Innovative Leadership for the Health Care Industry

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This article is from the new book Innovative Leadership for Health Care. The book was written by Maureen Metcalf of Innovative Leadership Institute and several other co-authors, to provide health care workers with frameworks and tools based on the most current research in leadership, psychology, neuroscience, and physiology to help them update or innovate how they lead and build the practices necessary to continue to update their leadership skills. It is a companion to the interview on Innovating Leadership, Co-creating Our Future between Dr. Neil Grunberg, one of the co-authors, and Maureen titled Innovative Leadership for the Health Care Industry that aired on Tuesday, March 23rd, 2021.

 

The Robert Wood Johnson Foundation’s Urban Institute reports that on an average night in the United States, around 465,000 people will go to sleep in our hospital beds. They will wear our gowns, eat food prepared in our kitchens, have their faces washed with water from our sinks. Some will undergo lifesaving procedures; some will undergo preventative observation, all will be in a state of vulnerability, unlike almost any other experience. Many will receive the care they would term as “miraculous.” Whether it is inside one of our 6,100 hospitals or in a rural office 100 miles from the nearest metro emergency room, health care is a big responsibility. It is always intimate. It is always humbling. It is often urgent.

Advances in training, education, information, public policy, and technology account for many of these daily miracles. We assert these miracles are also the result of extraordinary leadership. Leadership leveraging the strength of the team to go beyond the limitations of the individual. Leadership creating resources when and where they are needed. Leadership reaching beyond what can be touched and extending to the health care delivery system.

Just as receiving health care is intimate, humbling, and often urgent, so is leadership development. This book provides the education and tools to help you grow personally and increase your knowledge and skills. If you are not touched as well as challenged, lost as well as enlightened, and reflective as well as affirmed, then we have failed you. Leadership growth is a contact sport. Changing who you are is the real leadership growth that you seek. Creating miracles for your patients, staff, and community is your reward for risking this personal leadership journey.

Health care professionals are highly respected and valued in society. They have essential, existential roles as healers of the sick and injured and promoters of physical and mental health. Effective health care professionals apply their knowledge and skills appropriately and ethically. They respect colleagues, patients, patients’ significant others, and the limits of their knowledge and skills. They are leaders in that they are aspirational and inspirational. They influence these stakeholders and the organization’s cultures and systems in which they have a formal leadership role. They lead themselves, their people, their teams, and their organizations.

Becoming a better health care leader and optimizing innovation hinge on your ability to authentically examine your inner makeup and diligently address some challenging limitations. Leadership innovation or elevating your leadership quality can be accelerated by a structured process involving self-exploration, allowing you to enhance your leadership beyond tactical execution. While we provide a process, we want to be clear that readers should use this process to be effective for them. We each face different challenges and relate to leadership development in different ways. Each of us will use this book slightly differently. With that in mind, we tried to create a framework that is actionable and easy to follow. The process of leadership growth can be challenging, especially when it requires exploration of implicit beliefs and assumptions and potential changes to your overall worldview. Combining health care leadership with innovation requires you to transform the way you perceive yourself, others, and your role as a health care leader.

Wiley W. Souba noted, “Unless one knows how to lead one’s self, it would be presumptuous for anyone to be able to lead others effectively… Leading one’s self implies cultivating the skills and processes to experience a higher level of self-identity beyond one’s ordinary, reactive ego level… To get beyond their ‘ordinary, reactive ego,’ effective leaders relentlessly work on ‘unconcealing‘ the prevailing mental maps that they carry around in their heads. This unveiling is critical because leaders are more effective when they are not limited by their hidden frames of reference and taken-for-granted worldviews. This new way of understanding leadership requires that leaders spend more time learning about and leading themselves.”

By earnestly looking at your own experience—including motivations, inclinations, interpersonal skills, proficiencies, and worldview, and aligning them with the context in which you operate—you can optimize your effectiveness in the current dynamic environment. Through reflection, you learn to balance the hard skills you have acquired through experience with the introspection attained through in-depth examination—all the while setting the stage for further growth. In essence, you discover how to strategically and tactically innovate and elevate leadership the same way you innovate in other aspects of your profession.

We define leadership using the following chart. Leaders must attend to and align all elements of the overall system continually to respond to changes within the system and external factors within your context, such as insurers and government regulations.

This table is foundational to depict how we talk about the facets of the leader’s self and organization. When one facet changes, the leader must realign other aspects to ensure efficient and effective operation. Many leadership programs focus on leadership behaviors; this book is different in that it addresses where the leader fits within the overall system and how they are responsible for leading.

  • The upper left quadrant reflects the inner meaning-making of each leader (the personal). It contains both innate and developed capacities. This quadrant provides the foundation of self-awareness and individual development. It serves as the basis for behavior, competence, and resilience. Leaders must be aware of their inner landscape to be truly effective.
  • The upper right quadrant reflects observable behaviors, actions, competencies, and communication. This quadrant is what we see in leaders. Leadership training often focuses on checklists of behaviors because they are easier to assess and discuss. This book is different; it suggests actions, but it is not prescriptive. We acknowledge that behaviors tie to your meaning-making, culture, systems, and processes.
  • The lower left quadrant is inside the groups (interpersonal/dyads, teams, and organizations). It includes the vision, values, agreements, guiding principles, and other factors that create health care cultures.
  • The lower right quadrant reflects the visible systems, processes, physical infrastructure and equipment, facilities, technology, and reward and recognition systems

Part of what is innovative about this approach is that it requires leaders to focus on all four areas concurrently. When one area changes, others are impacted. When leaders’ beliefs change, their behaviors often change. Behavior changes impact culture and systems. The same is true when the organization changes, such as shelter in place during a pandemic. Health care leaders need to change their behaviors and face new challenges, such as telemedicine’s increasing use. One essential leadership skill is to quickly realign across all four quadrants in response to changes in any single quadrant.

Innovative health care leaders influence by equally engaging their personal intention and action with the organization’s culture and systems to move the health care organization forward to improve the lives of the people it serves. These leaders also take into consideration the rightful interests of the organizational members. Depending on the role of leaders and sphere of influence, they impact individuals, teams, and the entire organization. Health care professionals who are innovative leaders adapt and develop themselves and their organizations to optimize effectiveness with changing environments or contexts (psychological, social, physical). This book guides health care professionals in becoming Innovative Health Care Leaders.

 

To find out more about this new book, Innovative Leadership for Health Care, click here. To find out how to implement this innovative book into your health system, contact Innovative Leadership Institute here

Check out the companion interview and past episodes of Innovating Leadership, Co-creating Our Future, via iTunes, TuneIn, Stitcher, Spotify, Amazon Music, and iHeartRADIO. Stay up-to-date on new shows airing by following the Innovative Leadership Institute LinkedIn.

About the Authors

Maureen Metcalf, M.B.A., founder and CEO of the Innovative Leadership Institute, is a highly sought-after expert in anticipating and leveraging future business trends.

Erin S. Barry, M.S. is a Research Assistant Professor in the Department of Military and Emergency Medicine at the Uniformed Services University.

Dukagjin M. Blajak M.D., Ph. D. is an Associate Professor and H&N Division Director in the Radiation Oncology department at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

Suzanna Fitzpatrick, D.N.P., ACNP-BC, FNP-BC, is a senior nurse practitioner at the University of Maryland Medical Center in Baltimore, Maryland.

Michael Morrow-Fox, M.B.A., ED.S., is a consultant with the Innovative Leadership Institute experienced in health care, education, banking, government, and non-profit management.

Neil Grunberg, Ph.D., is Professor of Military & Emergency Medicine, Medical & Clinical Psychology, and Neuroscience in the Uniformed Services University (USU) of the Health Sciences School of Medicine; Professor in the USU Graduate School of Nursing; and Director of Research and Development in the USU Leader and Leadership Education and Development (LEAD) program, Bethesda, Maryland.

 

 

What’s “The Arena” Performance 101?

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This week’s interview features Brian Ferguson, Founder and CEO of Arena Labs.  This  blog was previously published on the Arena Labs blog.  It is a companion to Brian’s interview on Innovating Leadership, Co-creating Our Future titled High Performance Medicine: Healthcare and Innovation that aired on Tuesday, December 8th, 2020.

 

“It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better.  The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

–THEODORE ROOSEVELT, CITIZENSHIP IN A REPUBLIC, 1910

 

If you want to be in the Arena, you don’t get there by way of drifting through life.

The Arena is a place of action, and yet it is consciousness that defines its nature: to have an Arena in the first place, you need to have intently decided: This. This is the thing I will show up for. The thing that puts my most cherished values into action. The thing around which I will design my life so that I will not only show up well but show up better and better each time.

The Arena is the space for that thing, for the body doing that thing. It’s a context for risk. People act differently in different contexts. Think of yourself in different spaces. What are the contexts in which you are raucous, loud? What are the contexts in which you are reserved, quiet? What are the contexts in which you have swagger? (Ok silly question, you always have swagger.) When it comes to developing excellence, context is an interesting thing. What happens in one context has everything to do with how far you can go in another, some of which is predictable, and a lot of which as unexpected as it is tied to the very best of our unique human nature.

The Arena is there so that you can ask, and test: how far can we go?

The rules of the Arena are established so you can accept and fully take the risk with and for others­–the only way to tap human potential­–and play all-out while holding the sanctity of safety.

Performance is the knowledge deployed in the Arena. As Kristen Holmes describes, “performance is the science of human thriving.” It has three key aspects:

  1. The identification of the internal and environmental conditions that catalyze individuals and teams to play at their best.
  2. The understanding of the physiology of stress and fear and anxiety, and of our interdependence with others.
  3. The disposition to apply this science in one’s own body and lifeworld so to catalyze growth.

Performance knowledge springs from across sectors concerned with bodies and the care for human life. In recent years, a revolution in this knowledge has been driven by research and applied science in athletics, the military, and the performing arts.

At the end of the day, performance is a mindset: the humility of the expert learner. It is the trust in a collective’s ability to perform at its very best by nature of its diversity. It is deep curiosity about human nature, rigor in applying findings. It is a love of humans and what we might be able to do when we are working from the very best of our nature. And it is the wisdom to know that what you can control and what you can’t, with a big appetite for full ownership of what you truly can—a lot of it an inside job.

The Arena is the place for performance, for which we’ve relentlessly trained and practiced.

The place in which we activate, and then see what happens.

 

To become a more innovative leader, you can begin by taking our free leadership assessments and then enrolling in our online leadership development program.

Check out the companion interview and past episodes of Innovating Leadership, Co-creating Our Future, via iTunes, TuneIn, Stitcher, Spotify and iHeartRADIO. Stay up-to-date on new shows airing by following the Innovative Leadership Institute LinkedIn.

 

About the Author

Alexa Miller is a visual artist, writer, and facilitator by training, she has worked with thought leaders engaged in human-centered paradigm shifts in healthcare for the last two decades. Most known for her arts-based teaching with doctors and study of the role of observation in the diagnostic process, Alexa is an original co-creator of Harvard Medical School’s “Training the Eye: Improving the Art of Physical Diagnosis,” and contributed to the touchstone 2008 Harvard study that measured the impact of visual arts interventions on medical learners. She currently teaches a course on medical uncertainty at Brandeis University and studies high performance mindset through her work at Arena Labs.

Photo credit: Joel Harper

Physician Leadership: Flipping the Leadership Paradigm

This blog was written as a companion to the VoiceAmerica Interview with Dr. Wiley “Chip” Souba, MD, ScD, MBA on August 15, Physician Leadership, Flipping the Leadership Paradigm. This blog is the forward written by Dr. Souba for the Innovative Leadership Workbook for Physician Leaders. His focus is the leadership required now to address the volume of change in health care.

By any objective measure, the amount of painful, gut-wrenching change in health care continues to increase. Transformational change is always traumatic because in the process of taking it on, each of us must, in a very real sense, reinvent ourselves. We must change our assumptions, our cognitive frameworks, our ways of being and acting, and our ways of collaborating with one another. Jettisoning our familiar practices that are holding us back may make sense intellectually but rewiring the neural networks that underpin these habits can be overwhelming. It is no wonder that we don’t greet change with open arms. Understandably, we avoid significant change like the plague.

Avoidance, however, is no longer an option. Intense pressure from powerful stakeholders – big business, patients, legislators, and payers – is driving the healthcare transformation imperative. This leaves us with three options. We can choose to disengage, arguing that the health care conundrum is too complex to tackle, not our problem, and certainly not our fault. In so doing, we shortchange the future of our children and most Americans. Secondly, we could decide to continue pounding away, hoping for a future that is a continuation of the past. Hope is a good thing but it is not an executable strategy.1 Lastly, we can choose to revise the way in which we think about (make sense of) these challenges, and more specifically, revise the way in which we develop physicians who are more effective leaders going forward. Until and unless we re-language (reframe) our challenges, we will not alter, in any kind of meaningful way, our results.

How do we shift our thinking when the shackles of our long-standing cognitive maps are so entrenched and hidden? This workbook offers several assessments, tools, and practices to help you, as a leader, begin to examine your thinking and identify areas where you may need to transcend your current practices. While this process is not an easy one – it invites you to change how you see yourself in the world – it is an important part of developing yourself as a physician leader in a complex and convoluted environment.

Creating Leaders

Teaching people about leadership is different from creating leaders.2 Teaching leadership uses a third-person approach to impart someone else’s knowledge, which grants learners limited access to the being and actions of effective leaders. In contrast, creating leaders requires a first-person methodology, which provides direct access to what it means to be a leader and what it means to exercise good leadership in real time, with real results. Many health care transformation efforts run amuck because they overlook this distinction. This workbook emphasizes the inner work of leading oneself as well as the outer process of connecting personal values and actions to the organization’s culture. Leaders use the innovative leadership framework to learn what it is to be a leader and what it means to exercise leadership behaviors effectively by making use of a model that distinguishes being a leader as the foundation for the leader’s actions.

Why is the being of leadership foundational? Simply, because if you’re not being a leader, it is impossible to act like a leader.3 Because our understanding of what it means to be – a physician, a medical student, a researcher, a leader – is changing, a more effective approach to developing leaders starts with four pillars of being a leader – awareness, commitment, integrity, and authenticity – as the ontological foundation for what leaders know and do.4 This way of understanding leadership is core to the basic tenets of professionalism. The workbook will walk you through a series of self-assessments and reflection questions to increase your level of conscious awareness. You will build a development plan and enlist a support group in helping you meet your goals thereby creating an implicit commitment to yourself and to your team. The exercises and reflection questions invite you to examine what you believe and how those beliefs impact your actions. When they are not aligned, you will identify the misalignments and have the opportunity to bring your actions into integrity with your beliefs and to act in ways that are authentic.

Accessing Leadership

When we think of the word “access,” it tends to bring to mind the notion of making something available so as to utilize it, apply it, or take advantage of it (e.g., our bank account, the internet, the patient’s medical record). The idea that leadership is something we access may seem odd as we generally think of leadership as an ability that people just have or don’t have. However, when we recognize that leadership is about expanding our range of ways of being, thinking, and behaving so we can be more effective in dealing with those challenges for which conventional strategies are inadequate, the notion of access makes more sense.5 Without the ability to access new ways of being and acting, we will default to what is comfortable whenever we are called to take on a major leadership challenge and our results will be mediocre at best. The innovative leadership framework in this workbook combines personality-type tools to help you understand your innate inclinations and how they impact your leadership capabilities. The framework also includes a developmental perspective that looks at how you make meaning of the world. It is this meaning-making process that matures through a series of stages that increases your capacity as a leader. The workbook is designed to help you as a leader identify your current competence and build it, thereby giving you greater access to your personal leadership capacity.

Access to leadership occurs primarily through first-person and third-person approaches, although the former tends to be disregarded. Observing leaders – and then describing, measuring, and categorizing their behaviors and traits – uses a third-person methodology. This third-person approach to studying leadership, which emphasizes what leaders know, have, and do, is theoretical and inferential but continues to be the most common leadership pedagogy.2 Theories, explanations, and textbooks provide us with third-person access to leadership, but, in and of themselves, they do not impart what is required to be a leader, much as textbooks do not teach what it is to be a physician.

Rather than teaching leadership from a theoretical (third-person) vantage point, the first-person perspective teaches leadership as it is experienced. It is important to recognize that you and I do not lead from a theoretical standpoint; rather, we lead moment-to-moment, situation-to-situation in the way we experience leadership “as lived,” that is, from a first-person point of view.6 Such subjective experiences (first-person data) cannot be described using a third-person perspective. The distinctiveness of the first-person “as-lived/lived-through” approach lies in its capacity to disclose the hidden contexts that shape the ways of being, thinking, and acting that are the source of the leader’s performance.2 When one exercises leadership “as lived,” concurrently informed by theories, one tends to be in one’s “A” game. When using this workbook, you will be directly engaging in leadership development activities and reflection practices. This workbook is an attempt to integrate first-person and third-person learning. The first two chapters focus on the third-person theoretical frameworks of innovative leadership and physician leadership competencies. The book then shifts from third-person to first-person perspective as it asks you, as the leader, to complete a series of worksheets and reflection questions that explore yourself as an authentic person. You will explore your personal vision and values then develop a plan that helps you build yourself into the leader who can bring that vision into the world in a manner that is consistent with your values. The majority of the book is designed to lead you through an interactive process that helps you have the first-hand experience of yourself being a leader.

In order to gain access to more effective ways of leading, we must first expose our engrained beliefs and worldviews about leadership (e.g., I can’t look incompetent, I need to be right, I must have the answers) that are limiting us. This will allow us to relax those limiting (and often veiled) ways of being and acting that have become our automatic go-to formulas (e.g., making excuses, not holding ourselves and others accountable, blaming others) that actually constrain our freedom to lead.4 By probing this space you will explore your worldviews in general and your leadership presuppositions specifically. The authors recommend you take the MAP assessment to determine your worldview along with other assessments that help you determine your personality type and leadership behaviors. The combination of tools will give you a comprehensive view of who you are and what you do.

Mastering Language

The primary tool we use to gain access to leadership is language. In other words, discourse (with ourselves and others) is the medium through which we access and understand the world. Language allows us to bring our leadership challenges into sharper focus, allowing us to see details and “make sense” more clearly. Thus, the transformative power of language resides in its ability to create new futures. This workbook will immerse you in journaling exercises and conversations with others who are engaging in a similar process, thereby establishing a supportive network. Thus, the transformative power of conversation with your support team, in conjunction with the journaling exercises, you will create your own new futures through who you are becoming as leaders.

Because many of the changes that are taking place in health care are inevitable, mastering context as a leader is critical. Content (i.e., whatever we are dealing with) is always perceived through a linguistic context and, as human beings, we have the freedom to recontextualize our leadership challenges by shifting the context. Once we shift our context, “we can be a different kind of leader. When we change our thinking and speaking, a different reality becomes available to us. Shifts in our mental maps generate new possibilities for actions and outcomes not previously accessible. Only by means of language can we lead ourselves, each and every day, to become the wiser, more effective leaders that we must become.”6 The workbook aids you in your process of recontextualizing by using a framework for reflection questions that ask you: What are your beliefs? Why do you do what you do? What do we, as an organization, value? How do we produce this value through our systems and processes? In revisiting your leadership challenges using this analytical approach, they will become more accessible and more “hittable.”7

Curiously, as your leadership evolves, you will likely discover that the increase in your effectiveness won’t be, first and foremost, because you acquired another technical skill – rather, it will be because the context inside of which you operate has changed.5 A different “you” will show up. In other words, the improvement in your effectiveness will be less the result of having grasped some new theory and more a function of having altered the context through which you “perceive” your leadership challenges. This amazing capacity – to go beyond our ordinary selves to unleash our best selves – is unique to human beings and is only possible because we are not determined by a what, like an entity, but by a who that is shaped by our choices over time.6

To become a more innovative leader, please consider our online leader development program. For additional tools, we recommend taking leadership assessments, using the Innovative Leadership Fieldbook and Innovative Leaders Guide to Transforming Organizations, and adding coaching to our online innovative leadership program. We also offer several workshops to help you build these skills.

About the Author

Dr. Wiley “Chip” Souba MD, ScD, MBA has been Vice President for Health Affairs at Dartmouth College and as Dean of Dartmouth Medical School since October 1, 2010. Dr. Souba served as Dean of the College of Medicine and as Vice President and Executive Dean of Health Sciences at The Ohio State University. In 1999, he was named Waldhausen Professor and Chair of the Department of Surgery at the Penn State College of Medicine and Surgeon-in-Chief at Hershey Medical Center. He became Dean of The Ohio State University College of Medicine in 2006. He serves as a Trustee of Dartmouth-Hitchcock Medical Center. He is one of the top surgical oncologists in the country, is also a scientific researcher whose studies on amino acid metabolism, as related to the development of cancer of the intestine, have been funded by the National Institutes of Health and reported in over 300 peer-reviewed scientific articles.

References

  1. Souba W. Brock Starr: a leadership fable. Journal of Surgical Research. 2009. 155: 1-6.
  2. Souba W. The phenomenology of leadership. Open Journal of Leadership. In press.
  3. Souba W. The science of leading yourself: A missing piece in the healthcare reform puzzle. Open Journal of Leadership 2013; 2 (3): 45–55.
  4. Souba W. The being of leadership. Philosophy, Ethics, and Humanities in Medicine 2011; 6 (5). Available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050817/
  5. Souba W. Health care transformation begins with you. Academic Medicine. In press. Available at http://www.ncbi.nlm.nih.gov/pubmed/25340365
  6. Souba W. Rethinking Leadership Development. The Pharos, Summer 2014, 2-6. Available at http://alphaomegaalpha.org/pharos/PDFs/2014-3-Editorial.pdf
  7. Souba W. A new model of leadership performance in health care. Acad Med 2011; 86: 1241–52.

 

Building Wellbeing Builds Effective Leaders

This blog, written by part of a series of blogs as companions to the interview with three renowned experts from The Ohio State University.  Rustin M. Moore, DVM, PhD, DACVS, the dean and Ruth Stanton Chair of Veterinary Medicine in the Ohio State College of Veterinary Medicine (CVM).  Second is Bernadette Mazurek Melnyk, PhD, RN, CPNP/PMHNP, FAANP, FNAP, FAAN, VP for Health Promotion, University Chief Wellness Officer, Professor and Dean of the College of Nursing at The Ohio State University, and Professor of pediatrics and psychiatry at OSU’s College of Medicine. She’s an internationally recognized expert in evidence-based practice, intervention research, child & adolescent mental health, and health & wellness, and is a frequent keynote speaker at national/international conferences on these topics. Third, Jen Brandt, MSW, LISW-S, PhD, Director of CVM Counseling and Consultation is leading the effort to provide veterinary professionals with the communication, interpersonal and teamwork skills essential to quality veterinary care, veterinary career success, and life satisfaction on VoiceAmerica “Innovative Leaders Driving Thriving Organizations” on April 4, 2017 focusing on exploring the impact of mental health concerns in the general workplace and or veterinarians and vet students. It is designed to remove the stigma about getting help and equip colleagues and bosses have some idea for addressing it. The participants discuss general data on prevalence of mental health issues within the general population, veterinary data on prevalence of mental health issues within profession and veterinary students and factors to these issues in society in general and finally recommendations to identify issues and address them.

What is wellbeing?

According to Dodge et al., wellbeing is when “individuals have the psychological, social and physical resources they need to meet a particular psychological, social and/or physical challenge.” 1 Wellbeing includes “…the presence of positive emotions…the absence of negative emotions…satisfaction with life, fulfillment and positive functioning.” 2

Why is wellbeing important?

With all of our best intentions, it can be difficult to slow down and tune in to what we need to walk the tightrope between resources and challenges. Our drive to succeed can come at a cost to ourselves and others. We may yearn for simplicity and yet struggle to find it. We rationally understand the importance of balance, yet many of us may be hard pressed at times to achieve it or maintain it. It’s a worthwhile endeavor, however, as wellbeing is associated with numerous individual, family, and community related benefits including decreased risk for injury, illness, or disease; enhanced immune functioning; and increased longevity. Individuals with high levels of wellbeing are more productive and more able to contribute to their communities. 2

A Wellbeing Framework

Wellbeing stems from an interactive relationship between various dimensions of wellness. There is no single perfect plan for wellbeing. Rather, there is an entire spectrum of useful strategies and the optimal plan for one person will likely change over time. What “works” on a given day is dependent on a number of variables including environment, individual preferences, personal accountability, available resources, strengths, interests, and life phase.

The essential skills of being a whole, healthy veterinary professional include intentional integration of the following dimensions: 3

Occupational Wellness

The professionally well person engages in work to gain personal satisfaction and enrichment, consistent with values, goals, and lifestyle.

Intellectual Wellness

The intellectually well person values lifelong learning and seeks to foster critical thinking, develop moral reasoning, expand worldviews, and engage in education for the pursuit of knowledge.

Spiritual Wellness

The spiritually well person seeks harmony and balance by openly exploring the depth of human purpose, meaning, and connection through dialogue and self-reflection.

Social Wellness

The socially well person has a network of support based on interdependence, mutual trust, respect and has developed a sensitivity and awareness towards the feelings of others.

Emotional Wellness

The emotionally well person can identify, express, and manage the entire range of feelings and would consider seeking assistance to address areas of concern.

Physical Wellness

The physically well person gets an adequate amount of sleep, eats a balanced and nutritious diet, engages in exercise for 150 minutes per week, attends regular medical check-ups, limits use of intoxicating substances, and practices safe and healthy sexual relations.

Financial Wellness

The financially well person is fully aware of personal financial states and budgets, saves, and manages finances in order to achieve realistic goals.

Creative Wellness

The creatively well person values and actively participates in a diverse range of arts and cultural experiences as a means to understand and appreciate the surrounding world.

Environmental Wellness

The environmentally well person recognizes the responsibility to preserve, protect, and improve the environment and appreciates the interconnectedness of nature and the individual.

Putting Wellness Into Practice

Exercise One: Raise awareness. Find a quiet location to write about the following:

  • For each dimension of wellness, which do you currently have the resources to adequately meet the challenges?
  • For which dimensions are additional resources needed to adequately meet the challenges?
  • Rank each dimension in the order you value them, with 1 being the highest value to you, and 9 being the least value to you.
  • Reflecting on your rankings, which dimensions receive most of your time, energy, and attention? Which dimensions receive the least? Is there a gap between the dimensions you value the most and the ones that receive most of your time? If so, what are your thoughts about that?
  • If there is a mismatch between the dimensions you value most and the dimensions that receive more of your time and energy, what’s one small step you can take today to bring your values and behaviors into closer alignment?

Exercise Two: Three-Good-Things Writing Exercise

Dr. Martin Seligman is a leading authority in the fields of Positive Psychology, resilience, learned helplessness, depression, optimism and pessimism. He reports that within 6 months of engaging in this simple habit, you’ll statistically have less depression, less anxiety, and higher life satisfaction. 4

Write down three good things that you experience each day. (You can use the 9 dimensions of wellness as a foundation for the topics you write about). The three things can be small in importance (“I took time to sit down and chew my food. I didn’t multitask during lunch.”) or big (“I decided to hire a business coach!!!”). Next to each positive event, write about one of the following: “What does this mean to you?” “How can you have more of this good thing in the future?” 5

Big changes are the result of many small changes applied consistently over time. So, start small. Monitor what you value the most and where you spend most of your time and energy. When values and behaviors are out of alignment, get curious. Keep a notebook with you and jot down 3 good things each day until it becomes a habit.

About the Author

Jen Brandt, MSW, LISW-S, PhD, Director of CVM Counseling and Consultation is leading the effort to provide veterinary professionals with the communication, interpersonal and teamwork skills essential to quality veterinary care, veterinary career success, and life satisfaction. Her professional coaching, consultation and interpersonal skills training offer applied learning opportunities to increase self-awareness, improve wellness and resilience, resolve conflict, and enhance veterinary team communication.

She is a nationally and internationally acclaimed guest lecturer at veterinary colleges and conferences and has served as a master trainer and facilitator for the Institute for Healthcare Communication since 2003. She began working with The Ohio State University College of Veterinary Medicine in 1997 and currently serves as the Director of CVM Counseling and Consultation Services.

  1. Dodge R, Daly A, Huyton J, Sanders L. (2012). The challenge of defining wellbeing. International Journal of Wellbeing. 2012;2(3): 222-235.
  2. Health-Related Quality of Life (HRQOL). Centers for Disease Control & Prevention. https://www.cdc.gov/hrqol/wellbeing.htm.Published May 27, 2016. Accessed January 2017.
  3. 9 dimensions of Wellness. Student Wellness Center. Office of Student Life. The Ohio State University. https://swc.osu.edu/about-us/9-dimensions-of-wellness. Published 2017. Adapted with permission January 2017.
  4. Seligman M. Resilience training for educators. Authentic happiness. University of Pennsylvania. https://www.authentichappiness.sas.upenn.edu/es/learn/educatorresilience. Published 2017. Accessed January 2017.
  5. The PERMA Model: Your scientific theory of happiness. Positive Psychology Program. https://positivepsychologyprogram.com/perma-model/#seligman-perma-model. Published June 19, 2015. Accessed January 2017.

How Do Physician Led Organizations Respond to Change?

Physician LeadershipThis blog post is a companion a Voice America interview with Robert Falcone, MD in which he talks about his career progression and his current role as CEO of the Columbus Medical Association. This organization epitomizes the change effective organizations need to make to thrive and continue to meet their missions. Much of the content is drawn from the Innovative Leadership Workbook for Physician Leaders by Metcalf, Stoller, Pfeil and Morrow-Fox.

“Leadership plays a critical role in any health care organization’s long-term success, and innovation has become a strategic necessity in today’s health care environment. In short, physician leadership and innovation have a greater impact today than ever before. Despite the volume of resources exploring both leadership and innovation, most approaches provide merely anecdotal directional solutions that lack sufficient information to actually allow leaders to make measureable change. Add to this equation the impact a diverse workforce and increasing competition have on health care organizations, and leaders face an even greater challenge.

As the health care landscape becomes more complicated, the need for strong leadership increases at an ever-increasing pace. Physician and hospital leaders face more complex challenges as health care reform moves forward along with increasing competition and downward price pressures. The annual survey of top issues confronting hospitals, conducted by the American College of Healthcare Executives’ (ACHE’s) in 2012, asked respondents to rank eleven issues affecting their hospitals in order of importance and to identify specific areas of concern within each of those issues. The survey was sent to 1,202 community hospital CEOs who are ACHE members, of whom 472, or 39 percent, responded. Financial challenges again ranked No. 1 on the list of hospital CEOs’ top concerns in 2012, making it their No. 1 concern for the last nine years. Patient safety and quality ranked second. Health care reform implementation, which had been the No. 2 concern since it was introduced to the survey in 2009, moved to No. 3 in 2012. (www.ache.org/pubs/research/ceoissues.cfm)

In this continuously changing environment, the importance of strong physician leadership is accelerating at the same time that many physician leaders are retiring.

One primary reason for a potential leadership void is the pending retirement of the baby boom generation. Health care organizations have only recently begun to invest in developing their leaders. A 1995 survey of 122 CEO’s of healthcare institutions discovered that 31% of these organizations offered in-house leadership programs. In 2002, the health care industry spent only 1.25% of their payroll on training and development while the top corporations spent 4% of payroll on these activities

—Hopkins, O’Neil, FitzSimons, Bailin, Stoller

Leadership and Organization in Healthcare: Lessons from the Cleveland Clinic, 2011

With this rapid rate of change, questions on how to lead and where to innovate remain puzzlingly philosophically: What is the role of physician leadership in a time of looming uncertainty? How will organizations innovate to overcome challenges that are largely unprecedented? In a new climate of business, is there a formula for creating success in both areas?

Every system, including the human operating system, is built to get the results it gets. Moreover, every system has a design limit, which when reached cannot be surpassed unless it undergoes transformation. For human beings, reinvention means new ways of being, thinking and acting. Not surprisingly, reinvention and mastery are tightly linked. All of us, regardless of our talents, must learn to lead ourselves. “Conventional thinking”, writes Lee Thayer, “always and inevitably leads to conventional results” (Thayer, 2004). Slowly but surely we are learning that the process of transforming ourselves and our organizations is not just about acquiring more knowledge or changing our business strategy but also about exposing the hidden contexts that shape our ways of being and acting and limit our opportunity set for leading ourselves and others more effectively. Change resides in new ways of being, talking, and acting, which are shaped by our underlying yet hidden beliefs and assumptions (Souba, 2009). The kind of learning required to shift our worldviews is enormously challenging, but it is essential for effective leadership in health care given the enormous disequilibrium and turbulence in the environment.

—Wiley W. Souba, The Science of Leading Yourself: A Missing Piece in the Health Care Transformation Puzzle, 2013″

For leaders charting the course for the organizations impacted by the major changes in health care, it is critical that they look at both their leadership approach in this dynamic environment. The Columbus Medical Association is one organization proactively setting the course for these changes and Robert is a great example of a leader who has continually reinvented himself as he faces each successive organizational challenge.

To become a more innovative leader, please consider our online leader development program. For additional tools, we recommend taking leadership assessments, using the Innovative Leadership Fieldbook and Innovative Leaders Guide to Transforming Organizations, and adding coaching to our online innovative leadership program. We also offer several workshops to help you build these skills.

About the Columbus Medical Association

The Columbus Medical Association (CMA) has had a rich and honored history in central Ohio dating back to 1892. As it approaches its 125th anniversary, a compelling story of physicians who have come together to better serve the residents of the community can be told. Decade by decade, physician members of the CMA (formerly called the Academy of Medicine of Central Ohio) collaborated on issues that had an impact on patients locally and sometimes nationally. One of many highlights was the coordinated effort to administer the polio vaccine to the community in 1955.

In addition to the many ways the CMA physicians have responded to community needs, its membership has also looked ahead to find ways to proactively address issues that impact the health of central Ohioans. Indeed, the Columbus Medical Association Foundation (CMAF), Physicians CareConnection (PCC) and Central Ohio Trauma System (COTS) are all affiliate organizations of the CMA that were born from the vision of CMA members and are now thriving organizations serving community needs.

Today, physicians are more diverse and are practicing in an immensely more complex health care environment than they were in 1892. However, CMA physicians continue to look for ways to improve the health of their patients and the central Ohio community through advocacy, education and old-fashioned compassion.

 

CEO Perspectives: Changes in Primary Care

Changes in Primary Care1This blog was written as a collaboration between Maureen Metcalf and Jim Svagerko. It is a companion to the VoiceAmerica interview featuring Bill Wulf, MD and Jim Svagerko MA, PCC, talking about the leading work Central Ohio Primary Care with 300 physicians is doing and preparing for health care reform and new innovations in medical care over the next five years, and how it became a leader in their field and what they are doing to shape how the field of medicine and how it is practiced.

According to the Community Action Network, “A healthy community reflects a sense of mental and physical wellbeing and is the foundation for achieving all other goals. Good health is often taken for granted but is essential for a productive society. For example, every community needs a healthy workforce upon which to build its economy and healthier students are more equipped to learn and be successful academically.”

While the business of healthcare is run by physicians and administrators, health impacts every one of us. It is our responsibility to own our individual health because it effects our ability to enjoy life. Many of the challenges we face are a direct result multiple factors within the economy, and some health issues are a consequence of socio-economic disparity. Insurance plays a role when sometimes it is difficult to get access to the highest quality healthcare with the limitations on coverage. Additionally, factors in families and schools can play a role when adverse childhood events leave a lifelong impact on overall health. Injurious childhood events often contribute to mental health and drug and alcohol issues later in life. Often, the cycle continues. Many of these factors are interrelated and solving them requires cross-sector focus on community health. Communities like Franklin County in Columbus, Ohio, have strong collaborative processes to address these complex issues.

While each of us plays a role in our own care, the linchpin of health care delivery has been determined to be the primary care physician. Dr. Wulf is the CEO of Central Ohio Primary Care (COPC), a group of 300 doctors at 50 offices in four counties. His clinical interests are preventive care, population management, and maintaining a continuum of care for COPC patients. As the CEO of an organization that is nationally known for its exceptional care and innovative business model, he continues to look at what COPC will do next to meet patient needs in the context of a dynamic health care environment. Here are a few of the changes COPC is talking about:

  1. Move from pay for service to pay for outcomes: COPC is beginning to be paid for creating value for patients as they move from strictly fee-for-service payments. This shift completely changes how medicine is delivered and how doctors and all professionals associated with care delivery focus their efforts. COPC has taken a comprehensive approach to change that considers the overall system and how practices operate, the culture that encourages procedures as the foundation to manage risk, and physician scheduling and daily activities.
  2. Move to a culture of vibrancy and collaboration: Significant change is enabled by a culture of mutual respect and collaboration where all team members are encouraged to voice opinions.
  3. Leadership development: COPC has invested in physician leadership development through a variety of methods. Metcalf & Associate’s Maureen Metcalf and Jim Svagerko were engaged to support COPC, and assist them in their development. They guided the leadership team through their own personal development as well as a deep dive into the workings of COPC. Maureen and Jim will continue their work with COPC this summer and fall. In addition, COPC sends their physician leaders for education through a local professional association and their leadership team is using the Innovative Leadership Workbook for Physician Leaders, supported by Metcalf & Associates, as a team activity along with peer coaching to support growth and development, as well as promote a culture of growth and mutual support during its transition.

One of the key trends we see in health care is a shift in focus from the “all-knowing” physician to patient owning health outcomes. We are seeing a dramatic increase in “wearables”, everything to medical devices like an insulin pump to the standard Fitbit® and calorie counting apps. Many of us are using these devices to manage our own behaviors. Primary care physicians and other healthcare professional are also using these apps and the data they provide to manage the chronically ill.

It is crucial that leaders in health care arm themselves with resources to assist them as they move through these undefined areas. It will be necessary for leaders to first gain an understanding of their leadership style and abilities before they can hope to lead others. One way is through careful discernment with an executive coach/advisor to explore and present opportunities for the leader to move into a space that will allow them to create a climate and atmosphere that will serve future health care needs.

SO….what can you do about becoming more effective? To become a more innovative leader, please consider our online leader development program. For additional tools, we recommend taking leadership assessments, using the Innovative Leadership Fieldbook and Innovative Leaders Guide to Transforming Organizations, and adding coaching to our online innovative leadership program. We also offer several workshops to help you build these skills.

About the author

Maureen Metcalf, founder and CEO of Metcalf & Associates, Inc., is a renowned executive advisor, author, speaker, and coach who brings thirty years of business experience to provide high-impact, practical solutions that support her clients’ leadership development and organizational transformations. She is recognized as an innovative, principled thought leader who combines intellectual rigor and discipline with an ability to translate theory into practice. Her operational skills are coupled with the strategic ability to analyze, develop, and implement successful strategies for profitability, growth, and sustainability.

In addition to working as an executive advisor, Maureen designs and teaches MBA classes in Leadership and Organizational Transformation. She is also the host of an international radio show focusing on innovative leadership, and the author of an award-winning book series on Innovative Leadership, including the Innovative Leaders Guide to Transforming Organizations, winner of a 2014 International Book Award.