you're a very bad man. And what does the wizard say? No, my dear, I'm not a very bad man. I'm actually a very good man. I'm just a very bad wizard. So what do we learn in this? What we learned a couple things. First of all, that the wizard itself is the least authentic component, and in the metaphor of this journey, the dog Toto actually represents the authenticity here. That we never want to be a leader, pay no attention to the man behind the curtain. And not all good people make good leaders. That's when, when he says, no, my dear, I'm a very good man. I'm just a very bad leader. There are a lot of good people. All of you dedicated your life to being the best you could be to help others. We're not all the best leaders. We don't learn leadership as physicians, and that's what this course is trying to do. And I think that's what the wizard was saying. I'm a good person. I'm just not a good wizard. There are good people who don't make good leaders, and I think we have to recognize that in our ability to do self-improvement, we want to ultimately improve ourselves. So, we have our brain, our heart, our courage, the authenticity, and what are the slippers? Remember how she gets home, she clicks her slippers, she says, there's no place like home. What is she saying? You know, my grass was pretty green back in Kansas. Maybe I should water my grass a little bit more. It's about gratitude and recognizing when we say, let's, before we say the grass is greener on the other side, let's look at what we have. Let's look at all the wonderful attributes that we have and actually water our own grass. And I think that's what the slippers represent. And that, For any journey that we have, who do we bring? Obviously we're gonna bring our brain, hopefully we'll bring our heart and our compassion. Hopefully we'll have the courage. I think we need those three components, but who else do you bring? Who do you bring from your entourage? Who do you bring from that 10,000 that I was talking about who's gonna walk along with you, along your journey, along your yellow brick road, and where's your yellow brick road gonna go? And by the way. If you remember when Dorothy meets the Scarecrow. The yellow brick road may follow the yellow brick road to Oz, but there were forks in that yellow brick road. She actually asked the Scarecrow, how do you go? So, even if we're following a yellow brick road, there are gonna be forks in that road, and we have to figure out who do we bring along, what attributes, who's helped us? Who do we need to find the right path. And I'm gonna end with this, hope. Now, let me just divert for a minute. Right up on this very stage, we had a TEDx at NYU that was incredible. It's the way I've met our keynote lecturer, Doctor Alan Schlechter, who you hear about later, talk about happiness. Um, we saw Doctor Bob Montgomery, who he himself had a heart transplant, inspirational about what that means for him and what he's been able to do going forward. And we will share with you a link so that you could all see some of these TEDx talks. They're fantastic. The talk that I gave at TEDx was on this, was on hope, and I was the last talk, and I told 3 stories. I'm not gonna go through the 3 stories now, but what I'm gonna share with you is number 5 about hope, is that there is always hope. I can't stress this enough. But the hope has to be realistic. At first when we meet a patient, there's hope for a cure. There's hope for a remedy. There's hope for relief. If that's not possible, there's hope for a new drug, a new clinical trial, someone doing research on something which many of you are probably involved with. If that's not possible, there's hope to live to see a life event. There's hope to attend something, to achieve something, to write down something, to make amends with someone. And if that's not available at the end of life, there's hope for comfort. Peace and comfort are provided by palliative care. Palliative care is not doing nothing. It's doing something really important. It's saying I'm here, it's holding a hand, it's being present, it's allowing someone to be comfortable at the end of their life. When we take away hope, we take away the most valuable attribute our patients have, and setting appropriate expectations is critically important that we don't give false hope. Imagine if a patient comes in with irritable bowel syndrome, and we know we can help them feel better, but imagine if we said we're gonna cure them of every symptom. They're never gonna have an ache or pain in their abdomen again. And even if we make them 90% better, we've given them false hope and in a sense they're not gonna feel like they're better, but if we give a realistic hope, not only can we make our patients feel better, but we can give them the ability to recognize that the journey is gonna be worthwhile, that the partnership's gonna be worthwhile, so hope is the essential ingredient in anything we do, whether it's for ourselves, for others around us, for our profession. For a country We need to have hope because without it, really, people can feel like all is lost and hopelessness is a horrific component to be, whether it's personal or professional. It leads to burnout and could be deleterious in so many ways. But having hope and always providing hope to our patients is something that we have to do not only as physicians but as healers and I'll end there. Thank you very much. Published February 7, 2025 Created by
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