LeadershipLeadershipin thein the

Medical PracticeMedical Practice

Dr. Itamar Offer

CEO

Neotia Elbit Hospital Venture Ltd.

LeadershipLeadershipwithoutwithout

Easy AnswersEasy 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?

23 year old womanHigh Fever and Sore ThroatSwollen Sub-mandibular lymph nodesTonsills – red, swollen and contain white exudates.

Diagnosis – Follicular Tonsillitis

50 years old MaleHad his first Executive Check-up todayOverweightHeavy smokerHigh Fasting GlucosePositive Stress test

57 years old Lady

2 months of lower abdominal pain and fatigue

Diagnosis: Metastatic Ovarian Cancer

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 situationsType 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 situationsType 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 situationsType 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 situationsType 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 situationsType 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 WorkAvoiding the Work! !

To summarizeTo summarize::

SituationProblem Definition

Solution & Implementation

Primary locus of responsibility for the work

Kind of Work

Type IClearClearPhysicianTechnical

Type IIClearRequires Learning

Physician & Patient

Technical & Adaptive

Type IIIRequires Learning

Requires Learning

Patient >> Physician

Adaptive

Heifetz R.A. Leadership without Easy Answers

www.takecareindia.net

Thanks You

The Shadow LineThe Shadow Lineby Joseph Conradby 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 LeadershipAttributes 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 LeadershipAttributes 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 LeadershipSecrets of Leadership::

• Being responsible sometimes means making people mad.

• Perpetual optimism is a force multiplier.

• Command is lonely

Secrets, Colin Powel

“The ability to subjugate their own needs to the greater ambition of something larger

and more lasting than themselves.”

Jim Collins

Leaders must haveLeaders must have......

• 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 non-adversarial.

• 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

זה רק מספיק – מאפשר לך להמשיך

ולהיבחןהיה מנהיג או עזור •

לבחור מנהיג ראוי ובעל מוטיבציה – ואז עזור לו

קבל את העובדה •שהצלחה היא לפעמים

רק מניעה של כישלוןEdward N. Hanley Jr. American Orthopedic Association

מעמד המפגש בין הרופא/ה למטופל מעמד המפגש בין הרופא/ה למטופל דורש מהרופא/ה יישום תכונות של דורש מהרופא/ה יישום תכונות של

מנהיגות.מנהיגות.

חומר למחשבהחומר למחשבה