HERDING CATS

Leadership guru Warren Bennis once said that “leading doctors is like herding cats.” Another doctor observed that doctors and leadership mixed as well as oil and water. Is it possible that the core strengths of doctoring – the pursuit of excellent results, the analytical skills, the low tolerance of errors (which could result in deaths) – can make it very difficult for doctors to lead teams?

With this question in mind, I asked Dr Saw Khay Yong, the founder of Kuala Lumpur Sports Medicine Centre, to play a game with me.

“Assume that in 30 minutes you will stop being the senior partner of KLSMC. Assume that I am doctor who is as skilled as you. And now I will take your place. Prepare me. Teach me how to run the hospital,” I told him. “What do I need to be successful?”

The first time I  asked him this question, he looked stupefied. He had a lot of trouble getting his mind around the idea that I (a creative writing major who grimaces at the sight of needles), not he, would run the hospital. And then he laughed. Okay, he’d play along. Then he got serious. Here’s what he said.

1. Gain your people’s respect

“Alvin, you may know everything about regenerating cartilage, but if your staff is not on your side, it won’t work. Your staff knows everything from A to Z. They run your clinic, go to theater during surgery, assist you during surgery, harvest the cells, prepare the cells in the lab. They are your core team. In a major hospital, the staff is never on your side, because you’re not their boss – you’re just a surgeon. Here, you need to gain their respect. They’ll watch how you develop patient rapport, listen to the patient, treat the patient, handle your surgical tools, and deliver surgical results. And you’ll need to encourage them to see things your away. My style of leadership is different from yours. So you need to explain – explain your way of doing things so your staff can understand.”

2. Create rapport with your patients.

“Alvin, you may be a famous surgeon, but don’t become arrogant. If somebody needs you to operate, you need to treat and respect your patient. In post-op care, they need to understand what’s going to happen next. You need to listen to their history and understand where they’re coming from. You’ll also encounter patients who will never listen to you – who think you’re inferior to their surgeons. Listen, you cannot operate on everybody even though you have the skills to do it. They’ll give your staff, front desk, therapists and other patients a terrible time. It’s better not to take them on.”

3. Focus, focus, focus

“Alvin, you’re an orthopedic surgeon, right? Now you’ve got to focus. Ninety-nine percent of your patients are knee patients. Focus on cartilage regeneration with stem cells and widen the application of stem cells. That’s what’s going to take us to the next level. If you don’t push this technology, the world won’t have this technology. Then people with cartilage injury will still suffer. This is the kind of work that will set you apart from everyone else in the world. And take time to write and publish. When your work in regenerating cartilage is recognized by your (orthopedic) peers, that gives you credibility.”

4. Be a giver

“Alvin, you’ll also be working with my medical partners. The most important thing you need to know is that you give more than you take. Partnerships fall apart when people take too much and give very little. You’ve to do more work than others and have less of the reward. Three years ago, I told the partners, ‘we need to set up our own stem cell lab.’ A partner said, ‘What do you know about setting up a lab?’ I said, ‘I don’t know.’ I told them the advantages: the R&D, gaining expertise, controlling the quality of stem cells, et cetera. But the partners were worried about the expense. I had a lot of difficulty persuading them. So I told them, “I’m going to do it anyway. If it works, we’ll share the pie. If it doesn’t work, it’s my problem, not yours.” That’s what you need to do: give more than what you take.”

HONEY, DO I COOK PEKING DUCK OR EXTRACT STEM CELLS?

How do you find time for your family while working in a high-performance environment? All of us struggle with work-life balance. Currently I juggle between writing, coaching, speaking and designing Barefoot Leadership programs for the government and private sector. It’s exciting. It’s relentless. It’s perplexing. But I’m not half as busy as crazy doctors.

The situation becomes nearly insane when you’re a doctor-cum-researcher. You’ve a long line of patients to see. A ton of paperwork. A hospital to administer and bills to pay. You’ve also got a research lab to run. Plus you need to write, publish, and deliver papers at conferences. Meanwhile your wife wants you to cook peking duck and your son needs you to help him with a math problem. What do you do?

1. Say No

Dr Saw Khay Yong, who runs KLSMC, says no to any form of window shopping. If he goes to KLCC to buy a camera, that’s all he does. In and out. He does not waste time getting distracted with anything else. He routinizes tasks at work. All the phone calls – with patients and doctors – are handled by his executive assistants. “Saying no is very important,” says Dr Saw.

2. Explain why you say no

Early on in his career, Dr Saw was swamped with unfinished tasks. The trouble was he could do many things well with his hands. Besides cutting open patients, he could also change diapers, wash toilets, and cook Peking duck and lobster thermidor. But he was overwhelmed. So he and his wife discussed their expectations. They explained their expectations to one another. The tasks of cooking and ironing clothes would go to the domestic helper. Dr Saw would still play badminton and piano with the kids, travel together on vacations, eat dinner together, and coach his son on math. “These days, I still do spaghetti bolognaise for the kids, and I recently I showed the maid how to do an omelette nicely, but I really do spend a lot of time in the hospital, even on Saturdays,” said Dr Saw, who has three pre-adolescent children. “You need family and career. A good family unit is the most important thing. I don’t want a situation where I’m thinking, I lost my son because I was too busy working all this time.”

3. Ruthlessly carve out time for family connections

It’s not enough to eat meals and watch TV together as a family. You need to create vital moments for active connection.  A while ago, hand surgeon Dr Ranjit Singh Gill and his wife (a family physician) discovered that one thing they could all do together as a family was bike-riding.  They engaged the children in the process of researching the bikes and choosing the bike racks. “We got excited together as we went to the bike shop to pick the bikes. It was a whole experience. There’s never enough time. But if you turn everything, including the bike research into times of family interaction, then everyone will remember the times spent together,” said Dr Ranjit, whose family goes biking together once a week.

4. At day’s end, take time to reflect on the day

Many people grind through one day after another, relentlessly, without hitting the pause button. Most of us can’t even recall the highs and lows of each week. Tragically we lose a great deal of insights on how to lead our own lives when we don’t take time to reflect. The busier you are, the more important it is to carve out time for reflection.

Dr Ranjit Singh, an introvert and a night owl by nature, listens to music or watches television to relax. After a while, he embarks on a process of “recollecting and rewinding” the day. He asks himself three questions:

  • What were the good experiences?
  • What were the not-so-good experiences – and what can I learn from these?
  • What do I need to prepare for the coming day?

The first question helps us realize the moments when we’re happy.  We can, sadly, feel happy and not know it. But if you’re aware of your happiness, that experience of happiness becomes enriched joy.

 

The second question is important because there will always be things in life that bug us. So often we don’t know why. We just know that our mood has been spoiled. Asking the second question helps us identify the actual moment during the day that triggered off our bad mood. The diagnosis helps us dig deeper into the root cause, and think about how to rectify or prevent the situation from arising again.

The third question helps us plan for future outcomes based on the insights we received by reflecting on what makes us grateful and less grateful. It is this process of reflecting on our actions, and acting on our reflections, that help us grow as centered leaders.

THE REDEMPTIVE STRENGTH OF THE ACHILLES HEEL

After spending several days with the orthopedic surgeons from KLSMC, I had to learn more about the Achilles heel. It is an important concept in leadership development and spiritual formation – both fields I’m passionate about.

An Achilles heel is a deadly weakness in spite of overall strength. In Greek mythology, Archilles (LINK TO WIKIPEDIA ON ARCHILLES’ HEEL) was magically invulnerable. He survived many great battles. But one day, he was killed by a poisonous arrow that lodged in his heel – his only point of vulnerability.

Every leader has points of vulnerability. The same goes for organizations too. What do we do with our Achilles’ heel? Can anything good come out of such weakness? I asked Dr Ranjit, a hand surgeon, to reflect on the Achilles tendon, the large and prominent tendon of the gastrocnemius and soleus muscles of the calf.

Q. Why is the concept of Achilles’ heel so important?

A. In the Greek myth, Achilles, a great soldier, falls because of one weak link. So your weakest link is important. You want to make sure the weakest link doesn’t give way.

Q. Shouldn’t we focus on our strengths, and build on our strengths in leadership?

A. Your strengths are fantastic, yes. But if you don’t take care of a fatal weakness, everything is going to collapse. You’ve got to keep an eye, reinforce it, try to strengthen it. When you focus that weak link, you make the whole thing work.

Q. How do I do that?

A. Your first step is to know your weakness, that’s the first step to your improvement. When you identify it, you can try to correct or overcome it. But it’s not easy to change over the years. So, just knowing your weaknesses is a positive point. As I understand my weakness more, I realize I may not be able to correct it. Therefore I must take measures to counter this weakness (even though I cannot get rid of the weakness).”

Q. What’s your weak link?

A. I’m a research freak. I like to know everything. Ha ha ha!

Q. That’s a weak link?

A. Research is a good thing. But when I over-research and get obsessive about it, I get tired, it’s time-consuming, and it irritates my family like crazy. And still I may not be solving the problem.

Q. And it’s really, really hard to stop researching?

A. Yes. I research everything. If we go biking, I research the bikes, the bike racks, the bike paths.

Q. Tell me about how you manage this weak link.

A. First, I keep an eye on myself. I try to recognize when I’m over-researching. If I’m sitting down for hours and hours, then I tell myself, this is enough. I need to make a decision. Second, I seek advice. I look for people who can help me in my area of weakness, people who can help me make decisions. Their advice gives me conviction to go forward. And third, even in my areas of expertise, sometimes I just have to go with my instincts and guts.

 

That conversation with Dr Ranjit reminded me of another conversation I had with my mentor, Jim Houston, the founder of Regent College. Dr Houston has often warned us that using our natural strengths alone can cause us to live addictively, and even practice addition in our relationships. We become over-dependent on our strengths.

Paradoxically, Dr Houston, a former professor of geography at Oxford University who founded North America’s top theological institution, has observed that the Achilles heel is the compass of our spiritual journey (link to http://www.leaderu.com/marshill/mhr06/houston1.html). To quote Houston: “When we discover our basic weakness or basic handicap, then we ask for God’s presence and grace to enter that area which is most needful of God’s grace. A broken bone, once healed, is stronger than one never broken.”

I’ve found this to be one of the most profound insights in leadership.

THE ART OF LISTENING

Listening is one of the most powerful tools in leadership. Leaders who listen well built the trust and goodwill that drives a high-performance team to go that extra mile.

Most people, myself included, underestimate the power of listening. We assume that we do it well – when the awful truth is that most of us suck at it (just talk to our spouses or teenaged children). We underestimate the power of listening because we assume that listening merely involves listening to another person. That’s not all. Great listeners also learn to listen to the outer environment they’re working in, and they learn to tune in to their inner life and emotions. These levels of listening are equally important.

In doing my research for Spark!, my new column for The Star, I discovered that doctors practice the art of listening – in similar yet different ways. Here are the listening skills and perspectives that I gleaned from them.

1.  Ask open-ended questions…

When a patient sees a doctor, it’s important for the doctor to ask a wide-open question. For example, if a patient is seeing you with a thumb problem and you already know that, the first question you ask is NOT: “what thumb problem do you have?” Your first question should be: “What brings you to see me today?” This open-ended question allows you to listen to what is really bothering them. It may not be the thumb alone. There could be something else.

2. …and then narrow down

After listening in general, you have to stop them from talking, because you are limited by the consultation time. Instead you probe deeper into the root issue of the problem. You need to guide them with a series of targeted questions. Your goal is to get the history of the patient.

3. Don’t listen to everybody

In social situations, do not listen to people who sit down and complain about the same things without offering solutions. It’s corrosive. You’ll be unhappy. Don’t join in the pity party.

4. Shut up

Listening is extremely difficult because you think you know more than the person who’s talking to you. It’s natural to want to jump in and say something. But when you shut up and actually listen, you’ll be surprised by how you hear a lot of things. You need to listen to everybody who’s involved in the organisation because the solution sometimes come from the most unexpected person. You cannot be constricted in seeking out solutions. You can find solutions in life by talking to the cleaner and the gardener.

 

The views expressed here are the personal opinion of the columnist.

Photo credit: Flickr user diekatrin

 

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