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The Ten (11) Commandments of

Surgery Department Leadership

Todd K. Rosengart, MDDeBakey-Bard Chair of Surgery

Baylor College of Medicine

October, 2015

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Todd Rosengart, MD: Leadership (Un)Qualifications

Medical school: NorthwesternGeneral surgery residency: NYUCardiac surgery residency: Cornell (NYP)Research fellowship: NIHAsst/Assoc. professor: Weill CornellProfessor: NorthwesternChair: SUNY, Stony Brook

DeBakey-Bard Chair of Surgery: Baylor College of Medicine

Business school:Masters (in anything): Sociology/psychology in college:

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Experience: “Eyes Wide Open”Dysfunctional faculty, staff and leadership opportunitiesHR nightmaresConflicts of interestNo good answers

MentorsO. Wayne Isom, MD (Cardiac surgeon; Weill Cornell)Frank Spencer, MD (Chair of surgery; NYU)Richard Fine, MD (Dean; SUNY Stony Brook)Mitch Rothschild (CEO & co-founder; Vital.comOthers (Modelling what not to do!)

BooksOne Minute Manager (K. Blanchard)Team of Teams (Gen. S. McChrystal)

CoursesHarvard School of Public HealthAmerican College of Surgeons Leadership Training

Todd Rosengart, MD: Leadership Qualifications

First Commandment: Protect Relationships

“Its All about the Relationship, not the Transaction”

Don’t “Win the Battle, lose the War”(It’s rarely worth it!)

- Always “Do the Right Thing” - Gathering chits are worth dividends down the road - How colleagues view you as a professional will affect how you are treated in subsequent transactions:• Downstream: allow (justifiable) expenditures• Upstream: accept disappointing decisions• Lateral: take a non-mandated pay cut

“We Work for the Faculty, Not Vice Versa” (We don’t want to be one of THEM)

“Push authority downstream” - Gen. Stanley McChrystal

Team of Teams

• (If you have the right teammates), they will do it better and faster• They will respect you for it• You can’t (shouldn’t) do it all..• But…keep close tabs

Second Commandment: Maintain Fidelity

Faculty

Staff

Chair

“Its All about the People”

• Seek “force multipliers”• Avoid “time and energy sinks”• Provide purpose and involvement (Forbes on Millenials)• After (documented) remediation, cut the cord

Third Commandment: Mine People Power

VS

Relationships and Team Set?

Move Forward….

“Model Performance Improvement”

One Minute Manager:• Set Goals • Make Feedback timely and brief• Sandwich with positives• Never shortchange Praise

Fourth Commandment: Construct over Time

With Trust in your Teammates…

“Let the Sun Shine…”

• What they don’t know can hurt You (unknown always worse…)• Sharing uncomfortable truths builds Trust and Collaboration

(caveat – unless it is truly personal, sensitive material)• Knowledge is power – share the power• Level the playing field

Fifth Commandment: Project Transparency

“To Err is Human, to Own Up to it is Divine”

• Self-transparency sets the standard• Service Recovery Paradox: corrected errors 25% more impactful than nominality• Sets up a lean management / high reliability organization

Sixth Commandment: Rejoice in Your Mistakes

VS

“If its Worth Being Said, Say it Again”

• Nothing is communicated in less than 5 episodes• Clear and specific feedback• Confirm receipt• Actions speak louder than words (lead by example)• Set deadlines• Allow no exceptions

Seventh Commandment: HyperCommunicate

Eighth Commandment:Maintain Vigilance

“When in Doubt Check it Out”No News is Often Not Good News!

• Things change• Be in the loop – watch out if you’re not• Don’t take the status quo for granted

(“The Constant Gardener”)

Even If You Got All That Right…..

#%*#! Happens!

“Consider the Other Point of View”

Assuming the counterparty is well-meaning and not Evil….• View the situation from their perspective• Assess Their goals and concerns/fears• Deliberate in person (NEVER by email) – body language

Ninth Commandment: Maintain Perspective

“Don’t kick your dog if he can’t do calculus” - O. Wayne Isom, MD (Old Texas proverb)

• Assess values and deficiencies• Leverage your emotional IQ (external awareness)• Work within team’s capabilities (the cards you are given)• But Still Set Goals as High as Possible (Forbes on Millenials)

Tenth Commandment: Embrace Mediocrity

“You Must Constantly Mind your Garden”- Stanley McChrystal

Team of Teams

Your work is never done!• Cultures erode• People forget or leave your program• Entropy and chaos are forever

Eleventh Commandment: Be the Constant Gardener

Be a Leader

Which Sometimes (Often?) Means Swimming Upstream!