Leadership Begins and Ends….

With You
CATCH-Healthy Tomorrows Training
Meeting
August 15-16, 2008
Chicago, Illinois

Gilbert C. Liu MD, MS

The speaker in this session has no relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider of
commercial services discussed in this CME activity. The speaker will not discuss or demonstrate pharmaceuticals and/or medical devices that are not
approved by the FDA and/or medical or surgical procedures that involve an unapproved or "off-label" use of an approved device or pharmaceutical.
 Why Leadership? Why Now?
• Health Care and Medicine at the Vortex of Change
• Citing a “leadership void” in health care-AMA,
AHA, IHI, AAMSE…..on and on
• Leadership is not position-Not just seats at the table
or at the head of the table-Leadership is about values,
vision, behavior and results
• The burden is greater in pediatrics-The profession
needs strong leadership-But children need strong
adult leaders more than ever-they have no voice
• ONE effective leader can make a HUGE difference
 Why Leadership?
The Physician Perspective
• When you learn it and apply it, you find leadership
really DOES matter
– Accounts for at least one-third of results of an
organization
• Amazingly, leaders in health care are often chosen
for reasons having nothing to do with ability to
lead
• Most of us have not thought of leadership as a
skill we need-We are incomplete without it.
• You can “grow” your leadership skills
 Exercise: A Leader You Know
• Think about a leader that has made a real
impact on you and/or your life
– List the attributes and behaviors of this leader
that made the deepest impression upon you, and
which you try to emulate
 Characteristics of Exemplary
Leaders Commonly Reported
• Honest
– Consistent, principled, trustworthy
• Forward looking
– Clear purpose and direction
• Inspiring
– Sense of purpose and worth, committed
• Competent

• CREDIBLE
 You Are Already a Leader…
• Leadership occurs at all levels and in all
positions within organizations
• Leadership is behavioral, and therefore,
learnable
Can You Learn to Be a Better Leader?
 Learning to Lead
• Observation of others (50%)
• Trial and error—Feedback (40%)
• Education (10%)

• Awareness and faith in your own abilities

 Leadership-It May Begin and End
With You-But It Is All About Others
• Bringing out the best in oneself and in
others in an effort to make a difference
• Not a position but rather practices and
behaviors that mobilize others
Avoid putting yourself before others and you
can become a leader among men.

---Lao Tzu
 The Best Science of Leadership
• Goleman’s “Emotional Intelligence”
• Kouzes and Posner’s 5 Practices in “The
Leadership Challenge”
Goleman:What Makes a Leader?
• IQ + EQ + Style(s)
– Intelligence
– Emotional Intelligence
– Repertory/Synergy of Leadership Styles
• Transformational vs. Transactional
• Servant Leadership
• Others
 Goleman’s Emotional Intelligence:
Summary
• Know thyself (γνωθι σεαυτόν)
• Control thyself
• Optimism: a positive attitude
• Empathy: care about others and care for others
• Vision
• Develop others
• Celebrate: encourage the heart
• Master multiple styles
 Leadership Styles
• Coercive: “Do what I tell you”
• Authoritative: “Come with me”
• Affiliative: “People come first”
• Democratic: “What do you think?”
• Pacesetting: “Do as I do, now!”
• Coaching: “Try this”
What Works….and What Doesn’t

Goleman D. Leadership that gets results. Harvard Business Review, March-April 2000
 How Often Do You
Look In the Mirror?
• Self Assessment
– Are you honest about strengths and weaknesses in
behaving as a leader?
– Do you have a good feel for your strongest and weakest
leadership styles?
– Do you see yourself as leading?

• Dialogue and Feedback From Others

– Are you open or closed to it?
• “ [A] leader releases energy, unites
energies, and all with the object not only of
carrying out a purpose, but of creating
further and larger purposes.”

• Mary Parker Follett

 Why Kouzes and Posner?
• Data collection and validation over 15
years-It works!
• Rigorous research standards
• Data collected in the field with real people
• 360 review (above, at level, below) of
leadership practices
• Practical-makes sense and easy to
remember and implement
 Leadership Is…
• Behavioral
• Learnable
• Which behaviors lead to success?
5 Practices of Excellent Leaders:
The Evidence Base
• Model the Way
• Inspire a Shared Vision
• Challenge the Process
• Enable Others to Act
• Encourage the Heart
 MODEL THE WAY

Farm Credit Services of America

 Model the Way
• FIND YOUR VOICE
– Clarifying, communicating, and living your
personal values is the “soul” of leadership
– Deeds are consistent with principles
• SET THE EXAMPLE
– Actions speak louder than words
– Produce small wins-get results
 Find Your Voice
– Clarify and remain consistent with values and
beliefs
– Pay attention to how team adheres to shared
values—create dialogue
• Standards, sense of pride
 Setting the Example
• Provide tangible evidence of your
commitment-show results
• DWYSYWD
 The Symbiosis of Leadership
and Management
• Leadership • Management
– What to accomplish – How to accomplish
– Doing right things – Doing things right
– Ladder in right place – Efficient climbing
– Direction/navigation – Detail/operation
– Destination – Road Map

R E S U L T S
 Leaders Need Tools
• Pediatric Leadership Alliance Toolkit
• “Whatever your mind can conceive and
believe, it can achieve.”

• Barbara A. Robinson
Inspire a Shared Vision

Stanford University
 Inspire a Shared Vision
• ENVISION THE FUTURE
– Vision of what could be
– Invent the future
• ENLIST OTHERS IN YOUR VISION
– Inspire commitment
– Share enthusiasm
– Open a dialogue
 Envisioning the Future
• Imagine the ideal
– Positive and engaging
– Standard of excellence, priorities, values
• Intuit the future
– New insights, focus energies in present

• Be Foresighted
 Enlist Others
• Focus collective energy
– Discover a common purpose, passion
• Build commitment
– Communicate expressively, appeal to interests, dreams
of others
• Impart responsibility, personal stake
– Make it their own
• Demonstrate personal conviction
• Outline your strategy and plan, bridging vision
with reality-Connect the dots for people
 Exercise: Great Visions
• Articulating end results in one sentence
• What are the greatest “visions” you have
ever heard leaders articulate?
• What do they have in common?
 Challenge the Process
• SEARCH FOR OPPORTUNITIES
– Innovate
– Change
– Grow
– Challenge motivates and raises performance levels
• EXPERIMENT AND TAKE RISKS
– Take risks
– Support good ideas
– Learn from mistakes to do better the next time
 Arousing Intrinsic Motivation

• Create opportunities for others to outdo

themselves
– Know what others can do and what they find
challenging—promote sense of self worth,
renew the team, help others develop personal
stake
• Remain open to other’s views
 Fostering Risk Taking
• Change as a positive challenge
– Identify possibilities for development, take
initiative
• Sense of control
– Challenging but within reach
• Commitment/interest
– Identify rewards, acknowledge fears, make it
safe to experiment…and fail
 Leadership:
Synonymous With Success in
Navigating Change
 The Dual Nature Of Change
The
Organizational
Goals
Iceberg
Products
Structure Structural
Technology Aspects
Financial Resources
Policies & Procedures
Roles & Responsibilities
Rewards & Recognition
Perceptions Human
Attitudes
Values Aspects
Feelings
Informal Interactions
Group Norms
 Individual Transition Process

The Journey

New
Endings Beginnings
Neutral
Zone

Productivity

“CHAOS”

Drake Beam Morin, Inc.

People must be nurtured
Change process must be
managed
 The Productivity Impact of Change

Idea of Change Introduced Managed

(restructuring, merger, plant closing, etc.) Change

Morale/ Minimum
Productivity/ Acceptable
Commitment
Unmanaged
Change

Time
Drake Beam Morin, Inc.
 Organizational Change

The objectives of organizational

change cannot be successfully
achieved until a critical mass
of people have completed
their own individual changes…
which changes the culture.
Working Change Model
for Working People
Courtesy of PLA
 Managing Complex Change
Action
Vision Skills Incentives Resources Status Quo
Plan

Case for Action

Skills Incentives Resources Confusion
Change Plan

Case for Action

Vision Incentives Resources Anxiety
Change Plan

Case for Action Gradual

Vision Skills Resources
Change Plan Change

Case for Action

Vision Skills Incentives Frustration
Change Plan

Case for False

Vision Skills Incentives Resources
Change Starts

Enabling Action
Shared Need Vision Skills Incentives Change
Systems Plan
Enable Others to Act

ReGen Technologies
 Enable Others to Act
• FOSTER COLLABORATION
– “We” mentality
– Build a team of strong, capable and committed
members
• STRENGTHEN OTHERS
– Share the sense of ownership
 Fostering Collaboration
• Improves performance
– Sustains future interaction, allows diverse
inputs
• Builds trusting relationships
• Betters espirit de corps
– Need each other
• Breeds commitment
– Shared goals and responsibility
 Strengthen Others

• Feeling powerful=feeling able

– Ensure self leadership
– Provide choices
– Develop competence-provide skills and
knowledge
– Assign tasks, make connections
– Offer support
 Achieve Small Wins
• Doable steps
• Keep momentum going
• Sustain commitment
• Accentuate intrinsic rewards
 Encourage the Heart
• RECOGNIZE CONTRIBUTIONS
– “Authentic” Recognition
– Individual and group achievements
• CELEBRATE THE VALUES AND
VICTORIES
– Spirit of Community
– Doing good and doing well
 Recognize Contributions
• Build self confidence through
expectations/feedback
• Stimulate and motivate internal drives
– Sense of accomplishment
• Connect performance and rewards
• BUT-if it is not “authentic” it can have the
opposite impact of what is desired
 Celebrate Accomplishments
• Honor team members
• Tell GREAT stories
• Share success
• Encourage others and their passion
• Link to core values
Exercise: Encouraging the Heart
• Discuss the most innovative and effective
ways you have seen leaders and
organizations recognize accomplishments,
achievements, and efforts
 “Ten Commitments of
Leadership”
• 1. Find your voice-Clarify • 6. Experiment and Take
personal values Risks-generate small wins
• 2. Set the example-Align • 7. Foster collaboration-
actions with values Cooperative goals and trust
• 3. Envision the future- • 8. Strengthen others-Share
ennobling and exciting power and discretion
• 9. Recognize contributions-
• 4. Enlist others-Appeal to
Show authentic appreciation
shared aspirations
• 10. Celebrate values and
• 5. Search for
• Victories-spirit of
opportunities-innovate,
community
grow, change
• “Leadership is not something that you learn
once and for all. It is an ever-evolving
pattern of skills, talents, and ideas that grow
and change as you do.”

• Sheila Murray Bethel

 LEAD!
• Your patients need you to lead
• Your Academy needs you to lead
• Your profession needs you to lead
• Make the practice of leadership a part of
your everyday practice

THANK YOU