Leadership
in the
Medical Practice
Dr. Itamar Offer
CEO
Neotia Elbit Hospital Venture Ltd.
Leadership
without
Easy Answers
Ronald A. Heifetz
Case #1
23 year old woman
High Fever and Sore Throat
Swollen Sub-mandibular lymph nodes
Tonsills – red, swollen and contain white
exudates.
Diagnosis – Follicular Tonsillitis
Case #2
50 years old Male
Had his first Executive Check-up today
Overweight
Heavy smoker
High Fasting Glucose
Positive Stress test
Case #3
57 years old Lady
2 months of lower abdominal pain and
fatigue
Diagnosis: Metastatic Ovarian Cancer
Are those Similar? Differernt?
57 years old Lady
2 months of lower
abdominal pain and
fatigue
Diagnosis: Metastatic
Ovarian Cancer
50 years old Male
Had his first Executive
Check-up today
Overweight
Heavy smoker
High Fasting Glucose
Positive Stress test
23 year old woman
High Fever and Sore
Throat
Swollen Submandibular lymph
nodes
Tonsills – red, swollen
and contain white
exudates.
Diagnosis – Follicular
Tonsillitis
Heifetz calls it “Type 1”
Patient’s expectations are realistic
The Doctor has the solution
The problem is well defined and curable:
The responsibility shifted to the Doctor’s
shoulders.
Type II situations
Problem Defined – but no “magic”
solution.
The Patient MUST be part of the solution.
e.g. – in Ischemic Heart Disease – Diet,
Drugs, Exercise, Lifestyle change etc.
Patient must go through an
“ADAPTIVE CHANGE”
Type III situations
Problem poorly defined and unclear.
There is no “Magic” solution
A mutual learning process of the Doctor and
the Patient must take place:
To Define the Problem and to apply the
solution
The Risk – choosing a Technical Solution
(Diagnosis and a prescription)
Type III situations
In our case – the disease is
cancer with very low
chances for cure.
Cancer is a SITUATION here
and not MAIN PROBLEM
Type III situations
So the real work is to deal with issues
beyond the Clinical situation:
• Best utilization of the rest of life.
• What will happen with the kids after
death?
• Preparing the family, friends, kids etc…
• Fulfillment of open tasks (professional?)
Type III situations
We – the Doctors may fall into the patient’s
expectations of only providing “treatment”
instead of drilling into the real important
(and hard) questions.
Heifetz calls it:
Avoiding the Work !
To summarize:
Situation Problem
Definition
Solution &
Implement
ation
Type I
Clear
Clear
Primary locus Kind of
of
Work
responsibility
for the work
Physician
Technical
Type II
Clear
Requires
Learning
Physician &
Patient
Technical
&
Adaptive
Type III
Requires
Learning
Requires
Learning
Patient >>
Physician
Adaptive
Heifetz R.A. Leadership without Easy Answers
www.takecareindia.net
Thanks You
The Shadow Line
by Joseph Conrad
Accepting responsibility for the situation
and rising above the difficulty – is the
appropriate behavior , however hard it
might be seem at the time.
“The novel provides a demonstration that
success requires more than sheer
professionalism – indispensable as that is,
or more accurately:
To be a good professional, you have to
be more than a professional!
Under normal conditions, fidelity to the
technicalities of the craftwill see you
through.”
1
“But in an exceptional trial, it needs to be
supplemented by human qualities that
may have nothing to do with the
professional skills, and may even work
against them.
Conrad allude to this character trait as
The Human Surplus”
2
Introduction to the 1986 edition of “The shadow line”
Attributes of Leadership
• Task competence
(skill)
• Intelligence and
judgment in action
• Eagerness to accept
responsibility
• Physical vitality and
stamina
• Understanding
constituents and their
needs
‫• כישורים‬
‫• אינטליגנציה ויכולת שיפוט‬
‫תוך כדי משימה‬
‫• נטייה חזקה לקחת‬
‫אחריות‬
‫• חיות ואנרגיה‬
‫• הבנה של הקהל וצרכיו‬
On Leadership, J.W. Gardner
Attributes of Leadership
• Skill in dealing with
people
• Capacity to motivate
• Good communication
skills
• Ability to win and hold
trust
• Adaptability and
flexibility
‫• יכולות עיסוק עם אנשים‬
‫• יכולת הנעה‬
‫• כישורי תקשורת‬
‫• יכולת לייצר תחושת אמון‬
‫ולשמר אותה‬
‫• גמישות ויכולת הסתגלות‬
On Leadership, J.W. Gardner
And...
• Courage - ‫אומץ‬
• Resolution ‫החלטיות‬
• Steadiness –
‫יישוב דעת‬
• Unsefishness –
‫חוסר אנוכיות‬
• Humility - ‫ענווה‬
On Leadership, J.W. Gardner
Secrets of Leadership:
• Being responsible sometimes means
making people mad.
• Perpetual optimism is a force multiplier.
• Command is lonely
Secrets, Colin Powel
Leaders must have...
“The ability to subjugate their own needs to
the greater ambition of something larger
and more lasting than themselves.”
Jim Collins
• Learn from the past
but don’t dwell on the
way things used to
be.
• Become as
comfortable as you
can be with ambiguity
• Diversify yourself
inside and outside of
medicine.
• Become involved in
your community.
• Develop business
expertise.
‫• למד מהעבר אך אל תתקבע‬
‫על איך שהדברים היו פעם‬
‫• תתרגל לחיות בנוח עם‬
‫מצבי אי וודאות‬
‫• הרחב אופקים בתוך‬
‫הרפואה ומחוצה לה‬
‫• היה מעורב בקהילה שלך‬
‫• פתח יכולות והבנה עסקית‬
Edward N. Hanley Jr. American
Orthopedic Association
• Become more
humanistic.
• Encourage
diversification in
gender and culture.
• Become nonadversarial.
• Develop a personal
mission and vision.
• Establish an
appropriate team or
join one.
‫• היה יותר הומני‬
‫• עודד מעורבות של בני שני‬
‫המינים ושל תרבויות‬
‫אחרות‬
‫• הימנע מהתנצחות‬
‫ומאבקים מיותרים‬
‫• פתח חזון אישי ומשימה‬
‫אישית‬
‫• הקם צוות מתאים או‬
‫הצטרף לצוות‬
Edward N. Hanley Jr. American
Orthopedic Association
• Remember that being
competent in your
field is not enough.
this just gets you the
chance to be tested.
• Be or help to select a
captain who is
qualified and
motivated, then
empower him or her.
• Accept the fact that
success sometimes
means only the
avoidance of failure.
‫• זכור שלהיות מקצועי‬
‫בתחום שלך זה לא מספיק‬
‫– זה רק מאפשר לך‬
‫להמשיך ולהיבחן‬
‫• היה מנהיג או עזור לבחור‬
‫מנהיג ראוי ובעל מוטיבציה‬
‫– ואז עזור לו‬
‫• קבל את העובדה שהצלחה‬
‫היא לפעמים רק מניעה של‬
‫כישלון‬
Edward N. Hanley Jr. American
Orthopedic Association
‫מעמד המפגש בין הרופא‪/‬ה למטופל דורש‬
‫מהרופא‪/‬ה יישום תכונות של מנהיגות‪.‬‬
‫חומר למחשבה‬