Embracing The Leadership Challenge

First published in 1987, The Leadership Challenge now has five editions, has been translated into 20 languages, and has sold over two million copies. Its focus is on individual leadership skills; the book’s name comes from the many challenges we all face in our efforts to “make extraordinary things happen.” Now isn’t this what we need to do as we change the healthcare system?!

Believing that leadership is a learned – not innate – skill, the authors conducted thousands of individual interviews and compiled over 75,000 surveys and case studies. Throughout, people were asked a simple question: “What do you do as a leader when you’re performing at your personal best?”The responses were analyzed, revealing five common practices – each of which also applies to how we can lead the way for ourselves and our loved ones in a healthcare setting:

  1. Model the way
  2. Inspire a shared vision
  3. Challenge the process
  4. Enable others to act
  5. Encourage the heart
  1. Model the Way

    When demonstrating this practice, you, with your own voice and values, behave the way you would encourage others to behave. Within Healthassist, I am constantly modeling for clients and providers what I expect from interactions during healthcare-related encounters. For example, whether in an emergency room, a hospital room, a physician’s office or during a diagnostic test, I am always extremely polite and communicative, even if I may sometimes need to be assertive to get needs met.Likewise, when I suggest that clients prepare an agenda for a physician visit, they are modeling what they expect from the meeting. They are organized, succinct, set expectations and are ready to engage and listen – exactly what they expect the provider to be.

    Here’s a comment clients say as they greet their physician:

    “I’m so pleased to see you today. I spent time preparing for our appointment and I created an agenda with a list of topics and questions I want to be sure to ask. Please take a look before we get started so you can see what I hope to accomplish today.”

    Here’s a comment when attempting to speak with a physician about a family member while in the hospital:

    “I’d like to speak to the physician responsible for caring for my mom while she is in the hospital, so that I can understand the evolving daily plan. What’s the best mechanism by which to achieve that, taking into account my work schedule? Can I pre-arrange a meeting time or a phone call and at what location or phone number?”

  1. Inspire a Shared Vision

    This practice involves creating a vision with a series of goals – goals that everyone cares about and works toward collectively and with clear understanding.Within Healthassist, I envision healthcare consumers realizing that what they have control over is themselves and the way in which they choose to interface with the system. Through that realization, they pave the way for how they will be treated within it.

    Clients demonstrate this when they share their goals with their provider and solicit the professional help and expertise a provider has to offer in order to achieve these goals. Here are some examples of client comments:

    “Dr. Jones, I envision a relationship with a new primary care physician in which we effectively communicate and work as a team. Can we please discuss how you work with your patients and what means of communication we can use together?”

    “I envision myself having a very long and healthy life. I may be living with some chronic medical conditions but I am counting on you, Dr. Jones, to educate me about my conditions and to guide me with recommendations as to how I can best care for myself.”

    “My goal is to live well with Parkinson’s disease. How do I best do that with you on my team?”

    “My goal is to resume skiing following my knee replacement. How will we work together to accomplish that?”

    “My goal is to return home following the transfer to a skilled nursing facility you are recommending for me right now. What will it take to achieve that and can I count on you after I leave the hospital?”

    “I envision spending my final days in my own home surrounded by family and friends. How can we work together on that?”

  1. Challenge the Process

    At Healthassist, we do this every day. As healthcare becomes more “patient and family centered,” challenging the process requires innovation and a willingness to make change.When, on occasion, I encounter people who describe an unsatisfying experience with the healthcare system, I encourage them to question the paradigm by which health care is delivered and discourage them from questioning themselves. Then we discuss how the system could better be aligned to meet their individual needs and we act accordingly. Here are some examples:

    Comment to a medical assistant who asked my client to change into a hospital gown:

    “As I’ve never met this physician before, I prefer not to change into a hospital gown until we’ve had a chance to get to know each other.”

    Comment to physician while going through the process of diagnosis and recommended treatment plans:

    “Dr. Jones, you’ve made several recommendations for diagnostic tests. Can you please explain how each test will inform you and what implications there will be for both a negative and a positive result?”

    Comment to physician expressing fear:

    “Dr. Jones, I have great fears about any surgical procedure. Can you please help allay those fears as they may prevent me from embarking on your recommended treatment plan?”

  1. Enable Others to Act

    This practice is based on creating a safe and trusting environment for people to collaborate, experiment and engage. This is exactly what we do as we coach our clients to interact with healthcare providers. It’s also what our clients must do as they set the tone with members of their healthcare team.Some examples during client appointments:

    “Dr. Jones, I realize that I must share some very personal and intimate information with you about my own health practices. As this is not easy for me, can we please discuss what you need from me to be able to work together?”

    “Dr. Jones, you are an essential member of my healthcare team and it’s important to me that we effectively communicate. What is the best mechanism to do this between appointments? I use email and texting. Is that possible between us?”

    “Dr. Jones, I’ve asked my ‘Care Partner’ to join me for this appointment today because as my wife, she is instrumental in helping me accomplish some of the recommendations you’ve outlined for me. Please allow me to introduce you to another member of our team.”

  1. Encourage the Heart

    This practice focuses on being sincere and may include celebrations devoted to recognizing the contributions and success of others. It often involves helping others to feel like heroes and asking their opinions.As clients access care, most feel vulnerable and without control. And so it is important that they recognize the value of every professional they encounter. This includes the receptionist, medical assistant, nursing assistant, nurse, physician and many other allied healthcare professionals. Positioning the professional as the owner of knowledge you hope they’ll share is important.

    While preparing for a diagnostic test:

    “I’ve never had this type of test before and I know you have lots of experience to share with me. Please walk me through what to expect so we can accomplish the best outcome.”

    While interacting with a medical assistant or nurse during an appointment:

    “Can you please share the results of the vital signs you just took and help me to understand what the numbers mean? How does that compare with the last time I was here?”

    While interacting with a home-based home health aide:

    “You are with my dad, day in and day out, so you are in a keen position to be my eyes and ears. Have you noticed any changes in his health or behavior? Please plan to accompany us to his appointment with the doctor as I know you will be able to help me answer questions the doctor may have.”

    While interacting with the primary care physician:

    “Dr. Jones, I’m here today because you specialize in providing comprehensive and continuing care for me and you’re going to help me to be as healthy as possible. I know I have a lot to learn from you so please share your knowledge and experience with me.”

    The overall idea in this fifth leadership practice is the need for developing long term, intimate and effective relationships with the professionals who touch our lives. Key to the success of those relationships is celebrating how important they may be to you. A letter, card, or even completing a feedback form are all effective ways to celebrate accomplishments.

As you apply The 5 Practices of Exemplary Leadership in your own interactions with healthcare providers, I hope that you, too, will become a leader of your healthcare.