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Learning to Lead in the Academic Medical Center: A Practical Guide PDF

221 Pages·2015·7.07 MB·English
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Learning to Lead in the Academic MMMeeedddiiicccaaalll CCCeeennnttteeerrr A Practical Guide Jeff rey L. Houpt Roderick W. Gilkey Susan H. Ehringhaus 123 Learning to Lead in the Academic Medical Center Jeffrey L. Houpt (cid:129) Roderick W. Gilkey Susan H. Ehringhaus Learning to Lead in the Academic Medical Center A Practical Guide Jeffrey L. Houpt , MD Roderick W. Gilkey , PhD Dean Emeritus, University of North Professor in the Practice of Organization Carolina School of Medicine & Management CEO, Emeritus, University of North Goizueta Business School Carolina Health Care System Professor of Psychiatry and Behavioral Chapel Hill , NC , USA Sciences Emory University School of Medicine Susan H. Ehringhaus , JD Atlanta , GA , USA Senior Manager, Offi ce for Interactions with Industry Partners HealthCare Boston , MA , USA ISBN 978-3-319-21259-3 ISBN 978-3-319-21260-9 (eBook) DOI 10.1007/978-3-319-21260-9 Library of Congress Control Number: 2015946606 Springer Cham Heidelberg New York Dordrecht London © Springer International Publishing Switzerland 2015 T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. T he use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. T he publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper S pringer International Publishing AG Switzerland is part of Springer Science+Business Media (www.springer.com) Foreword: Leadership Really Matters If there is one thing that is evident from my more than 100 visits to academic health centers in the USA and around the world, it is the importance of leadership. I have seen leaders succeed and fail—and many who struggle. As I have gotten to know a good portion of them on a personal level, I have learned a lot about leadership skills as well as the process that brought them to leadership positions. Because academic health centers are complex institutions facing a highly challenging environment, with big budgets and many moving parts—not to mention egos—a high level of leadership skill is required. The necessary skill sets for these positions are usually discussed in broad general terms, such as “has vision,” “is a good communicator,” “works well with others,” and so forth. But the tools to assess these characteristics, much less nurture them in potential leaders, are strikingly absent from the dialogue. More importantly, the key leadership attributes that involve personality factors, such as emotional intelligence, are even more rarely discussed. What’s needed is a handbook for current and aspiring leaders—hence the impor- tance and relevance of this book. Houpt, Gilkey, and Ehringhaus do an extraordinary job of presenting both a broad overview of the dynamics of the academic health cen- ter and a granular “how to” for the myriad of situations that demand skilled leader- ship. This volume is abundantly fi lled with meaningful examples and worthy insights. It is not surprising that in the world of academic health centers most leaders come from the academic ranks. This is both fi tting and just, in that a deep-seated understanding of and respect for the core ethos of academia is indeed essential. Many such leaders are accomplished researchers, department chairs, institute and program directors, or come from other specialty-focused positions. They often have served at a high level in specialty societies, edited journals in their fi eld, and been appointed to NIH study sections. But an insight I have obtained through my visits and personal contacts with academic health center leadership is that academic skills do not necessarily translate into leadership skills (Fig. 1 ). Intellectual achievement, of course, is critical for academic success, whether it be in the creation of new knowledge, the development of a new program, or insight- ful commentary. However, intellectual ability does not necessarily imply that the necessary leadership behavioral skills are present, such as emotional intelligence v vi Foreword: Leadership Really Matters Fig. 1 Academic skills versus leadership skills [1] and the ability to negotiate, which are well defi ned in this book. Most academics develop a specifi c and necessarily narrow knowledge base as a requirement for deep expertise in a specialty or research area. Yet, the successful leader of an aca- demic health center must cultivate broad interests to effectively manage the institu- tion, such as the “non-academic” pursuits of human resource departments, budgeting cycles, and public relations. Academically successful individuals are generally highly self-motivated in that their achievements are judged by what they do to benefi t their careers. However, leadership of an academic health center requires institutional motivation in the sense that success is institutional, not per- sonal. Institutional leadership therefore demands institutional results, which are far more diffuse and more diffi cult to sharply defi ne than markers of individual suc- cess. The successful academic rises up the promotional and reputation ladder, whereas the successful leader must learn to “manage 360°,” being rewarded by the achievements of others. (Of course, a strong work ethic, an honest character, and sound judgment are essential in any position.) There is thus much to learn for an aspiring leader who comes from a traditional academic background, and this book presents an excellent platform. T he pathway to leadership of an academic health center generally follows the timeworn tradition of academe by largely relying on a “search committee” that seeks an accomplished academic achiever. It is not unusual, therefore, for individu- als with successful academic careers to fi nd themselves 1 day in the position of “accidental leader,” whereby success in one’s fi eld is assumed to automatically translate into successful institutional leadership. Or, perhaps, talented faculty who might be outstanding leaders eschew leadership, referring to it dismissively as “the suits” who are “sitting on a pile of money and not giving me enough of it.” The problem thus is threefold: leadership is often opaque and vague to the faculty; aca- demic success, as previously pointed out, is not necessarily the ticket to leadership success; and the search process for leaders is often fl awed. T he authors conclude the book with a discussion of the challenges in fi nding the right leaders. I agree with much of what they say. Finding the “right” leader for a given institution is indeed a signifi cant challenge. The actual search process, to the appli- cants and others, often appears unfocused and somewhat diffuse. Search committees, Foreword: Leadership Really Matters vii instead of concentrating on specifi c leadership abilities, often fi nd themselves looking for the Deus ex machine, generally in the form of a physician–scientist, who will lead them into the Promised Land. In compiling a handbook of best search practices [2], I have suggested a set of guiding principles and basic management strategies to increase the likelihood of a successful search. In brief, leadership searches should be given the highest priority, and the institu- tion must be cognizant of the extent to which the search refl ects on the culture and reputation of the institution. In many cases that I’ve observed, the search has been delegated to a search committee that often consists of institutional leaders with their own agendas about what is best for the institution. The search committee’s role must be clearly defi ned and differentiated from that of the decision maker, who ultimately determines the terms of the contract to be signed, and who must be fully engaged throughout the entire process. It is essential that a broad and diverse pool of candi- dates be considered, and that the search process be well organized, preferably into three distinct phases: pre-search, active, and on-boarding. Houpt, Gilkey, and Ehringhaus meet a critical need with this book. While the book reads logically from start to fi nish, the reader may want to prioritize certain sections. After brushing up on how the academic health center functions in Part I, the reader might try to recall personal situations in the past involving interactions with academic health center leaders that may or may not have come out well. These situations, for example, could involve negotiation, confl ict resolution, or simply run- ning a good (or bad) meeting. By reading the relevant chapters through a personal lens, the important lessons of the book become meaningfully individualized and then go on to serve as a platform for reviewing the remaining sections of the book. (Of course, this is just a suggestion, and I’m sure many readers will simply read the chapters in order.) Another thought is for the reader to discuss the various manage- ment scenarios presented in the book with a mentor or others in a small group set- ting, if that is possible, to both gain a deeper understanding and to practice specifi c skills. But please keep in mind that this book is more than a manual: it should be viewed as a highly personal journey toward a deeper understanding of one’s strengths and weaknesses, and how this journey can enable successful leadership. Academic health centers face a number of signifi cant challenges in the twenty- fi rst century. These include, among others, signifi cant disruption with new care delivery and payment mechanisms, scientifi c and technological advances, and con- tinued patient empowerment. It should be obvious that skilled leadership is essential to weather this perfect storm. The key to success in this environment, I believe, is the leader’s ability to align the various missions (education, research, and patient care) so as to have each support and inform the others. Ultimately, the successful leader will be able to do so by changing culture and behavior. This book is a good place to start the journey. Washington , DC , USA Steven A. Wartman, M.D., Ph.D., M.A.C.P. Association of Academic Health Centers viii Foreword: Leadership Really Matters References 1 . W artman SA. Future shock or future success? The transformation of academic health centers: meeting the challenges of healthcare’s changing landscape. Elsevier; 2015. 2 . W artman SA. Searching for leadership. Washington, DC: Association of Academic Health Centers; 2014. Introd uction W e always wanted to know what’s in a book before we decide to invest the time to read it. And we thought you would, too, so here you are. T here are fi ve parts to this book. The fi rst three parts are narrative which are intended to help you learn to be a better leader. The fi rst part looks at the AMC as a social system; the second at the role of personality; and the third at a set of neces- sary skill sets. The fourth part is a series of case vignettes to solve based on the material in sections which preceded it. The fi nal part provides a set of solutions to those cases. Part I attempts to take the mystery out of how the academic medical center (AMC) works. It can be intimidating to the novice leader with its size, built-in con- fl icts, and pressures to meet fi nancial goals. Further, if the new leader begins, as many do, with a belief that its only control mechanisms are formal vertical hierar- chies (dean to chair to division head), he or she is destined to play with one hand tied behind his or her back. Many novice leaders recruited from outside an institu- tion compound the dilemma by mistakenly believing that what worked at their old institution will work at the new one. The reality is different. Each AMC has its own unique culture with its own control mechanisms that the leader needs to adapt to and actively use. W e suggest that you begin by looking at the AMC as a group—nothing more and nothing less—and by focusing on how a group functions. If you can understand how a group maintains control with both formal and informal mechanisms, how it clings to its values, why it rewards some and punishes others, how there are different interests within the same group, how and why the group bestows authority on its leader, and what the group wants from its leader, you are equipped to make decisions and to lead the organization to new heights. If, however, you veer off this pathway and violate deeply ingrained cultural norms, you will not be successful until you address these forces. Unfortunately, many new leaders have no awareness of these powerful forces. The fi rst part of the book provides ways to understand these issues, which we have framed in terms of group dynamics. The same dynamics occur for a dean (albeit on a more complicated level), chair, division head, training director, ward ix

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This compelling title is a comprehensive, practical guide for current and aspiring leaders in academic medical centers (AMC). Offering both a broad overview of the dynamics of the AMC and a detailed “how-to” set of instructions for the wide-ranging situations that demand skilled leadership, this
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