Lessons learned: Your first months as a leader in healthcare

As we move through fall and continue in a new phase of the COVID-19 pandemic, career moves and leadership changes are everywhere in healthcare. If you are starting in a new leadership position, it will take time to learn the culture of your new workplace; or, if you have moved into a leadership role in an organization you have already worked for, it’s time to think about how your new role as a leader differs, and how you can both hit the ground running and be most effective in guiding your colleagues.

Listen and learn — without getting stuck in the past. 

Conventional wisdom is correct: when you're the new leader, you need to get out and talk to a lot of people. You have a great window of opportunity as the "new person" to meet people and really listen to them. Gather as much information as you can  —  what works? What would they change if they could? Who else should you talk to? Then listen, but leave room to make your own internal assessments. Too much history can make it difficult to move forward; set new agendas and reset relationships. And remember the iceberg principle: department heads and executives will likely only be privy to the part of the iceberg that shows above the water — the other 90 percent (and the part that can sink the ship) is likely only known and discussed among those on the front lines.

Think (differently) before you speak — or act.

As a leader, you have to act differently. An offhand remark takes on a different meaning now that you are leading the group: when the Red Queen in Alice in Wonderland says, "Off with their heads," people take her seriously. Be careful about what you say and how you say it, as people will remember every comment you make. They'll also watch you set the example. Everyone has a bad day, needs to eat lunch and take a break. And, while hopefully, everyone who meets with you knows this, they nonetheless expect that you, as the leader, will always be on top of your game. Even if they know you have simultaneous serious crises to manage, they'll still expect you to listen to their problem.

Time management, endurance and staying calm are essential skills to master.

I've found it anchoring to remind myself that being calm and staying calm no matter what is part of the job. Remaining calm under pressure regardless of how everyone else is acting is not just a good thing to master as a leader — it's one of the essential responsibilities. This concept can help give you the distance from the emotional content of some situations and allow you to keep calmness front and center. Another way to help yourself stay calm is to take as much additional stress off your plate as you can by maximizing marginal time. Valuing your time is essential  —  having your nanny arrive a half hour earlier in the morning, paying to upgrade to that earlier flight home or back to the office, outsourcing dinner and using our old friend dictation are all ways to add valuable minutes to your day while reducing stress. You'll find that making the most of your marginal time will also help boost your endurance — the days can be long, requiring back-to-back-to-back meetings without a break (I've broken the Zoom CEO's daily record on a few occasions!), and endurance is an undervalued leadership asset.

Process is your friend.

A colleague once told me that you could recover from a bad mistake if you use a good process. However, a bad mistake with a lousy process can be career-limiting, if not career-ending, especially with an HR issue or other complicated situations. For example, in addition to good processes, learn to pace and phase: give people time to digest and improve your plans. Pacing change will also help with cultural adjustment, giving you time to adjust your plans as needed and giving everyone else time to adjust to your ideas and style. There is a difference between a consensus culture and a culture that actively solicits feedback and ideas. You can improve the approach to problem-solving but still be (or designate) an official decision-maker. Lastly, remember that you don't have to solve every problem when presented to you. Sometimes, problems solve themselves, and other times a better opportunity to solve the problem eventually presents itself.

There are also two pitfalls to watch for.

First, be careful of the special deal. For example, sometimes it seems imperative to retain or recruit a star performer, but to meet his or her needs would disrupt the parity and fairness for everyone else. Proceed with caution: the resulting subversive effects to culture and morale can take years to undo. Sometimes you have to lose that particular recruit for the good of the whole.  Second, no one ever says we broke up too early. If you know someone is not going to work out, is not performing well or is negatively affecting the group, don't be afraid to take action. Most of the time, when you see how much better the outcome is, you'll end up thinking, "I should have done that earlier."

In conclusion, I have found that even if you cannot solve a problem, if the person who has brought it to you feels heard — just like a patient who feels that you did not rush through the encounter and were genuinely concerned — you will have succeeded as a leader. And what you learn by listening will allow you to lead — hopefully not through another pandemic, but through each challenge you will undoubtedly face. Follow your interests. Raise your hand. Seek new skills. Be prepared to pivot. Be curious. And keep listening.

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