Taking the Lead: A Guide for Emerging Leaders in Academic Medical Centers

Description:

This practical, insightful title is a must read for anyone interested in or recently appointed to a leadership role in an academic medical center. Taking the Lead: A Guide for Emerging Leaders in Academic Medical Centers represents the highly accomplished authors’ more than 60 years of collective insights about leadership and leading effectively in an academic medical center environment.

The authors present creative and highly applicable themes synthesized from their knowledge, career experiences, unique reflections, practice, mistakes, and observations of successful (and not so successful) leaders. The result is a book of leadership wisdom – a wealth of ideas, concepts, and insights to inform the reader’s career journey and to become the best leader they can be.

Organized in five parts,this work examines the successful leadership transition in the unique (and sometimes perplexing) academic medical center environment. Informal, conversational in tone, and often engagingly humorous, Taking the Lead: A Guide for Emerging Leaders in Academic Medical Centers represents a concise and invaluable introductory read for the next generation of leaders, as well as a helpful resource for experienced healthcare leaders.

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Preface

We, the authors of this book, propose that “leadership” has been with us literally from the dawn of time. In fact, we believe leadership is an inherent characteristic of the human experience. The initial conversation between the first two speaking human beings, we imagine, went something like this…
Human #1: “OK, so now whatta’ we do?”
Human #2: “Follow me.”
And thus, leadership was born!

All kidding aside, the purpose of this book is to provide skill development guidance for anyone interested in or recently appointed to a leadership role in an academic medical center (more on this in Chap. 1). We say “skill development” as we believe leadership can be learned. That is, knowledge and insights can be gained, competencies practiced, and abilities refined, based on learning, experience, and reflection.

However, we also believe that leadership is as much art as science. Which is why it is equally magnificent and vexing. Every leader may acquire the knowledge and competencies to lead, but how they apply and refine these tools is the art which often determines the leader’s success.

Collectively, we have been involved in a variety of leadership roles for more than 60 years, and have coached, mentored, and developed future leaders for nearly as long. In these roles we have learned, experimented, reflected, failed often, and come back for more. Co-author Kyle P. Meyer traces the beginning of his formal leadership journey to 1977 when he was elected as the president of his physical therapy class. He went on to serve in formal roles as Chief Pediatric Physical Therapist, Director of Clinical Education, President of the Faculty Senate, chair of a national professional committee, president of a regional professional committee, Associate Dean, Senior Associate Dean, and Founding Dean. Along the way, he also served in volunteer leadership positions as President of the PTA, chair of a not-for-profit board, and president of an alumni association.
Co-author Rob Kramer has served in leadership roles in higher education as Senior Leadership Advisor, Founding Center Director, and Department Director; in non-profits as Executive Director; and as a professional Executive Coach, working with clients including hospital CEOs and C-suite executives, academic medical center deans, chairs, and administrative leaders, university presidents, provosts, deans, and other senior academic leaders. He is also the founder and CEO of a successfulviii
coaching and consulting firm, leading a team of more than 30 coaches who provide executive coaching and leadership development for senior leaders in higher education, academic medicine, non-profits, and the public sector.

This brief overview of our leadership journeys is not intended for selfaggrandizement, rather, simply to establish some credibility. We want you to know that with each of our respective roles we’ve acquired invaluable lessons in leadership. These came from knowledge gained through formal instruction, informal mentoring, considerable reading, from coaching and being coached, and by applying knowledge from other fields to the art of leadership.

And we have benefited from wonderful colleagues and mentors who often saw more in us than we saw in ourselves. The list of people we could acknowledge for their contributions to our personal, professional, and leadership development is astonishingly long. These individuals taught, challenged, and more than once, bailed us out!

Our primary goal with this book is to serve you in a similar role. To share our lived experiences as mentors, formal and informal coaches and leaders, teachers, supporters, and guides. It is our sincere hope that our reflections, insights, tools, and ideas will serve as both conceptual and practical guidance for you along your leadership journey.

This book is not intended to be a “how to” nor a comprehensive “tour de force” on leadership (although it certainly contains plenty of useful and applicable information). In perusing the table of contents, you likely note that there are no chapters on preparing a budget, strategic planning, or managing personnel issues. Rather, this book represents our collective insights—a book of leadership wisdom if you will. The chapters present a series of leadership themes, derived from our own unique observations and perspectives, our own personal mistakes and growing pains, and our observations of other leaders (both successful and unsuccessful). We have selected themes we find important, both about leadership in general and leading in an academic medical center.

We use the word “theme” deliberately because the content of any given chapter is not wholly about a specific topic, but rather an assembling together of observations, reflections, insights, and tools related to that topic. Our purpose is to provide you with ideas, concepts, and insights that have helped us, and in so doing, our hope is that our experience can inform yours, assisting you in acquiring new skills and different perspectives, avoiding some of the mistakes we made, and becoming the best leader you can be.

A note about our writing style. You’ll quickly learn that we’re very serious about developing new leaders in academic medical centers, but we’re also pretty informal. We believe we can better convey our thoughts in a more conversational style. And we think humor is an important aspect of leadership, and life, so you’ll note some subtle (or not so subtle) reflections that are on the “lighter side” throughout the book.

We want to draw your attention to a unique feature of the book. We’ve ended each chapter with a section entitled, “How do I get started?” It includes a “virtual” executive coaching session consisting of relevant questions, not unlike the guidance you might receive from an executive coach. The questions are designed and arranged to facilitate your continual reflection on, and application of, the key concepts within the chapter. We encourage you to return to them often, as you will generate different answers and new insights as you continue to gain leadership experience. We also conclude each chapter with additional resources, entitled “Curious to learn more?” to assist you in building your leadership understanding and knowledge.
Thank you for your passion to lead and for letting us be a part of your journey!

Omaha, NE, USA Kyle P. Meyer
Chapel Hill, NC, USA Rob Kramer

Table of contents :

Foreword
Preface
Acknowledgments
Contents
About the Authors
Part I: Leadership in the Academic Medical Center: Insights and Perspectives
1: Introduction: Why You Should Read this Book
The Need to Develop Leaders
The “Emerging” Leader
What to Expect
References
2: The Milieu of the Academic Medical Center
Some General Observations about Academic Medical Centers
Multiple Missions
Shared Governance
“Government Should Be Run Like a Business” … Or Should It?
Incremental Pluralism
The Leader’s Role as Storyteller
References
3: Transitioning to Leadership in the Academic Medical Center: Conceptual Considerations
Why it Matters to You, the New Leader
Two General Conditions of Hire for a New Leader
Assets, Challenges, and Errors Associated with Being an Internal Hire
Assets, Challenges, and Errors Associated with Being an External Hire
Two Transition Challenges for the Internal or External Hire
Concluding Thoughts
References
4: Transitioning to Leadership in the Academic Medical Center: Practical Considerations
DO Understand Your New Role
DO Clarify Expectations (for Others and Yourself)
DO Establish a Cabinet
DO Hire a Good Administrator
DO Focus on Developing this Important Skill
DO Expect and Respond to Early Leadership Challenges
DON’T Be in Too Big of a Hurry
DON’T Assume Others’ Problems
DON’T Listen to this Advice
DO Take Care of Yourself (DON’T Assume the Academic Medical Center Will)
Concluding Thoughts
References
5: Strengths and Motivations of the Leader
Observation #1: Traits—Duality Versus Continuum
Observation #2: The Impact of Stress on the Manifestation of Traits
Observation #3: Strengths as Weaknesses
Observation #4: The Humility–Ego Dichotomy
Observation #5: Reflective Is Effective
Observation #6: The Value of Emotional Intelligence
Observation #7: The Compelling Motivation to Lead
References
6: The Work of Leading in the Academic Medical Center
What Do Leaders Do?
Leaders Create Meaning (and Manage Uncertainty)
Take Another Look at the List
Developing People
Balancing and Aligning Competing Interests
Power Versus Purpose
Vision Versus People
Individual Versus Collective
So… “What Would Ya’ Say You Do Here?”
References
Part II: Deciding About Decision-Making
7: The Multiple Dimensions of Decision-Making in the Academic Medical Center
A “Wide-Angle” View of Decision-Making
Four Frames of Decision-Making
All the Frames, All the Time
The Nuances of Good Decision-Making
“Stay in Your Lane”
References
8: Making Leadership Decisions Versus Clinical Decisions
What Are Health Professionals Taught?
Why it Matters
A “Non-Decision” May Be the Best Decision
New Day, New Way
References
9: Getting Comfortable with the “Limits” of Decision-Making
The 70% Rule
The 70% Rule’s Impact on Change
The “Late Majority”
Being Deliberate about Deliberative Decision-Making
References
10: Decisions about Your Academic Medical Center Career Trajectory
Developing Your Career as Leader
Opportunities Abound
Abundance Restraint
When Your Supervisor Speaks, Listen
Strategies for Picking the “Right” Opportunities
A Model for Evaluating Opportunities in the AMC
Committing to Opportunities
Concluding Thoughts
References
Part III: It’s the Little (or Not So Little) Things
11: Leading by Following
Following Your Supervisor(s): Tending to Their Tendencies
Courageous Followership
Leading Up
A Note on Manipulation
Following your Followers: Servant Leadership
Following Good Leaders
Concluding Thoughts
References
12: Understanding (and Following) the Academic Medical Center’s “Chain of Command”
Chain of Command
Successfully Navigating the Chain of Command in Your Academic Medical Center
Who’s in This Chain, Anyway?
The Art of Advocating
Other Chains of Communication at the Academic Medical Center
The “Secret of Life”
References
13: The Value of “Invisible” Leadership
Behind the Scenes Is Often the “Scene”
Money
People
Change
Brokering
The Art of Playing the Long Game
Step #1: Seed Your Idea
Step #2: Speaking Your Plan into Existence
Step #3: Getting Your Idea on the “Agenda”
Wait, What? A Note About “Getting Credit”
References
14: The Leader’s Role in Academic Medical Center Philanthropy
The Basics of Philanthropy
The Leader’s Role in Philanthropy
Preparing Your Proposal
An Investment, Not an Ask
The Process
Philanthropists and Elected and Appointed Officials
Concluding Thoughts
References
15: Accreditation: The Regulatory Lifeblood of the Academic Medical Center
Purposes of Accreditation
Accrediting Agencies and Accreditation Standards
Beginning the Accreditation Review Process
Writing the Self-Study
Hosting the Site Visit
A Final Tip on the Schedule for the Site Visit
Concluding Thoughts
References
Part IV: Leadership Challenges and Challenges to Leadership
16: Leading Change in the Academic Medical Center
A “Systems” Perspective on Change
Change as “Perturbation”
Time to Change and Time for Adapting to Change
Practical Recommendations for Leading Change in the Academic Medical Center
Everyone Is a Change Agent
Closing Encouragement
References
17: Leading Conflict Resolution
General Principles of Conflict Resolution
Fundamental Elements of Conflict Resolution
Content or Relationship?
Process
Tenor and Language
Conscious Listening
Avoid Avoiding Difficult Conversations
Steps for Having a Difficult Conversation
The Opening of the Meeting
The Middle of the Meeting
The End of the Meeting
Number and Format of Meetings
Don’t Be Intimidated or Undermined
Concluding Thoughts
References
18: Crisis Leadership in the Academic Medical Center
A Crisis Is Coming
Strategies and Skills for Crisis Leadership
The Great Multiplier
References
19: Betrayal: Such Is the Life of a Leader
Leadership Betrayal
The “Storyline” of Betrayal
Results of Betrayal
How to Respond to Betrayal
Situations Not to Be Confused as Betrayal
Learning from Betrayal
Part V: Epilogue
20: You Can’t Lead if You Don’t Take Care of Yourself
There’s More to Life than Leading
Bicycling as a Metaphor for Leadership
Wind, Wind, and More Wind
What’s Your Destination?
Have a Good Ride!
Index