American Association for Physician Leadership

Team Building and Teamwork

Leadership Strategies: Achieving Personal and Professional Success

Ronald Menaker, EdD, FACMPE

June 8, 2016


Abstract:

Physicians and allied health staff in healthcare are finding themselves in situations characterized by uncertainty, chaos, and ambiguity, with high levels of burnout. A major influence is an aging U.S. population, resulting in increasing cost and reimbursement pressures. Medical group practices need leaders who have the capability to thrive in this environment. This article presents an integrated leadership model offering strategies and insights gained from keeping a journal for 40 years. Strategies to be shared include leading self through learning, leading others by developing relationships, leading organizations by achieving excellence, and achieving work–life integration and synergy.




After completing graduate school and starting a career, it became clear that my formal schooling had provided a firm foundation to begin employment. There was, however, a need to develop my abilities in self-management, including stress management and building relationships with others. To help me improve these abilities, I started to journal my thoughts, inspirations, and frustrations. I carried this journal so I could capture important reflections and leadership concepts at the moment they occurred to me. Entries involved observations, stressors, concerns, successes, and failures. The journal provided me an immediate opportunity to capture the thought, emotion, or inspiration I was experiencing at that moment.

Writing these entries was also cathartic. As a manager, I was often confronted with high-conflict or high-risk situations. I was often tempted to act defensively or negatively, but I knew the release of negative emotion often causes damage. The journal allowed release of emotion in a positive and private way.

The journal also became a tool of lifelong learning. It helped me capture moments of creativity and inspiration so I could use them as intellectual capital to enrich my practice. I also recorded reflections that occurred during times of disappointment, rejection, or depression. A friend once told me that good judgment comes from experience, and experience sometimes stems from bad judgment. If I could capture the wisdom gained from bad judgment, it would, I reasoned, help me improve my effectiveness as a leader.

As I gained experience, my focus and journal entries shifted from growing and self-learning to developing relationships and leading others. Over time I extended the learning to achieve organizational excellence. Although the early years were relatively stress free, the responsibilities of marriage, children, and home ownership combined with more stress and responsibilities at work led me to a fourth focus area: finding a healthy balance between work and life. As my responsibilities shifted, I felt a continuing need to maintain the leadership journal.

One of the questions that I asked throughout my journey is: Who are the leaders in the enterprise, and why are they the leaders? In my definition, leaders are not just the individuals in positions of leadership. Rather, they are the “go to” individuals who can be counted on, who are approachable, and who have developed and used their leadership strategies effectively. I recorded my insights and inspirations from observing these leaders.

During the process of reviewing my 2200 journal entries, I realized they were written as strategies in a logical sequence from which I developed an integrated leadership model. This model represents the four aspects in a leader’s career, with practical and specific behavioral strategies to achieve sustainable personal and professional success (Figure 1).

Figure 1. Integrated Leadership Model. The integrated leadership model provides an understanding of how one leads self through learning, leads others by developing relationships, and leads organizations by achieving excellence, all while maintaining work–life integration and synergy.

Leading Self Through Learning

When considering self-leadership, how do we learn and reflect and address the anger, frustration, and anxiety that we all experience? How do we develop humility, optimism, patience, resilience, and confidence? Strategies for successful learning include learning by reading, learning from interactions with others, and learning from experiences (both good and bad). Learning involves overcoming the fear of the unknown, established habits, unplanned speed bumps and challenges, and a rapidly changing environment that has the potential to overwhelm:

  • Reflection allows for a reevaluation and consideration of past actions through assessment of the current situation; absorption of new ideas; understanding of the relevance of the mission or vision strategies; weighing whether stated values are lived values; and evaluating the appropriateness of resource allocation.

  • Humility is a powerful antidote for arrogance, a fatal characteristic that derails leaders. Maintaining a lower profile that recognizes and authentically appreciates the contributions of others will enhance effectiveness.

  • Frustration, anger, and anxiety are a reality in the lives of all of us. Identifying the source, developing reacting and coping mechanisms, and understanding and managing the emotional intelligence capabilities of self-perception and self-confidence are critical.

  • Optimism and patience are hallmarks of effective leadership, which also include being physically fit, being enthusiastic, understanding and living your values, having a positive attitude, and acquiring new knowledge. Both can guide leaders through the natural apprehension and delays that normally occur in the development and implementation of operational and strategic plans.

  • Resilience and confidence are important in accepting and adapting to setbacks, influencing emotional and cognitive reactions to develop new approaches with a learning orientation.

Leading Others Through Building Relationships

When leading others, do we display professionalism with empathetic listening to work through the inherent conflict found when working with others? Do we have capabilities in managing conflict, valuing diversity, being assertive, and maintaining a perspective on priorities and values?

Relationships are the core of leadership through which leaders have the opportunity to learn from others, to serve and listen, to build trust, to hear and respond to feedback, to discover the values of others which influence their choices, and to coach and mentor the leaders of tomorrow:

  • Professionalism often is displayed with a tolerance for potential frustrations, a focus on priorities, and the ability to navigate challenges and obstacles with a calm, patient, mindful approach. Professionals self-regulate and set a standard of excellence, taking the long view with accountability for their actions.

  • Listening is the most important leadership behavior, because it is the mechanism to enhance relationships. The empathetic listener provides an intense focus on the speaker, listening for his or her feelings nonjudgmentally. Listening, and the silence that accompanies it, is how the voices of others are heard.

  • Conflict management is the area where leaders often are tested. Resolution of conflict requires a display of effective communication, understanding differences in goals or objectives, understanding different personalities, appreciating variable work issues, and resisting the urge to blame or become defensive.

  • Assertiveness is a delicate capability that involves empathetic listening, speaking up, minimizing defensive reactions, and an understanding of assertiveness, in contrast with aggressive, passive-aggressive, and passive behaviors. Assertiveness also can minimize unproductive interactions that can consume resources inefficiently.

  • Diversity and inclusiveness recognize the business and human case for seeking the wisdom of the team to craft solutions for sustainable performance. Diversity and inclusiveness become a source of innovative ideas, building on the experiences of many stakeholders, especially during times of volatility, uncertainty, chaos, and ambiguity.

  • Perspective is enhanced by reflecting on past experiences, understanding goals and strategies and putting them in context, learning from others, and maintaining a system-wide understanding of the industry and phenomena that one is living.

Leading Organizations by Achieving Organizational Excellence

Leading oneself and others serves as the foundation to what we as leaders are expected to do: achieve organizational excellence for long-term success. Strategies include having a vision, setting priorities and reducing noise, being organized, solving problems, taking initiative, and managing change. Achieving results, including being persistent and accountable, is the ultimate goal for attaining excellence:

  • Having a vision is one of the most appreciated qualities of effective leaders. The vision is the overarching super ordinate goal that guides the alignment of all decisions and the allocation of resources.

  • Setting priorities and being organized is the vital next step following the visioning process. Establishing priorities and organizing them appropriately identifies which vital initiatives will receive attention and resources. This maintains a focus on mission and vision critical plans, which will be the agenda for meetings and reports.

  • Taking the initiative is enhanced when individuals are empowered to act on ideas without seeking unnecessary approval and share the vision with a passion and enthusiasm that generates high levels of discretionary engagement and effort.

  • Problem-solving capabilities are higher when leaders can differentiate when extensive planning is required, know how to acquire the necessary resources, and have the ability to understand the larger problem, not just the symptoms, and the potential solutions that should be pursued.

  • Leaders of successful change management efforts understand the presence of inertia, when a clear vision or sense of urgency is lacking. They can focus on communication, knowledge, and ability acquisition with appropriate reinforcement actions for sustainability. Understanding the emotions involved is paramount, especially in sensitive situations.

  • Achieving results is the ultimate end game, a result of disciplined strategy, focus, and execution. Performance metrics need to be identified and shared for all people, processes and outcomes being monitored. Pulse checks to assure accountability are vital to avoid wasted efforts and to detect unplanned influences.

Achieving a Healthy Work–Life Integration and Synergy

Personal sustainability is not possible without a vital fourth area, work–life integration and synergy. The pressures of self and relationship management and a career can easily cause damage to one’s self, creating imbalances that result in poor health—emotional, physical, or both. Accordingly, as leaders, we need strategies, including relaxation and accepting reality, to achieve personal health and wealth in the leadership journey. The “wealth” referred to in this case is a “psychic” wealth—the wealth that comes from leading a meaningful life of contribution that is consistent with personal values.

Physicians and allied health professionals in medical group practices are experiencing very high levels of burnout. This burnout is substantial, affecting organizational performance and patient care. The drivers of burnout are coming from all directions: additional workloads; the need to change processes to increase efficiency; competing priorities from work–life demands; and increasing loss of autonomy and time challenges to do the work that is most meaningful.

Strategies to address burnout include being mindful of competing needs, recognizing signs of physician and emotional exhaustion, accepting mistakes as learning opportunities, seeking moderation and balance in work and personal efforts, and understanding and seeking the meaningful aspect of work. Also, it is important to recognize strategies for avoiding burnout by improving work–life integration and synergy will come from multiple sources, including the organization, the work unit, the leader, and the individual.

The Future

The unprecedented rate of change in the healthcare industry is resulting in enormous leadership challenges to improve the effectiveness and efficiency of our practices and our success at implementing changes. The industry needs leaders with the capabilities and strategies to successfully carry organizations through these challenging times. At the same time, leaders need to manage themselves as they manage their organizations to sustain a high level of effectiveness.

Four overarching themes, or “memos to self,” have emerged as I have studied the journal entries on my leadership journey:

  • Leading self involves being positive, patient, and persistent. Successful change requires all three components. Develop a psychological capital by reading to develop your leadership capabilities, continually reflecting on what is and is not working as desired.

  • Leading others involves listening, the key message in building relationships. My young daughter reminded me that the same letters that spell listen, spell silent. When we listen, and more importantly, hear the voices of others . . . when we take the time to be with others, we build the social capital we need.

  • Leading organizations involves a focus on the vision. The research I did on transformational leadership identified very clearly the importance of visioning, to provide direction for where the organization is going. The vision becomes the anchor for priority management.

  • Work–life integration and synergy involves a focus on your priorities. We all get to choose what is important to each of us. Like emotions, values are not right or wrong. If we understand our priorities, a product of our values, then our efforts should allow for a healthier integration and synergy between work and life.

Editor’s Notes: Ronald Menaker is the author of Leadership Strategies: Achieving Personal and Professional Success, published by the Medical Group Management Association and available at www.mgma.com . Also, Ronald Menaker retains the rights to the Integrated Leadership Model shown in Figure 1.

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Ronald Menaker, EdD, FACMPE

Mayo Clinic, 200 First Street, SW, Rochester, MN 55905; phone: 507-538-7340; e-mail: menaker.ronald@mayo.edu.

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