ÄRZTE IN FÜHRUNG - Interview mit Paul F. Levy

Paul F. Levy is the author of “Goal Play! Leadership Lessons from the Soccer Field” and former CEO of Beth Israel Deaconess Medical Center (BIDMC), a teaching hospital of Harvard Medical School. In a time of transition for BIDMC in 2006, Paul took the unusual step of launching a blog, “Running a hospital”, sharing his ideas about negotiation theory and practice, and leadership training. We asked Paul for his perspective on medical leadership and his thoughts on decision making, transparency, and mindfulness.

What important leadership advice did you receive?

"Lead as though you have no authority." If you find yourself being highly directive towards others, rather than relying upon them to be trustworthy, thoughtful, and well intentioned, you will end up trying to do their jobs as well as your own. Your task as leader is to coach those in your organization, promoting their personal and professional development. Ultimately, you will be judged on the quality of the people who have worked for you, not on the day to day tasks facing your organization.

Any advice on decision making?

One aspect that is mostly absent in training is the deleterious impact that cognitive errors can have. Cognitive errors, by their very nature, are usually not noticed by the person experiencing them. Among doctors, the most common cognitive error is “premature closure”, the tendency to reach a medical conclusion too quickly – often influenced by recent experiences. Less evident perhaps is the fact that administrators often suffer from the same type of bias. Relying on their past experience in other settings or anecdotes, they can be overly quick to diagnose operational or organizational flaws. The result can be an attempt to design policies or make decisions that have insufficient analytical rigor. In their zeal to appear decisive, administrators can actually impair the ability of clinicians and other staff to do their work properly. Those involved in people leadership need to take extra steps to ensure that they have properly consulted appropriate people before adopting a particular path. Thus, they need to make clear that they are open to constructive suggestions and criticism from all levels in the organization.

How about transparency?

Another cognitive bias is for people to think they are achieving better results than they actually are. This phenomenon is not a result of a desire to mislead others. It is just a natural tendency to think that we are doing better than we actually are. This can occur at the individual and institutional level. A survey of Victorian hospitals by M. Bismark et al., for example, demonstrated this "Lake Wobergon" effect, showing that the boards of trustees of several dozen hospitals all felt that their hospitals were above average when compared to the norm (Australian Health Review 37). The remedy to this problem is transparency of clinical outcomes, to present for you and the world to see, just exactly what is going on.

What are your thoughts on mindfulness?

Mindfulness is the ability to take stock of the situation in which you are working and take note of your own emotional and physical state. These self-derived factors can have a substantial impact on your ability to properly carry out your diagnostic and treatment pathways. A lack of mindfulness can also impede your ability to communicate effectively with other members of the care delivery team.