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EDITORIAL
Year : 2016  |  Volume : 6  |  Issue : 2  |  Page : 29-30

Leadership and the persona of the academic surgeon


Johns Hopkins Medical Institutions, Distinguished Service Professor, Department of Otolaryngology Head and Neck Surgery, Professor of Oncology, Baltimore, US

Date of Web Publication13-Oct-2017

Correspondence Address:
Charles W Cummings
Johns Hopkins Medical Institution, Distinguished Service Professor, Department of Otolaryngology Head and Neck Surgery, Professor of Oncology, 601 North Caroline Street, Suite 1080 Baltimore, MD 21287
US
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jlv.JLV_11_17

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How to cite this article:
Cummings CW. Leadership and the persona of the academic surgeon. J Laryngol Voice 2016;6:29-30

How to cite this URL:
Cummings CW. Leadership and the persona of the academic surgeon. J Laryngol Voice [serial online] 2016 [cited 2017 Nov 24];6:29-30. Available from: http://www.laryngologyandvoice.org/text.asp?2016/6/2/29/216702




Although destined for a journal focused on Laryngology, my thoughts are more generic to the profession of Medicine and apply to the whole of this calling. The significant core constituents contributing to the persona of a premier academic clinician can be reduced to 5 seminal entities.

The first core component is that of clinical competence and currency of knowledge. It is fair to say that the measure of accomplishment in these two arenas sets the bar for the effective practice of the physician/surgeon. Please note that I include currency of knowledge, implying that there must be an active effort to enhance what was established as core competency during the training process, through an active process of maintaining familiarity with contemporary concepts and physician practices.

The second core element is honesty and ethical practice. Now, I know it's assumed that all who enter medicine are imbued with these qualities. Unfortunately, some have allowed themselves be distracted such that an acceptable level of these two qualities has been leeched away. In my opinion, it's hard work to be honest and ethical, and it requires an ongoing personal surveillance system.

The third component is an absolutely unflagging dedication to the profession and the work at hand. Here again, it takes constant effort to maintain dedication and avoid distraction. The best physicians have this quality.

The fourth core quality involves the ability to lead. I'll have more to say about this later, but in my opinion, the potential to be a good leader exists in all of us, but even the most naturally gifted individual requires both a broad vista and a degree of selflessness. The practice of medicine requires leadership, guidance, and counsel.

The final of the five seminal areas of emphasis is a reverence for life. By that, I mean an unending sense of wonder and appreciation of the vast cultural differences around the globe, sensitivity to human fragility, and humility brought on by an unending FAILURE to fully understand the meaning of life.

With respect to leadership, we can acknowledge that there are born leaders, who are attractive, personable, charismatic, and easy to follow but most of us are not like that and must learn to be effective leaders. As we all know in the residency training process, pressure, responsibility, uncertainty, and an incomplete fund of knowledge and fear of failure. All exert influence on our performance, in some individuals extremely negatively.

For the most part, I have observed notable leadership; however, I have seen glaring examples of poor leadership in the training process, examples of the martinet, the inconsiderate, the inappropriate assigner of blame, and the buck passer. At times, these aberrancies of human behavior have served as templates for the future transgressions by those who were at one time the recipients. The phenomenon of bad behavior perpetuating bad behavior may exist in the training process.

Peter Drucker has stated, “Leadership is not a magnetic personality…. that can just as well be a glib tongue. It is not making friends and influencing people… that is flattery. Leadership is lifting a person's vision to higher sights, the raising of a person's performance to a higher standard, the building of a personality beyond its normal limitations”.

Segaharin comments that “Leadership is not so much about techniques and methods, as it is about opening the heart; it is about the inspiration of one's self and of others. Great leadership is about human experiences, not processes. It is how one influences a formula or program. It is a human activity that comes from the heart and considers the hearts of others. It is an attitude, not a routine.” So… in reality,… Leadership is a complex process by which a person permits others to accomplish a mission, a task, an objective, and directs the organization in a way that makes it more cohesive and coherent. In my opinion, there are certain requisites for the development of leadership skills as they relate to all of us.

  • First, know yourself and seek self-improvement
  • Seek out and take responsibility
  • Possess and hone your technical skills
  • Continually expand your fund of knowledge
  • Communicate up the line and down the line
  • Expect; in fact, demand a sense of responsibility in others
  • Make sound and timely decisions
  • Make certain that others understand
  • Encourage collaboration and teamwork
  • Reward good actions and behavior
  • Above all, led by example.


The process of acquiring great leadership skills is based on the premise that one must understand and then challenge the process; one must create a shared vision and enable others to proceed toward realization of that goal. It may be as simple as maximizing the potential for cure of your patient, one must be capable of energizing the motivation, sharing the glory, and the hardest part, keeping the pain of the process to yourself.

Jeff Bezos of Amazon said that “he was taught that it is harder to be kind than it is to be clever“… remember this in the occasional dark moment ahead. Further on this tack, Gary Schandling has said, “Nice guys finish first, if you don't know that then you don't know where the finish line is.”

So let me construct my dream leader for you, the person that I feel we all should strive to be. He or she should be a visionary. Bean counters need not apply for this particular role. He or she must be absolutely fair, not impartial mind you, but fair. He or she must be accomplished. A frame of reference will most certainly be derived from the accomplishments that one has experienced on the road to the present. One must be committed: committed to the process, committed to the institution, committed to the team, and committed to the cause. He or she must be a communicator… must be able to convey in a clear and concise style, the goals, the obstacles, the process, and the reason.

One must be group centered and collaborative. A good leader must not have, as a central motivator, improvement of his own personal stature. Those afflicted with egocentrism may achieve great recognition; however, the joy derived from advancing those around you will be lost, and the opportunity for maximum contributions will be stultified. One must be convincing and one must be principled. In my opinion, the great leader evokes little skepticism from those who are being lead. A great leader must be courageous and must be a risk taker. By this, I do not mean a crap shooter but one who moves toward the goal in a deliberate fashion despite the potential of uncomfortable confrontation, and yes, even failure. The great leader must be thoughtful of others and must be considerate of all. Prejudicial and biased behaviors have no role in the framework of great leadership.

Above all, the great leader must be a complete person…… as I alluded to at the beginning of this talk, a great leader must know oneself.

Among us, we have saviors of the present and the future. They will overcome any demons that I have presented to you. Health-care today remains an unfulfilled phenomenon serving as an attracter for the most motivated, caring, talented people on the earth.

Global flattening through technological transfer and bridgeless communication only enhances the opportunity to be of importance to society and humanity.

Scientific accomplishments have helped define the aging process and overcome deadly challenges: As examples, cardiac disease, any phase of malignancies, profound neurosensory depravations in the form of hearing loss and soon to be balance, sight, and smell.

The basic good in people remains in a state of challenge but it also remains unsullied. In my opinion, the flame of human goodness still burns brightly, and opportunities for personal fulfillment abound. Clinical competence and currency of knowledge, honesty and ethical practice, dedication and hard work, great leadership, and a reverence for life will ensure continued primacy of the profession we love.




 

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