By: Anne Massaro, Ph.D. Project Manager, Office of Human Resources
James Kouzes and Barry Posner, authors of The Leadership Challenge, identified “modeling the way” as one of five practices of exemplary leadership. Others of us know this practice as “leading by example” and being aware of the “shadow we are casting.” From my perspective, it is the most critical leadership practice. When we ask our colleagues to engage in something for which they have reluctance, and when we ask our colleagues to embrace new behaviors, they will hesitate long enough to see if we are fully engaged and willing to embrace what is uncomfortable, different and new. If our leaders are not fully engaged in a new strategy and in changing their own behavior to meaningfully contribute to the new strategy, why should we?
In a recent retreat, a participant reminded me of the quote, “Who you are speaks so loudly I can’t hear a word you’re saying.” I don’t know the author of this quote, and the author’s name wasn’t offered to me. The meaning of the quote, however, I know. We do what our leaders do. Consciously and unconsciously, we commit when our leaders commit. We walk the talk when we observe those we deem credible walking the talk. We risk our personal investment when they risk and personally invest.
The Ohio State University values give us hundreds of opportunities every day to “model the way.” If I am accountable for successes and for mistakes, others around me will do the same. If I am open to receiving feedback, and acting on the feedback I receive, it will be easier for those around me to be open to feedback. If I communicate in honest and direct ways, I will likely receive the same, in return. Values on the wall are nice to have and they sound impressive. Lived values, values “in-use” are what will really change culture, one person at a time.
By: Michael A. Caligiuri, MD Director, The Ohio State University Comprehensive Cancer Center
Chief Executive Officer, James Cancer Hospital and Solove Research Institute
A mere 10 years ago, a biomedical researcher had very little contact with a clinical researcher, let alone a practicing physician or other health professional. But then again, 10 years ago the secrets of the human genome were just beginning to emerge, and biomedical informatics and biotechnology were still in their infancy.
Fast-forward to the leading academic medical centers of today, and you find that the most successful model for innovation is one that promotes a multidisciplinary and integrated approach to medical research and patient care. This brave new world requires a new kind of leader, one who can bring teams of individuals – from different disciplines and speaking different “languages” – together to solve complex patient-care issues and translate the most promising research discoveries into effective, appropriate therapies.
The guiding principles for leaders in this environment are mutual respect and mutual purpose. And while these individuals may sometimes appear to be facilitators more than leaders, their strength is in their ability to keep the team focused on these guiding principles and the role each person on the team plays in achieving them. Our most effective physicians, scientists, administrators and middle managers are those who can promote this kind of team culture.
What do you do in your organization to promote “team problem-solving” and interaction across disciplines?
What do you believe are the most important characteristics of an effective team leader?
By: E. Gordon Gee
President, The Ohio State University
E. Gordon Gee
With increasing frequency, I am asked to speak on the topic of leadership. I attribute the growing number of requests to age and longevity, as much as anything else.
I always preface the talks by saying that we learn more from our mistakes than we do from our successes. Truth be told, I have amassed a treasure-trove of mistakes – rich material for these discussions – during the past three decades of leading universities. And whether we are college presidents, physicians, business-owners, elected officials, or students, the same rules of the road apply.
Here, I offer a couple of my many leadership lessons-learned principles.
First, as the world becomes increasingly complex and nettlesome, it is absolutely critical that leaders assemble the most dynamic, capable teams. Forevermore, our economy will be tied to the generation of ideas, creativity, and collaboration. It is essential that we hire the most talented people to generate those ideas and to work together to solve the day’s pressing problems.
The ultimate litmus test for leaders, I believe, is their ability to hire and retain exceptional people. And so it is a grave mistake to think that if we cannot hire the person we want, we should move on to our second, third, or fourth choice. Simply put: Mediocre people breed mediocre organizations.
Another mistake I made early on in my career was believing that my experience of the organization was similar to that of others. Leaders must understand that their experiences differ greatly – in my case, from faculty, staff, students, parents, alumni, and others who are engaged with the University. For example, bureaucratic processes spike my blood pressure as little else can, and yet I am not nearly as encumbered by them as are others in the University.
To fully understand the organizations we lead, we must reach out and treat everyone in our institutions as our teachers. We must regularly take the pulse of our organizations, ask others about their circumstances, and act quickly and decisively when problems arise. In an age of nomadic leaders, assertively understanding organizations is essential.
The real lesson, of course, is that simply celebrating our triumphs does not move us forward or prepare us for the next challenge. The truly teachable moments are often the most painful ones, but they offer lasting benefits if we are wise enough to think them through and to consider what we could have done differently to achieve better results.
By: Chip Souba
Dean, Ohio State University College of Medicine
Every academic medical center – large or small, public or private, wealthy or lacking – has one resource that is more precious, more vital than any other. And that asset is its people – and, in particular, the right people. Some might argue that cash is king or that grants trump everything or that operating margin rules. These factors matter, but not near as much as the right human capital.
The war for talent is intense and it is tempting to grab superstars if and when you can. Amidst the frenzy of the rat race, one guiding principle is key: social competence is just as important as technical competence. Recruiting talent with an eye for leadership and people skills doesn’t mean that candidates must have a capital “L” branded on their forehead. Most leadership is of the small “l” variety. It does mean that fit with the culture is essential. It means paying attention to competencies that are not apparent in a CV. It means saying no if the interviews, evaluations or the references raise a red flag. Everyone knows that it only takes one skunk to ruin a perfectly good picnic (see below, Brock Starr: A Leadership Fable).
What has worked for you in identifying and recruiting “l”eaders who have a high level of social competence?
What are you doing to develop the pipeline of tomorrow’s “l”eaders?
By: Jerry Friedman
Associate Vice President in the Office of Health Sciences
The State of the Union address is the CEO’s annual report on the American enterprise. The 70 minute speech about the health of our country was long on economics and short on health care reform, or as it has come to be known “health insurance reform,” devoting less than 5 minutes to the subject).
photo credit: http://mediaite.com
Health care was presented in context. People are suffering. The cost of care has become unaffordable for individuals and unsustainable for the nation. As our economy sheds jobs, our system of employer-sponsored health insurance continues to create two-fers: unemployed and uninsured.
For those of us who live and breathe health care, what has been going on for the past year has been both exhilarating and daunting — exhilarating because of the hope for real and necessary change in the world within which we work; daunting because, for all the rhetoric about “the best health care in the world”, we know that we should and can do better.
Reforming our “sick care” system is a means to an end, not an end in itself. The business of medicine and the business of insurance are seen as locked in a tug of war for our insurance premium dollar, rather than improving the health of our communities. The cost is preventing us from raising real wages, investing in innovation and improving our productivity and competiveness in a global marketplace. The perceived lack of value adds to the deficit of trust of our citizens towards the government and our patients towards our “industry.” What is the return on investment?
The objectives of the plans on the table are to reduce premium costs, reduce the deficit, reduce the numbers of people without coverage, increase quality & access, and eliminate insurance company abuses. To the loyal opposition, the gauntlet is thrown down: where is your plan that accomplishes these objectives? Just saying “no” is unacceptable.
“The problem is not going away. Don’t walk away. Get it done.”
The need to enhance the delivery of primary care is not a new dilemma, although there has been a renewed recognition of the necessity to do so in any current health care reform debate. As it now stands, the lack of a strong primary care infrastructure will only be exacerbated as the population ages and the need for up to 44,000 more primary care physicians by 2025 has been reported (http://www.sciencedaily.com/releases/2008/06/080617111826.htm).
The reason for the decline in medical students entering primary care has been debated for many years. Some of the causes are obvious, such as lower reimbursement. In fact, it has gotten so bad in some areas of the country that well known practices are no longer accepting Medicare reimbursement as they struggle to survive economically (http://www.bloomberg.com/apps/news?pid=20601202&sid=aHoYSI84VdL0), (http://www.foxnews.com/story/0,2933,306439,00.html. ). This does not even address the issue of Medicaid reimbursement a focal point for expanding coverage and reducing cost in congress. Keep reading →
The short history of government intervention in stimulating or retarding the supply of physicians and other health professionals has been checkered at best. Evolution of the profession from the proprietary schools of the 19th century through the Flexner influenced growth of science- based practice and the modern university medical school relied in large part on the natural ebb and flow of society and the marketplace to right size the supply.
Fast forward to the mid 20th century where the growth of employer based insurance and passage of government sponsored medical care coverage through Medicare and Medicaid provided new sources of revenue and different economic incentives. Government support for expanded physician education and training also grew as the demand increased.
As that century progressed the cost of providing medical services grew and the health of our population declined. Even as life expectancy increased through the advancements of science & technology, our reliance on medicine as a sick care system has fostered lifestyles and behaviors that have lead to an increasingly unhealthy population. The prevalence of obesity and chronic illness amplify that health does not happen in a doctor’s office. The rising cost of health care was becoming unaffordable for individuals & unsustainable for society.
In 1997, Congress capped the number of interns & residents that the government would pay to subsidize the training of through the Medicare and Medicaid programs. Insurance companies, transitioning from non-profit mutual companies to publicly traded for profit entities also denied responsibility to fund this public good. Teaching hospitals met the growing demand and lack of explicit revenue by exercising its redistributive black box and shifting the costs for training as well as the increasing costs of uncompensated care, to its decreasing percentage of privately covered patients.
Organizations use their rankings primarily as public relations and marketing tools. As such, institutional efforts to improve rankings are often, but not always, made for their marketing impact. This opinion is based, in part, on my interpretation of countless billboards, newspaper advertisements, and TV and radio commercials across the country.
While rankings can function as organizational performance metrics, rankings are indirect measurements better suited to creating an immediate impression. They rarely provide the critical details necessary for iterative revision of tactics and strategies. While this is a disadvantage in their operational use as metrics, it is an advantage in marketing, where a ranking is often used to make the simple statement “We’re better than others.” Creating this impression through the aura of “ranking” adds an additional quasi-scientific credential to what is otherwise an advertisement.
A wise medical student once remarked, “rankings are important because Americans like lists.” Magazines promising to provide the low-down on the top 10 songs, best movies, most beautiful beaches, most talented chefs, the top colleges are guaranteed to sell. Lists provide a starting point for people to make decisions when they have many options to choose from. Americans want to believe that in a capitalist society, they should be able to find and pick the best value their budget can afford.
For rankings to be useful, two things have to be true. First, people have to have a choice they can make. Second, the rankings have to measure what is important to people making the choices. Beyond that are pesky details like validity and reliability of the data but let’s just deal with the high level assumptions. Choice and values in health care. Do rankings like US News & World Report’s Americas Best Hospitals help consumers make good choices? Keep reading →
“For me, goals and daily metrics are the key to keeping me focused. If I don’t have access to the right stats, every day, it is so easy for me to move on mentally to the next thing. But if I have quick access to key metrics every day, my creativity stays within certain bounds–my ideas all center on how to achieve our goals”.
Jim Collins in the book Good to Great found that the most successful companies have laser-like focus on finding what drives resources, what they can be best at, and what their team is most passionate at accomplishing. Discipline in execution and focus on core ideology is found most often in the most successful companies. Constantly measuring execution of these strategies is necessary to reach these goals, but measurements alone will not provide sustained competitive advantage – this is the job of culture.
Jay Barney, from the Fisher Business School at The Ohio State University, who is an expert in strategy, has told us that culture determines sustainable competitive advantage for the organization. Thus, a bridge must be built between strategy and culture to reach sustained success. This is reflected well in the entertaining YouTube video, Culture Eats Strategy for Lunch produced by the Coffman Organization, a consulting firm specializing in creating engaged cultures:
Chip Souba is Vice President and Executive Dean, Health Sciences and Dean, The Ohio State University College of Medicine.
Clay Marsh is the Vice Dean of Research at the Ohio State University Collge of Medicine, and Executive Director of the Center for Personalized Health Care
Catherine Lucey is Vice Dean of Education at The Ohio State University College of Medicine.
Daniel Sedmak is Executive Vice Dean at The Ohio State University College of Medicine.
Jerry Friedman is an Associate Vice President in the Office of Health Sciences and Advisor for Health Policy at The Ohio State University Medical Center.
E. Gordon Gee is the President of The Ohio State University.
Michael Caligiuri, MD is Director, The Ohio State University Comprehensive Cancer Center
and CEO, James Cancer Hospital and Solove Research Institute
James Kouzes and Barry Posner, authors of The Leadership Challenge, identified “modeling the way” as one of five practices of exemplary leadership. Others of us know this practice as “leading by example” and being aware of the “shadow we are casting.” From my perspective, it is the most critical leadership practice. When we ask our colleagues to engage in something for which they have reluctance, and when we ask our colleagues to embrace new behaviors, they will hesitate long enough to see if we are fully engaged and willing to embrace what is uncomfortable, different and new. If our leaders are not fully engaged in a new strategy and in changing their own behavior to meaningfully contribute to the new strategy, why should we? 
