American Association for Physician Leadership

Motivations and Thinking Style

Finding the Marvel in the Marble Part III: Developing Others

Joseph E. Swartz | Neil Baum, MD

February 8, 2020


Abstract:

The world stands in awe when looking at Michelangelo’s David in the Galleria dell’Accademia in Florence, Italy. We have great admiration for Michelangelo’s talent, which has yet to be duplicated nearly 500 years later. However, Michelangelo did have traits and behaviors that are not so admirable, including his being a “solo pilot” and not a team player. The world of healthcare is different: working as part of a team is part and parcel of achieving success in medicine. It is rare for physicians to do it all alone. They need the support of others in order to take care of their patients. Also, a physician has the responsibility of training others, which means passing on the knowledge that he or she learned during training plus the knowledge and experience that has been acquired during and after medical school, residency, and fellowship. If physicians kept secrets, then the knowledge base of the profession would be stagnant, and medicine would make little progress.




This article is the third of three parts.

Michelangelo had many wonderful opportunities to develop as an artist. When he was very young, he was wet-nursed by the wife of a stonecutter in the mountains overlooking Florence. While living with the stonecutter as a young boy, he learned the art of cutting and sculpting stone. At age 13, he decided that art would be his profession. Beatings from his father, who wanted him to pursue the profession of business, failed to persuade him otherwise. The next year his father turned him over to be apprenticed for three years to Bertoldo—the finest art teacher of the region and one of the finest sculptors in Italy at the time. Additionally, Lorenzo de’ Medici, a very wealthy businessman, sponsored many young artists, including Michelangelo. de’ Medici brought many famous thinkers and teachers of the time to visit his Florence palace to expose the young artists to a variety of ideas. Many of the fine poets, writers, and philosophers that de’ Medici brought to the palace were followers of the ancient Greek philosopher Plato. Plato believed that people, buildings, and mountains are imperfect copies of ideal forms that exist in the ideal realm. He postulated that our souls come from this ideal realm, and we can “remember” these ideal forms if we search deep enough within ourselves for them.(1)

Young Michelangelo absorbed the ideas presented to him and combined them with his Christian beliefs. He came to believe that the ideal form was an idea held in the mind of God, and it was his creative task as an artist to see this form and to free it from its marble bonds. That is why Michelangelo saw David at the “ideal” moment, and not at the “moment of triumph” as other artists had. He saw David at the “moment of decision,” when David stepped out to face the enemy—Goliath.

At the tender age of 22, Michelangelo was hailed as one of the greatest sculptors of all time after completing the renowned Pieta, which still sits in St. Peter’s Cathedral in Rome. By his 26th year, Michelangelo had developed the requisite knowledge and experience in the art of sculpting needed to tackle the difficult David. Had he not had those great opportunities to be developed as a youth, he may never have achieved greatness. He carried those lessons throughout his life.

Although Michelangelo had a staff of people who loyally worked for him, some for as long as 35 years, he was a loner when it came to design and did not work well with others.(2) Michelangelo took every opportunity to learn from others to develop himself, but he was not good at developing others. He was secretive about his techniques and allowed only a few helpers to watch him work. And although he was loyal to his workforce of 10 to 12 workers and treated them well, only a few became masters, because he would not allow them to see his techniques or to do the difficult, delicate work that set his work apart.(3) He was a master of seeing David in the stone, but he did not see it for others. He found no personal meaning in the success of others—they were simply his helpers.

Over 300 years after Michelangelo’s death, the great French sculptor Rodin learned as much as he could from Michelangelo. He considered Michelangelo to be his master and mentor. Rodin, said, “Let me tell you, since the moment I got to Florence I’ve been studying Michelangelo—that won’t surprise you, and I think the great magician is going to give me some of his secrets.”(2)

Rodin deeply studied every work of Michelangelo, including his writings, in order to understand and learn from him. Rodin said, “Michelangelo called me to Italy and there I received precious insights which I took into my spirit and into my work.” He said, “During my journey to Rome, Naples, Siena, and Venice, I continued drawing, in hope of discovering the principles upon which the compositions of Michelangelo’s figures were founded.”(4) Michelangelo may have been a better teacher after his death than he was when he was alive.

Teaching and mentoring to develop others can be very difficult. Learners have free will and only learn well if they are motivated to learn.

Physicians have great opportunities to learn and develop from the moment they take the Hippocratic Oath until they remove the shingle from their doors and close their practices. Medical education is marvelously designed and structured to develop their knowledge and skills. Residency allows them to practice their skills under the guidance of experienced teachers. However, once out of the environment of structured education, it can be more challenging to develop further.

Physicians tend to be driven and competitive and, like Michelangelo, may not share the finest aspects of what they know and practice. It can be challenging to spend valuable time to develop other physicians or caregivers, unless they are in an educational institution, in a teaching hospital, or managing a team of other providers. Educators are often intrinsically motivated to share their time and expertise with other providers. Pay and extrinsic incentives typically are structured on the basis of patient care, but there are few incentives to develop the skills of others.

However, developing others is an important leadership responsibility. Some physicians have a talent for developing the talents of others, whereas some struggle in their effort to develop others. To be effective at developing others we should start by asking ourselves two questions:

  1. Why should I develop others?

  2. How should I develop others?

First, asking why will help determine what intent is driving our desire to develop others. Michelangelo focused his development on works of art, but what if he had also focused on helping others find the ideal form within themselves and helped them release their talents in the world around them? Imagine the art that could have been created if Michelangelo had helped to develop others to their fullest potential the way he himself was developed.

I (NHB) have mentored college graduates in their gap year between undergraduate school and medical school. The pre-med societies at several local universities have invited me as a speaker to talk about the practice of medicine and how to matriculate into medical school. I often talk to the undergraduate students about how to make their application to medical school stand out. For example, Tulane University has over 10,000 applications for 150 positions in each incoming class of medical school. So how does a student make his or her application stand out in pile of 10,000 other applicants? I suggest that young doctor-wannabes do more than work in an emergency department or operating room or climb Mount Kilimanjaro. One of my suggestions is that they shadow or scribe for a physician in practice. I offer to accept one scribe per year, and I usually receive 10 to 15 applications for the position. Next, I recommend that they write a paper with the mentor physician that gets published so they can have this on their resumes. I can assure you that only a handful of applications will contain a reference to a published paper in a peer-reviewed journal.

Most medical practices recognize the importance of having a scribe to enter the data into the electronic medical record. By being a scribe, the gap-year student learns about taking a history and the review of systems. He or she learns about patient discussions and patient education. The scribe also learns communication etiquette through communicating with other physicians either by phone or written communication. In some instances, the scribe is able to gain knowledge about coding, prior authorization, and insurance issues. In most instances, when the student has an interview for medical school, he or she knows more about the private practice of medicine than the person interviewing the applicant.

A learner must be open to learning and must be able to handle challenges objectively and well.

I have mentored nearly two dozen gap-year students, and all but one of them now are either doctors, medical students, or physician assistants. I am proud of these students who have passed through the portals of my practice and have chosen medicine as their careers.

Are you developing others so that they can continue the care of patients you started? Or are you developing your own practice for your own benefit or glory, like Michelangelo did?

A learner must be open to learning and must be able to handle challenges objectively and well. When leading physicians challenge the knowledge of those who are developing as physicians, it can be stressful for all involved. The Socratic method is a useful way of teaching. Asking open-ended questions helps learners become less defensive and helps them enter the journey of self-discovery as they go in search of answering probing questions for themselves.

A few other ways to develop others are:

  • Giving presentations at medical conferences;

  • Coaching younger physicians;

  • Mentoring students;

  • Forming friendships with younger physicians and students; and

  • Writing, publishing, and contributing to the medical literature.

As healthcare becomes more specialized and complex, it is necessary for physicians to work together in cross-functional, interdisciplinary teams. This is especially true in this era of technical complexity. If the work is more than what one person can handle within the schedule required, then at some point it needs to be divided among others on the team. Knowing how to divide and distribute work is a necessity if you wish to create great contributions. Leading a large-scale care team involving dozens or hundreds of people needs an architect of the first order to conceptually integrate and coordinate the implementation design.

Bottom Line: Michelangelo remains the most famous sculptor in the world. Can you imagine how art and sculpture would have progressed and escalated if Michelangelo had shared his skills with others, and especially with his students? Can you imagine how many more David sculptures or similar masterpieces would have been created if Michelangelo had become a mentor/teacher and had helped other students achieve their potential? Let us take some of the lessons that Michelangelo left us; but let us not emulate his keeping his skills a secret. Let us go forward and share our knowledge and skills with others to make medicine and healthcare better for our patients and the profession.

References

  1. Swartz JB, Swartz JE. Seeing David in the Stone: Find and Seize Great Opportunities. Carmel, IN: Leading Books Press; 2006.

  2. Dunkelman M. What Michelangelo learned in Bologna. Artibus et Historiae. 2014;35:107-135.

  3. Vasari G. The Life of Michelangelo. London: Pallas Athene; 2013.

  4. Butler R. Rodin: The Shape of Genius. New Haven, CT: Yale University Press; 1996.

Joseph E. Swartz

Administrative Director of Business Transformation, Franciscan Health, Indianapolis, Indiana


Neil Baum, MD

Neil Baum, MD, is a professor of clinical urology at Tulane Medical School, New Orleans, Louisiana.

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