I feel like I’m always reading though I typically only get to read books when I’m on vacation. I had a couple of great reads during a recent family trip, and I’ve been thinking about my summer vacation for months.
As much as I like to read junk novels on the beach, I try to balance that with non-medical books that will make me a better leader and manager. I hope you can find something from the list below that positively impacts your life.
Turn the Ship Around! by L. David Marquet
The author was a Navy Submarine Captain who took over command of an underperforming submarine and implemented his leadership philosophy which significantly differed from the Navy’s manual. His goal was to take the Navy’s “Leader-Follow” model and convert it to a “Leader-Leader” model. He was a student of leadership and wanted to build a sub that would not only excel but would continue to excel through changes in leadership. In medicine, we refer to this ongoing success as hard wiring something. This was a good read and his struggles to improve performance mirror so much of what we see and talk about in healthcare leadership.
Captain Marquet empowered his frontline workers, eliminated waste, and got to the heart of what motivates and inspires people. He understood the importance of “deliberate action,” or taking a moment to pause and consider exactly what you’re doing. (How often does an attending miss a STEMI on an EKG, not because they don’t have the knowledge to read an EKG but because they didn’t take the moment to focus on the EKG.) He frequently writes about the importance of clear and frequent communication. He also understood the need for ongoing learning because if you’re empowering front line employees to do more, then they need to know more to make the right decision.
Consider the similarity of triage nurses ordering protocols or nurses monitoring critically ill patients at the bedside while the doc leaves the room to attend to another to another task. Doing this in a nuclear-powered submarine in preparation for deployment, where consequences can lead to the deaths of all sailors on the sub, adds a level of stress that is arguably more than what we face in the ER every day. Finally, at the end of each chapter, he switches gear from the lessons aboard his submarine to practical business applications and also lists additional questions to consider (for learning or discussion). (There are also some great YouTube videos if you don’t want to read the book)
The 6 Types of Working Genius by Patrick Lencioni
I am a big fan of the author and have recommended his books several times over the years. The author uses a fable to teach his leadership lessons and it’s incredibly easy to read and understand. Basically, the book describes six aspects of the professional world from innovation of ideas to implementing them. What Lencioni discovered in his own work, and told effectively in the fable, is that all of us have some skills we’re really good at, some things we can tolerate, and a couple of things that make us cranky (or burned out) at work.
We’re happiest and most productive when we’re doing the work we’re most passionate and successful at. While this may not be possible all the time in the clinical area, for healthcare leaders, we may be able to build our admin/leadership team such that project management has people whose skills cover all six types of working genius. In fact, one can argue, that we should look to build our teams with people whose skill sets complement each other when considering all the types of “working genius.”
My only complaint about buying this book is that I read it all on a flight that was less than two hours and probably should have gotten it from the library or found a less expensive way to read it electronically.
SWITCH—How to Change Things When Change is Hard by Chip Heath and Dan Heath
This book starts with why movie goers mindlessly eat free popcorn even when the popcorn is manufactured to be wretched and pivots to the impact that small groups of people can have on huge problems by identifying “bright spots” and showing people the path to success. As leaders, we often spend a lot of time trying to improve processes and make change and just like the title states, change is hard. Our change may be developing strategies to reduce arrival to doc time to something as mundane as making sure people document septic shock charts to hit the metric indicators.
The authors break down change management throughout the book with the analogy of a rider, an elephant, and a path. The elephant represents our emotional side (which is powerful but can be erratic), and the rider represents our rational side (which plans and strategizes). Successful change requires both the elephant and the rider to work together. The rider needs clear goals, breaking down the change into manageable steps, and creating a plan that outlines specific actions. The elephant needs to feel motivated and engaged. This can be achieved by appealing to emotions such as hope, enthusiasm, and a sense of identity or purpose. The environment or “path” plays a crucial role in facilitating change. By tweaking the environment, removing obstacles, and creating supportive structures, change becomes easier to sustain.
There’s a lot about analysis paralysis, or how having too many decisions to make, can impact the ultimate decision-making. When creating a path, It is important to script out the change process that is desired. I really love books that draw on a wide range of case studies and examples from areas outside of medicine and this book did not let me down. There are plenty of examples of individuals and organizations that successfully implement change, often in environments more challenging than our emergency departments. You will consider all kinds of problems in your life as you read this book and you will also be able to provide practical insights as you manage the complexities of change.
The Situational Leadership Model by Paul Hersey and Ken Blanchard
The authors present a leadership theory that emphasizes the need for leaders to adapt their leadership style based on the readiness or maturity level of the followers they are leading. I’ve written about leadership styles before, and we can all agree that no one size fits all approach works. The core idea behind the Situational Leadership Model is that leaders must adjust their style to meet the needs of their team members in different situations. The model identifies four primary leadership styles based on the amount of direction (task behavior) and support (relationship behavior) that the leader provides.
The styles range from: Telling: High task behavior, low relationship behavior. The leader provides specific instructions and closely supervises the task. Selling: High task behavior, high relationship behavior. The leader explains decisions and provides opportunities for clarification and support. Participating: Low task behavior, high relationship behavior. The leader supports and facilitates, while followers take more responsibility for task execution. Delegating: Low task behavior, low relationship behavior. The leader provides minimal direction and support, allowing followers to make their own decisions. The next section comes down to follower readiness. This evaluates competence and commitment.
You can imagine supervising a 3rd year medical student who wants to enter the pharmaceutical industry after medical school in a mandatory ER rotation at a community hospital (low competence and low commitment) compared to managing your star attending doc (high competence and high commitment). As medical directors, our attendings are generally highly competent clinicians, but there is a wide range of commitment. And some of our attendings are less competent when it comes to completing documentation requirements or even their charts. The secret of the model is matching the leadership style to the follower readiness.
For your attending who can’t just figure out chart completion and don’t prioritize it, (Unable and Unwilling), leaders should use a directive (Telling) style. Compare this to a doc who is happy and willing to evaluate (and even discharge) patients from the waiting room. They don’t need to be told exactly when to go, because they are able and willing, and you can use a delegative style. Others on your team may be able to see patients in the waiting room but are unwilling to do so. They require a more supportive style which involves sharing decision making (when to go to triage and where to work) and require increased accountability.
As medical directors and managers, we’re going to need to continuously monitor our team and adapt our leadership style to foster a supportive and effective work environment and optimize team performance that ultimately enhances patient care and outcomes. This book can help you understand what style belongs in what situation.
Designing Your Life: How to Build a Well-Lived, Joyful Life by Bill Burnett and Dave Evans
Apple does not create beautiful products (including packaging) by accident. The authors are engineers who teach in the school of design at Stanford and have applied design principles meant for products and industry to life and career planning. Two of my good friends read this book before I did as they prepared for retirement. But it’s not just about retirement. The authors believe that everyone is entitled to happiness in both their personal and professional lives so this book could be applicable for any adult. Specific to emergency medicine, however, this book could be helpful to so many of us given the number of emergency physicians looking to change jobs, get in or out of administration, or get out of the ER completely yet continue working and not just those considering retirement.
Design thinking is a problem-solving approach typically used in product design. There is a clear process that readers should follow, and the authors provide numerous exercises that are aimed at helping the reader take concrete steps towards action. The process starts by accessing how full your tank is related to work, health, love, and play. I realized I have some opportunity this year in health and play. The process includes exercises that help you figure out what you like you do and can help you design a plan to get there. Exercises take from 5 to 30 minutes and will require some effort but figuring out your next steps is probably worth the effort.
Both of my friends who read the book did it in combination with an executive coach which probably amplifies the benefits of the exercises. The authors actually recommend “having a design team” of people who are reading the book alongside you, and everyone can discuss it, including providing feedback to you on some of your exercises. If you’re wondering “what’s next,” or what your next five years could be like, I highly recommend this book.
