So, the skill category that works for the future, and this table will be for most of us in ultra-skills. She made a very nice comment that if we're here for super-skills we'll be in the ultrasound course, we won't. Actually, the skill, that's for skills, not even super-skills, that is just skills. Skills, but since we're here, ultra-skills is- Yeah. Why did you think that we spend so much time on the skills? I'm just curious, why do you think that's the case? Why people spend more time over there? No, in general, throughout your career, society, everybody, yeah. Because as we mentioned that to really become a leader, you have to be strong clinically, strong with all the skills. Okay, closer. Yes. You hear me now? Yeah. Yeah. So, we said to become a leader, you have to be strong clinically, so people can look at you as a role model, especially clinically, and that will, you again, you respect it when you become a leader in the management side. So, those skills are very important for that. Okay. Send it to the next table. Thank you. And just to elaborate more on this question as well. Go ahead. Yeah. I hope we're getting it. We'll give you the microphone. Yeah. Just get it close. Yeah. Sure. So, just to elaborate on your answer, I think we, for the most part, focus more on our skills, because that is something that we are taught about, and we are not taught about developing those super skills and ultra skills during our graduation, which now, as Dr. Emlick mentioned, that it's being incorporated in the graduate schools. But we went to graduate schools in the time, when this was not being taught. It was just taught that if you develop your skills, you're going to be good, and you will be respected, and everything else was thought to be coming naturally, and it was thought that possibly doctors could run hospitals. But now, we know that you have to have some administration degree. You have to have some other degrees as well to be a good leader and be a good manager or administrator of a hospital as well. I think that is where it comes from as well. Perfect. Next table, any thoughts? Right next there, Rob. I think they want to talk. Yeah. So, I was reflecting upon whether both super skills and ultra skills are important. I think super skills are part of your personal growth and personal journey, and that is a lifelong commitment, right? Ultra skills relate to how you approach other people, how you interact in your multidisciplinary team, how you present yourself and interact with others. I think they're both equally important. Excellent. Table three. And while we wait for the table, one of the things that's very interesting when you really look into this whole skill discussion and the literature is that for hundreds of years, possessing knowledge was a differentiator. And those who knew were very superior in performance than those who didn't. But in our current knowledge economy, the access to knowledge is universal, right? Our patients can read the same things that we're reading. They might not understand it. They might not have the background, but access to that is universal. So, the difference between what good intensivists know about ARDS is very narrow. I've never, rarely you'll see somebody come in and know something that nobody else knew that actually changes the course of the case. Very rare, right? So, now there's more value in building teams and building and growing professionally. And I think that's where those super and ultra skills are going to become more and more value when you see it. I mean, when you have the opportunity to interview and evaluate talent over and over again, we are very bad in predicting who's going to be successful, right? Because you bring people who might have amazing skills, but they have no super skills or ultra skills. And within three years, somebody else is like way ahead of them moving the team, having followers. And I think that that's something that we have to pay more attention to individually, but also on the teams that we work on. Table three, any comments? I was going to share just I completely agree with what you just said. I rolled into a position of management five years ago when I managed 45 advanced practice providers and 90 percent of my job is these super and ultra skills. And it's really like it's hard to be a good leader if you don't have super skills and have done a lot of reflection and introspection in order to be good at these ultra skills with your team. And I think that there's also a growing need to improve our own skills, right? So, people who are my age trained in critical care when ultrasound was not something that we did all the time. And now, I mean, right, it's changed. So, you need to also adapt and learn new skills as well. This table. Thank you. I think one thing we all need to know or need to do is we focus too much for skills. We really need to send our juniors for the super skill and ultra skills. We do not push sort of put enough emphasis on that for our junior trainees. So, I've been in the profession for quite a long time. And during our training, the super skills and ultra skills were sort of put aside and learn how to resuscitate, how to intubate all those sort of skills. So, I think even the society can do something or recommend something so that the juniors are sent for this sort of training. Thank you. And there's studies, I mean, that they haven't called it super skills and ultra skills, but there's plenty of literature out there that two-thirds to 70% of the success of high-level executives is based on what people would call self-awareness and relational skills, which are emotional intelligence skills or super, supra and ultra skills. So, I think that maybe 100 years ago, there were some clinicians who knew things that nobody else knew and it made a difference. But in 2025, when you can find all that information, I'm old enough that I remember that there was value in knowing the dose of a medication of memory, right? Now that's like laughable today, right? Who would even care about memorizing doses, right? But I think just realizing also that we are evolving very, very quickly. I think- I was just gonna say, and I don't mean to be a pessimist, but I think this is our reality. We have a very transactional healthcare system, which makes it so that skills are identifiable and measurable. They get RVUs attached to them. It's easy to compare people that way. And because our healthcare system is so transactional, I think that there's still a lot of attention put to that. And with super skills and ultra skills, we know, and especially, and I think in other industries, why they're meaningful, but it's really hard for a healthcare leader executive to say, well, I can attach a value to someone's super skills or ultra skills, even though we know there's value. And that might shift with more value-based care. And we know that it should be important, and there's probably cost effectiveness if we can create better teams that create opportunities for retention and lack of turnover and better morale and all of those things that could then, I think, equate to some cost savings. But our system does not actually promote and recognize these things because it is so transactional. Well, and I think that I wouldn't, so I would push back a little bit on the transactional because I think that if you were to go to the business world of full for-profit, the supra and ultra skills are still gonna be super valuable. What we don't know is how to measure them well. So it's very easy that we measure, it's easy to measure the RVUs, right? You did X amount of RVUs. However, I would say that in every one of your works, wherever you work, there are people who have these ultra and super skills, and they are valued when they're outliers, right? And how do we get there? I think as individuals is a big question. Josh, go ahead. I was just gonna offer two examples of where these skills actually can have cost savings that might be worth bringing back to your institutions. One is people who are better communicators when there are adverse events or medical errors are less likely to get sued. So as a risk reduction initiative for your hospital, teaching people how to communicate effectively and partner with families can actually reduce tort claims for the hospital. And then the other one is palliative care physicians and palliative care team members who are very good at relational communication. You don't get a lot of benefit from RVUs from practicing palliative care, but what you do get is a reduction in length of stay, ICU length of stay, and utilization of advanced modes of life-sustaining therapies. Absolutely. So to close this discussion before we go to the panel, I want each one of you to just put skills, super skills and ultra skills. And I want you to think of one specific skill in each category that you wanna work on over the next, over this year. So just take the time to think about one skill that's related directly to your job, one super skill that impacts you mostly in your growth, and one ultra skill, which is about making other people perform at their highest. Put anything that comes to mind and then we'll share a couple before we close. So take a couple minutes to do that. So why don't we share a little bit and then we'll go into our panel before the break. Go ahead. We can start in the back. I mean, along with sharing, I have a question for you as you're into the administration for so many years. What I have personally seen is the super skills and the ultra skills. Without our awareness, we do a lot, like in the sense like personality development for the super skills and ultra skills as an intense list as a team leader for ICU, you do a lot. But super skills, I feel like, I mean, for example, if I want to talk about my three things as a part of the topic, it's proficient in procedures, which is a skill, and good communicator being a super skill, and building up the team is an ultra skill. But that is my role as a clinician. Even as a clinician, I can do the ultra skills, but my role is only limited to up to that part. I'm not, I mean, the super skills is in our hands, like in the sense we can work on it, we can develop it. But for ultra skills to grow to next further level, I feel like you need an opportunity, you need to be in the right place at the right time to get more into the administration. So I would say that, I would push back on that. And I think that's something I said at the beginning. There's a difference between managers are appointed, we always talk about position of leadership, leadership is not an appointed position. There are people who might be chairman of a department and are not good leaders, and there might be somebody who has no title who is a true leader in that group. So leaders are defined by only one factor, do they have followers, right? Leaders have followers. And if you are a clinician and you're ICU, and you want to have the best results for your patient, it doesn't depend only on you. It depends on the nurse, the RT, the clinical pharmacist, everybody doing their best version, everybody being able to point out mistakes, everybody being able to learn from failure, and that is an ultra skill to move a team towards that mindset. And anybody can do that. Now, one of the things that you mentioned I think is very important, and I think is ultimately what we're trying to get to with this whole course is that a lot of us get into leadership or grow professionally by default. If you want a 10X performance to that, you got to do it by design. So you might become a better communicator by doing a lot of difficult conversations. You will become a much better communicator if you take what Josh taught us, you go and read about it, you take a course, you then apply it, so you take it as this is a skill that I'm going to master, right? And that is really what we're trying to instill. You can't do everything, but I can guarantee you that whatever skill you choose or super skill or ultra skill, if you were to say I'm going to actually come up with a plan or even get a coach and I'm going to read about it and I'm going to try to get better, your performance will be exponentially higher. And that's ultimately what it's about, right? To pick the things that are strengths for you, that fill you in, and to be intentional about being better every day about it. That's where you're going to not only have the greatest professional satisfaction, but you're going to have the greatest impact on other people's lives. So that's really kind of what we're pointing out. So I think that, I hear what you're saying, but I think that it applies. No, no, you answered my question. That's what exactly I'm asking about. Yeah. Thank you. I think there's a... I think inherently what we're talking about and the reasons why a lot of us are put into these positions is because we're problem solvers and we solve problems and we make issues go away and these types of things. But as I continue to progress in my career, I realized that just fixing the problem for everybody else does not allow those people then to be able to fix the problems themselves. And so what was once a skill is now becoming a hindrance to others because we are fixing so-and-so's issue, so-and-so's issue. Whereas instead of coming in at the last or the 11th hour, and I'm sure a lot of us can relate to this, to save the day with a family conversation or what have you, if at the beginning we say, we have to pre-think about this before it becomes a problem where the other people on our staff can get to a point where now the unit or what have you can run on its own even with, you can plug and play, you can have other people in there and the so-called leader doesn't necessarily need to be there, it's a very challenging situation and it really requires a lot of humility because it requires you to trust into the other people to be able to have not only the glory of doing the positive things or doing all those things, but it's an important aspect that I think as I continue to listen to these types of conversations and hear other people's opinions, it's something that I think a lot about. I don't know if you can speak on that for a little bit. Absolutely, I think it's a great point and I would say that an example of applying this to this framework would be my ability to solve problems and lateral thinking, thinking out of the box is a super skill that I can work on by different venues, by participating in problem solving, by reading, by getting coaching, by looking at things outside of medicine. Now if I want to take it a step up, if I can empower other people to solve problems and teach them how to do it and give them an opportunity, that's the ultra skill, that's exactly what you said, right? It's great, it feels great when you solve a problem, but I can guarantee you it feels ten times better when you come and the problem's been solved by your people, right? Because they've learned or you created the environment that supports that. People have solutions, they just might not be in an environment where they feel safe and we'll talk about that a little bit later to share their thoughts and that's an ultra skill to create that environment, right? To create that culture of growth and ultimately if you can get other people to solve problems as well, you have 10x the performance of your team, right? No matter how good you are, you can't do as much as they can do and that is an ultra skill and you're absolutely right and it takes humility for sure, but I think it also takes intention and thinking, okay, what are the element, the key parts of this skill that we have to teach others so that others can do it, that's a great point. Any other comments or questions? Okay, well first of all, so thanks for the feedback on the difficulty finding some of the pre-assigned material, we will solve that, but you still have it available so I would encourage you to look at some of that and I think, Timothy, you had one last comment or question? I had two, I'm not sure which one I want to ask, but maybe I'll just do the simple one. For the panelists on there, I'm very interested about how you approach it all, so if you could tell me the book that had, or the book that you go to that had the biggest impact on you and how you approach your job, maybe that was a simple thing that we could all get five or six good reads out of it. Okay. Perfect segue to the panel. I think that's a great, that's a great way to start, maybe, Josh, you want to go first or you want me to go first and we can go one extreme or the other? Yeah, no, when I took on my newest role as the Vice Chief of Medicine at the VA in Philadelphia one of my mentors gave me the book, The New One Minute Manager. It's not a medicine book, it's a business book and it breaks it down, it's about this thick, it's like super thin, you could read it in a day, you could read it in two hours and it goes through how to manage your staff and it teaches you, it helps you develop skills on how to provide positive feedback, on how to provide constructive feedback and on how to get the most out of your employees and it was a really quick read and a really insightful read and the take home point of the book really is if you can generate positive energy by constantly offering positive feedback to your staff when it, and you build that credibility by them believing in you through all the feedback that they're getting when they're doing good work then when it's time for you to provide some constructive feedback for behavioral change and performance change they're going to be much more open to listening to it and it was really valuable. So that's The One Minute Manager. My recommendation is maybe a little bit different but it's one I read recently that is the first that kind of came to mind. It's called Off the Clock and I pulled up the title, the subtitle is Feel Less Busy While Getting More Done and so that was really impactful for me just to rethink my time because I think we can all agree that time is in short supply a lot of days and for me to think more efficiently about how I'm utilizing that time and consider time tracking to recognize areas where I can improve. Perfect. I'm going to suggest two actually. My favorite book is probably actually Atomic Habits which I think maybe many of you have read only because for most of my clients they struggle with maybe the execution. They have great lofty dreams, they're very inspirational, they're high performers but then they realize they're just baby little habits they just need to put into place and then they're suddenly like 100% optimized. So I do like James Clear's Atomic Habits book. The one I'm reading right now actually which I think is very useful for a lot of people who are in management is actually by Mike Michalowicz called All In and it's about really getting the most out of employees because I think unfortunately in healthcare everyone's an employee mindset. I read some of these books more because I have to now manage a team and I too have the same struggles with trying to make it psychologically safe for retention of my coaches and who I want to bring into the partnership for the business and so it's a whole nother world as Sergio will attest and so All In. You have to read the three, sorry. Mike Michalowicz? Yeah. So I guess I'd have to pick one manager as well, I read that years ago but let me just share with you a story of how I got into a leadership role. We were hiring APPs like crazy and I was one of the senior APPs there at Emory and so I went to my supervisor and I had an 8 1⁄2 by 11 sheet of paper with some ideas I thought we could orient them better because I didn't think we were doing a very good job. It was basically here's your lab coat, two articles and you're on night call Thursday night so that was your orientation. I wanted to do more so I went in here and so my boss who grasps things quite quickly spent about 40 nanoseconds looking at my sheet and then said here's what I really want you to do, I want you to become program director and stuff and so an hour and a half later I walked back across the quadrangle realizing I had a new job. Needless to say I didn't have a whole lot of time to read a book, he said oh by the way I've already hired two residents to go through your program and they start next week. So I had other things to read about but seriously one of the things I found very helpful and going back to the business aspect of things is reading the Wall Street Journal. I've read a lot of you know succinct articles on helping with management and understanding people. I cited several of them in my talk today but I'd encourage you to peruse that excuse me that periodical and just see what kind of little because it's gem like material it's not you know 300 page book and so it can give you some really good pointers. So I think when I think of the question of the book I think it's a great question and I think there's so much that's been written out that we can learn from other people. I'm really more interested in being a leader than being a manager even though I have a position as a CMO and for leadership I think that the book has influenced me the most is Meditations by Marcos Aurelius which was probably one of the greatest Roman emperors and I think it brings a lot of very interesting points. One is the most powerful man on the earth and probably in history was so humble who am I not to maybe humble myself a little bit more. Number two I think the idea of understanding that there are things we control and things we don't control and to really put our effort on the things that we do control and I think ultimately what I really like about his philosophy or what he wrote that is just his journal basically is that it's not enough to be right you have to be kind as well and I think that being right and it goes to the example of the anesthesiologist right even if you are right and then somebody needs something different there's a way to do it that is respectful and kind and if an emperor could do it I'm sure all of us could as well so I think that look also for inspiration outside of maybe your immediate sphere because I think that ultimately innovation is nothing more than just taking an idea from another department or another world and bringing it to your own right so I think yeah. Should I give a book too? I forgot the author's name but a lot of the books that they've talked about are really great and I have a long list of kind of my syllabus that I frequently read and reread I guess but one of the first books that I read that was non-medical and sort of more about productivity and management and leadership was Getting Things Done and it's a little outdated in what it talks about in terms of like the file cabinet system and things like that but I think a lot of it you can take away to your to and kind of translate into our world now but it I read it probably 10 years ago now and it definitely changed my life in terms of just taking a big project or goal or vision and breaking it down into smaller minute tasks and kind of like what Lillian was saying just the it's almost like the art of execution like how do you actually get to here without taking that one big step but taking these little steps and really making sure that you're getting these little things done bit by bit so. That was a great question for our first question for our panel we were kind of envisioning that you know really anything that's come up so far for today you guys it's fair game to ask so anything that you weren't able to ask earlier from the panel or anything else that's on your mind feel free to to raise your hand yeah. So I know earlier we were talking about like coaching and mentoring people that you know are kind of having a difficult time how would you handle somebody who thinks that they are doing better than they might actually be doing and trying to point out like some of those struggles that they're having when they're not taking ownership for those. That's a good question. I think it's also a complicated question because it's it gets into the interpersonal piece as well so I think to answer you I think that the best way to do that is be as analytical as you possibly can set the individual down and say okay how do you think you're doing you get the positive response right. You say well let me show you a few things here and you you take out either your laptop or your piece of paper your legal pad for those of you who don't know that's a yellow thing and and with with these facts on it and say these are some of the comments that came through on your evaluations how what kind of grade would you give yourself on the basis of these observations but the more data you can present I think the better you would be in a potentially tricky situation there. I think so in the giving feedback portion always the asking but I also ask what things do you think might make you even better because I think you have to diagnose first is not only is there lack of insight of true performance competency and matching to where they really are they're so that self-inflated or is just they actually do actually have desire to improve or change or accept new feedback because then you're about to give them the data. So there's a couple layers of ask before you do any kind of the tell to readjust calibration and I also ask permission to recalibrate them like I'm about to tell you some interesting things so I do a couple asks to prime them because you're sort of testing the waters to see if they want to even change because if they don't then you have to start getting more curious like then you have to go into coaching modes like I'm curious like why like why you are a high performer if they think they're a high performer like you are a high performer why don't you want even get better like that's so weird because only high performers always just want to get better you know so then you can open two different sides to then begin to figure out what the problem is and a lot of times it's it's honestly is the psychosocial stuff right like they just are really anxious right the most people with the biggest bravado and the biggest egos are actually the most fragile inside and so then the question is how do you make that trust so that you can actually then recalibrate them and and I think that we always fixate on those outliers that are repeat offenders or like the worst of the worst but I do believe that most people when you bring up to them maybe how what they're doing is impacting other people want to do better most people might not be aware that maybe they think they have the best style and running coach but then you show them that everybody feels intimidated nobody wants to bring up problems people don't want to call when there's a problem because of how they are and I think that again there might be some behaviors that are kind of pathological and hard to change but a lot of people just not not it's a blame it's a blind spot right they're not self-aware of how what they do is impacting others they think they're the best leader in the world right and because they they talk talk talk talk in their meetings and nobody raises any questions and then they're done and it's because there's no safety right and and I think showing that to people also sometimes can help from a leadership standpoint in Daniel Pink's book he talks about autonomy so my question being specific is as leaders you typically you have units you have to cover you have clinic you have to provide staff for etc how do you encourage autonomy in a closed system I mean I'll take that first I guess that's something that I think about a lot and my my my position to everybody is that people sometimes confuse what autonomy really means they confuse what it means they don't understand what it really for me autonomy in health care means that I have the latitude to apply my best skills my strengths in a way that makes a difference for the life of somebody else and if you think about it yes I have to go to the shift and it starts at 7 and ends at 7 but within that shift I have tremendous freedom and autonomy to make decisions that ultimately can impact the life of another person in a very meaningful way right when you're I mean even when you're running a code right and you can call that code at one point or you can keep going those are I think are examples of autonomy at sometimes I think clinicians and I'm going to talk about as a physician because I'm a physician forget even if you're the CEO of a hospital or the CEO of a company or the founding CEO of a company you might have a board that can can move you out right but yet you have autonomy to figure out how to use your strengths to make a difference for the people around you and I think that that's what you need to that's an example of understanding what you control and what you don't control there's things we don't control about how health care is going but there's things in every day you show up to work and I'm going to talk about shift because that's what I do where you have absolute control and can make a huge difference and if you focus on those and aligning those with your values and with your strengths I think you will be motivated I mean I think you're referring to to drive that says autonomy purpose and mastery right and you can find that I think a hundred percent no matter where you are it's something that you have to get kind of create this is just a question slightly related to the handling disruptive behavior this morning now how do we set boundaries among appears as well as across hierarchies people who are senior to us without appearing to be That's a really great question, thanks for asking that. I want to point out first, I am not a behavioral psychologist, and I don't know that I possess any greater skill than anyone else in this room at a lot of this stuff. I think that there's not a one-size-fits-all answer, and I think that setting boundaries when there's hierarchy and when it's interprofessional across sort of different individuals, one may be a physician, another a pharmacist, another an APP, et cetera, it's very different than when you're setting boundaries with a colleague, which is very different than when you're setting boundaries with a supervisor. I think it starts with knowing what's outside of the bounds, and I described some of that in my talk, so sort of threats of violence, those types of boundary issues, that's like an absolute no. Inside of the box, a lot of it is just really relationship building, and having those conversations proactively and prospectively, so when you move into a new position, ideally your supervisor will do this with you, but if not, you're allowed to do that, so again, when I took this new position at the VA, I didn't get a lot of information about what my role was going to be, and so I asked a lot of questions, and it was about me sort of establishing what are the expectations for me in this job, what are you looking for, what are you asking me to do, what types of things don't you want me doing, and sort of setting those standards ahead of time so that when I was in a situation where I felt like I was out of bounds or maybe beyond sort of my depth, I could come back and say, like, this is what I'm thinking, this is what I'm feeling, et cetera, and then, you know, I would just, when you're dealing with someone in an interpersonal way and you feel like they may be butting up against your boundaries, I think that, you know, again, it's finding ways to communicate human to human and finding ways not to escalate the conflict by becoming competitive, and so I'm really a big believer, and maybe some other folks on this stage will have some other ideas or those in the audience, but I'm a big believer in I think, I feel, I hope statements as a way to ground the conversation, so I think that it would be really helpful for me if, and also speaking from an I statement, right, this is so I'm speaking to me, not you can't talk to me that way, but I think it would be helpful for me if when we're talking about this, dot, dot, dot, or I worry or I feel that when I hear this, it makes me think this, you know, and so, like, being able to couch it that way allows the other individual potentially to sort of appreciate your perspective, so we talked earlier a lot about perspective taking, trying to put yourself in the other person's shoes, trying to understand their perspective, that's what you're really trying to get the person to do that you're having this sort of, like, issue with is understand your perspective without saying you're wrong, I'm right. Is that helpful? My question is about change management. I read that on UltraSkills. Now we see with this financial difficulties with healthcare, sometimes there's KPIs, OKRs, there's a lot of changes implemented from above down or all the way down, and you want to tell your team or try to prepare your team, but I just want to hear if you have any examples of change management, yeah. We could talk about that for a whole course, but I do think that nobody's going to do something because you tell them to do it. It doesn't really work. People have to do things that they want to do, so you have to try to understand, I mean, explain to them what is it for them, tie it to, I think you mentioned purpose, autonomy, and mastery. Those are true motivators for all individuals, and I talk about that a little bit in one of our talks, but I think that trying to connect the change to the purpose, to what they can learn, to what they have latitude to do, right, and to explain also the reality. I mean, I think my job in a big group is to try to make sure that we stay true to our mission of bringing better to the bedside within the constraints of real-world medicine and trying to be a nexus between executives and clinicians at the bedside, right, and I think it's hard, but sometimes you have to push back on one way or on the other, but I think you can try to find the common ground. I think there are things that we can all get around and try to move in that direction. The only other thing I would say about change management, and then maybe you want to hear from the rest of the panel, is that we tend to focus a lot on the naysayers and what the evidence suggests is that we should be focusing on the champions and on the early adapters, and as that group grows, people will start falling in line, so focus on, again, which is no different than what Kwame spoke about today, we tend to focus on what needs to be improved on weaknesses when we should be focusing on strengths. We tend to focus on those who are against the change when we should be focusing on those who are helping us change and grow that group. I'll just add that probably, I'm assuming your organization probably has change management specialists and also change management psychologists who are helping your organization within HR, assuming you have those. If you think about the emotions that your team is feeling and even yourself as a leader going into the unknown, I think someone had on their card that they picked that they had just jumped off of the cliff into an unknown space. I also usually pick those as well, like that kind of a photograph. It's inspiring that same kind of emotional response inside our brain of palpitations, fear, sweaty palms. There's 50% of your group who are probably completely terrified and there's 50% who are completely exhilarated to jump off of that cliff. The question is really about getting everyone more looking towards the, it's exhilarating. It's the same thing when you're speaking. When you're speaking, some people get really anxious up here and at the same time because they're nervous and it's the same physiology that's happening for, it's exciting too. When you as a leader can remain stable and calm and have an emotional intelligence to be the steady guiding light, to have that vision that changes something we're going to get through together, then we can at least begin to see like, well, my buddy here finds this exciting, so maybe I should hang out with these people and we can go get there together. I almost named that book if you guys haven't read it the iceberg is melting. It's a it's a fence It's another like non-medical book It's a fantastic fable that really talks a lot about team-building and leaning into those people who are gonna be problem solvers And and not the naysayers highly recommend So I have a question about Obviously all of you are in positions of leadership and have made hires and other types of things when you're looking to Get people into new positions of responsibility What are what? Modalities have you seen that people have used that have been effective for you to be able to say this is somebody that knows Their stuff knows what they're doing and somebody that I'm gonna have to clearly respect and have to give the long hard thought about Also kind of just as a tag-along How does the person in the situation do this without making others in the group or others in the hospital system? Not look like they're not doing as good of a job as they think that we're gonna be doing I know that that's a challenge as well when you when somebody's saying or thinking that they can do Another management position or another job like that without kind of stepping on somebody else's toes Have you had an experience with that anybody or do you have any guidance on some situations like this? I Mean I think the first thing is finding individuals that are willing to say yes The number of times I've asked people to do what seems to be very you know Minimal work and they say no I just know immediately that those aren't people that are going to be Leaders in the institution and the people who want to be leaders are oftentimes stepping up and saying yes and I think so it starts with identifying people who are in some ways self-identifying as as folks that are up-and-coming and then to the to the second part of your question, I I'd like to offer a an example of where I failed as a leader Although it's worked out fine, I suppose As I as kovat was hitting and I and I was as the ICU director I was always doing all of the scheduling and a lot of this sort of organizational stuff for my staff and I really wanted One of my staff members to take that on and I'd had one person who had expressed interest But he didn't do a very good job in doing it and I had another staff member who had expressed a lot of desire to to take on additional responsibilities and I asked her to do it and she just took off and did an amazing job and I subsequently after kovat ended as a in many ways a reward for the Reciprocity for the great work she had done over about three years of taking on those extra Responsibilities was I named her the clinical director for our hospital for a hospitalist program for the ICU and I realized that I really hadn't talked to any of the other hospitalists about that position or My rationale for the position or why I was giving it to this one individual without having sort of like an open call for it And it did lay lead within my sort of hospital ICU hospitalist group It led to some hard feelings of individuals who felt like you know Why didn't you look at me for that job? and the truth is She was the right person in the right place at the right time who had stepped up and said she was interested when nobody else Did and so it I would have picked her anyway, but but I should have handled it differently and so I think as a cautionary tale you want to try and be Transparent whenever you're looking to sort of advance people to make sure that that their peers Aren't going to get into a situation like you described where they feel like they're being left behind That was a good learning experience for me as a leader I think goes back to what they said about transparency right in terms of how the process goes, but also Think about other people I think that Asking for people to raise their hand is always a good starting point right? but a lot of people raise their hand and then don't do anything, so I think that also giving people opportunities and incremental responsibilities and Coaching them and mentoring them as they go along, but in terms of what I look for it's super and ultra skills I don't care how much I mean I assume that anybody who works for me has a Baseline of medical knowledge that is what we need and No matter how smart and how talented you are at the bedside and what your papers and diploma says if you don't have those super Skills and ultra skills of that emotional intelligence. I know it's not going to work long term so that's ultimately what helps identify those people who are leaders and And you see that over and over again, right? I mean Look at just look at what happens in sports. They spend millions of dollars to try to identify talent and then you have people like without I mean being fair with any tour, but yeah, I mean like Tom Brady goes in the seventh round of Of the draft and then becomes arguably the best quarterback in history like we're not good at identifying Talent that's just the reality That's just a reality, right I think one more question and then maybe we'll break that's okay This is a question to follow up with with with surgery especially and with the team There's a lot of things that you we're asking as a team leader from our fellow Physicians that are really non RV you kind of activities like sitting with the family Doing this being politically correct Talking etc. And these are not gonna be counting in their productivity what I mean, maybe you recognize him, okay, he's a great guy, but how do you as a CMO of a big group, how do you combine two relatively contradictory pathways one of them is Productivity RV use get things going in the icing and then also ask to do all these things that are really not counting the productivity Of the physician and if he stacks in the productivity, he's gonna be looked upon in a different way. Thank you

leadership development

emotional intelligence

clinical strength

team dynamics

change management

healthcare leadership

administrative skills

personal growth