Leadership in the Medical Practice

Dr. Itamar Offer CEO Neotia Elbit Hospital Venture Ltd.

Leadership without Easy Answers

Ronald A. Heifetz

Case #1

23 year old woman High Fever and Sore Throat Swollen Sub-mandibular lymph nodes Tonsills – red, swollen and contain white exudates.

Diagnosis – Follicular Tonsillitis

Case #2

50 years old Male Had his first Executive Check-up today Overweight Heavy smoker High Fasting Glucose Positive Stress test

Case #3

57 years old Lady 2 months of lower abdominal pain and fatigue Diagnosis: Metastatic Ovarian Cancer

Are those Similar? Differernt?

57 years old Lady 2 months of lower abdominal pain and fatigue Diagnosis: Metastatic Ovarian Cancer 50 years old Male Had his first Executive Check-up today Overweight Heavy smoker High Fasting Glucose Positive Stress test 23 year old woman High Fever and Sore Throat Swollen Sub mandibular lymph nodes Tonsills – red, swollen and contain white exudates.

Diagnosis – Follicular Tonsillitis

Heifetz calls it “Type 1”

Patient ’s expectations are realistic The Doctor has the solution The problem is well defined and curable:

The responsibility shifted to the Doctor ’s shoulders.

Type II situations

Problem Defined – but no “magic” solution.

The Patient MUST be part of the solution.

e.g. – in Ischemic Heart Disease – Diet, Drugs, Exercise, Lifestyle change etc.

Patient must go through an “ADAPTIVE CHANGE”

Type III situations

Problem poorly defined and unclear.

There is no “Magic” solution A mutual learning process of the Doctor and the Patient must take place: To

Define the Problem

and to

apply the solution The Risk –

choosing a

Technical Solution

(Diagnosis and a prescription)

Type III situations

In our case – the disease is cancer with very low chances for cure.

Cancer is a SITUATION here and not MAIN PROBLEM

Type III situations

So the real work is to deal with issues beyond the Clinical situation: • Best utilization of the rest of life.

• What will happen with the kids after death?

• Preparing the family, friends, kids etc… • Fulfillment of open tasks (professional?)

Type III situations

We – the Doctors may fall into the patient’s expectations of only providing “treatment” instead of drilling into the real important (and hard) questions.

Heifetz calls it:

Avoiding the Work !

To summarize:

Situation Problem Definition

Type I Clear

Solution & Implement ation

Clear

Primary locus of responsibility for the work

Physician

Kind of Work

Technical Type II Clear Requires Learning Physician & Patient Type III Requires Learning Requires Learning Patient >> Physician Heifetz R.A. Leadership without Easy Answers Technical & Adaptive Adaptive

www.takecareindia.net

Thanks You

The Shadow Line

by Joseph Conrad

Accepting responsibility for the situation and rising above the difficulty – is the appropriate behavior , however hard it might be seem at the time.

“The novel provides a demonstration that success requires more than sheer professionalism – indispensable as that is, or more accurately:

To be a good professional, you have to be more than a professional!

Under normal conditions, fidelity to the technicalities of the craftwill see you through.

” 1

“But in an exceptional trial, it needs to be supplemented by human qualities that may have nothing to do with the professional skills, and may even work against them.

Conrad allude to this character trait as

The Human Surplus

” 2 Introduction to the 1986 edition of “The shadow line”

Attributes of Leadership

• Task competence (skill) • Intelligence and judgment in action • Eagerness to accept responsibility • Physical vitality and stamina • Understanding constituents and their needs םירושיכ טופיש תלוכיו היצנגילטניא המישמ ידכ ךות תחקל הקזח הייטנ

On Leadership,

J.W. Gardner תוירחא היגרנאו תויח ויכרצו להקה לש הנבה • • • • •

Attributes of Leadership

• Skill in dealing with people • Capacity to motivate • Good communication skills • Ability to win and hold trust • Adaptability and flexibility םישנא םע קוסיע תולוכי הענה תלוכי תרושקת ירושיכ ןומא תשוחת רצייל תלוכי התוא רמשלו תולגתסה תלוכיו תושימג • • • • •

On Leadership,

J.W. Gardner

And...

• Courage - ץמוא • Resolution תויטלחה • Steadiness – תעד בושיי • Unsefishness – תויכונא רסוח • Humility - הוונע

On Leadership,

J.W. Gardner

Secrets of Leadership:

• Being responsible sometimes means making people mad.

• Perpetual optimism is a force multiplier.

• Command is lonely

Secrets, Colin Powel

Leaders must have...

“The ability to subjugate their own needs to the greater ambition of something larger and more lasting than themselves.

” Jim Collins

• Learn from the past but don ’t dwell on the way things used to be.

• Become as comfortable as you can be with ambiguity • Diversify yourself inside and outside of medicine.

• Become involved in your community.

• Develop business expertise.

לא ךא רבעהמ דמל םירבדהש ךיא לע עבקתת םעפ ויה םע חונב תויחל לגרתת תואדוו יא יבצמ ךותב םיקפוא בחרה הל הצוחמו האופרה ךלש הליהקב ברועמ היה תיקסע הנבהו תולוכי חתפ Edward N. Hanley Jr. American Orthopedic Association • • • • •

• Become more humanistic.

• Encourage diversification in gender and culture.

• Become non adversarial.

• Develop a personal mission and vision.

• Establish an appropriate team or join one.

ינמוה רתוי היה • ינש ינב לש תוברועמ דדוע תויוברת לשו םינימה תורחא תוחצנתהמ ענמיה םירתוימ םיקבאמו • • המישמו ישיא ןוזח חתפ תישיא וא םיאתמ תווצ םקה תווצל ףרטצה • • Edward N. Hanley Jr. American Orthopedic Association

• Remember that being competent in your field is not enough. this just

gets you the chance to be tested

.

• Be or help to select a captain who is qualified and motivated, then empower him or her.

• Accept the fact that success sometimes means only the avoidance of failure.

יעוצקמ תויהלש רוכז אל הז ךלש םוחתב

רשפאמ קר הז

– קיפסמ

ןחביהלו ךישמהל ךל

רוחבל רוזע וא גיהנמ היה לעבו יואר גיהנמ ול רוזע זאו – היצביטומ הדבועה תא לבק קר םימעפל איה החלצהש ןולשיכ לש העינמ Edward N. Hanley Jr. American Orthopedic Association • • •

שרוד לפוטמל ה / אפורה ןיב שגפמה דמעמ .

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