Episode 1: This is US!
Transcript:
Pete
What does it mean to lead with both head and heart in healthcare?
In this episode, we explore the origins of this podcast and the inspiration behind its focus on leadership in healthcare. You'll be introduced to a practical framework that can enhance your professional relationships—viewed through the lens of diverse interprofessional perspectives. Whether you're just starting your career or have decades of experience, there's something here for you.
We’ll also share our personal stories—our leadership wins, the challenges we've faced, and the lessons we've learned along the way. You might even hear a few secrets we've uncovered about ourselves on this leadership journey.
Stay tuned, because we are coming next!
Pete
Welcome everyone to healthcare relationships. Need a hug? A podcast about leadership, teamwork, and reimagining healthcare. My name is Peter Longley. I'm going to moderate for this episode, and we'll go into everyone introducing themselves, and we'll further go into our stories after that.
So Maya first.
Maya
Hi everyone. How are you? I am Maya Doyle. I am a social worker and faculty in the social work program here at Quinnipiac.
Rahul
Hi everyone, I'm Rahul Anand. I'm an infectious disease physician and faculty at the Netter School of Medicine and I'm excited to co-host this podcast.
Pete
Amber.
Amber
Hi everyone. My name is Amber Vargas. I'm a medical student at Frank H Netter School of Medicine at Quinnipiac University. In my 4th year and going into emergency medicine.
Pete
Awesome.
Very good. And I've just learned that you're in the ICU right now for your rotation.
Amber
Yes. Oh yes, I I'm. I'm currently in the ICU learning how to, you know, learning more about critical care and management of really sick patients.
Pete
That was my old stomping grounds back in the SICU at Yale.
Amber
Oh yeah. Oh, wow. Oh, so we have a lot to talk about then, how did you like that?
Pete
Ohh, I loved it. Then I started having kids.
Maya
When I was in the I was in the PICU at Bellevue a long time ago too, so it's a fascinating environment.
Amber
Very intense I could imagine.
Maya
You can talk a lot about teamwork. And that ICU experience, I'm sure.
Pete
All right. Excellent. So I wanted to go a little bit deeper into our experiences so the listener understands where we're coming from because we're all coming from different points in our journey, our careers. So me, Peter, I'm a registered nurse with almost 30 years experience and I've had multiple roles, one of them being in the ICU.
I've been a nurse manager. I've gone into data, into finance and now I'm, you know, a faculty member here at Quinnipiac and in school and nursing and my whole thing is what I'm trying to figure out, a solution to improve our healthcare situation here in America. I've always been interested in leadership ever since, I guess high school, since playing football and everyone wanted me to be the captain and I felt the pressure of that. I was like, I don't want to be captain. No. But then it happened again in the army and in nursing. And here today I'm just trying to understand all the theoretical framework behind it and how to share it so we can improve our healthcare system.
Maya
I've learned something new about Peter in football today, so thank you. It's exciting. So I've been also a social worker for around 30 years. I always worked in pediatric settings, mostly at large urban hospitals. I've always primarily been the boots on the ground, direct care person. I've had no formal leadership roles ever. But yet I've always thought of myself as an informal leader, helping get things done, helping my team get things done, helping recognize when things are going well or not going well with our team, or hey, we need to do something else on behalf of our our patients. And I think I bring that same vibe now to where I am in my department as a faculty member, but also where I am with our students.
But thinking about also how as we all evolve, right, how do we make that leap from maybe informal being role models and being supporters to actually being folks who have a little bit more power than me change. So we've already been on a bit of a journey together and learning about this, so I'm excited to see where it goes.
Pete
Great. Whoever's next, Rahul.
Rahul
Alright, I'll go next.
Yeah. So I share what Maya said about being boots on the ground. I think that's what connects the four of us that we're all frontline boots on the ground, very close to the patients in our careers and now very close to students and learners. So my journey started in India. I did my medical training there, connected my family's health journey to becoming a physician and wanted to make my own life. And of those around me better and of people I could take care of. I did a medicine residency in India and then came to the US after that. And had to do another medicine residency. So one of the happiest days was when I had to do no more night call of residency.
And I felt that in all of the work done as a clinician educator, which I am at heart, there was. There were opportunities to lead at every step, whether it's interacting with the patient or family or with team members. And then when I took up infectious diseases, it's an it's a specialty where you're always either working with a patient or family with a very distressing situation. Or you're a consultant and you're negotiating and communicating and collaborating with multiple teams. Or you're working with the health system and looking at organizational or system issues to make an impact. So I felt and ended up in a specialty with an outsized impact of leadership and teamwork. And that's partly how I got interested in it.
Pete
Oh, great. Amber, what's your story?
Amber
So for me, leadership has been like this abstract idea where you just kind of formulate a framework based on experiences you have like positive and negative experiences and you know, strive to be the leader you think is a great one. And then when I came to medical school and Dr. Anand introduced this course of leadership for medical students, it was very intriguing. Like, what is this course about like, what is it focused on? And he was very passionate about it. So I took it as an elective and then when I was in the in the course, I was like, oh, wow, this is so meaningful, so impactful, so life changing. And it actually did have like a really big impact on my life and my career advancement and journey thus far. I feel like a lot of the things that I've gotten involved with throughout medical school and now the career that I'm pursuing post medical school is very intertwined with leadership and building that part of myself. So for example, some of the things I got involved with in medical school is the Latino Medical Student Association. I sit on the Executive Board and at the regional level and at the national level now.
And not only have I, you know, made strides in my own leadership development, but being able to take that to the other people in my organization who are also invested in being leaders in their community and serving very vulnerable patient populations, it's just it's been incredible to see how the things we are learning in the classroom and this course can be translated to real time and helping patients in real time, so that's a little bit of my journey.
Pete
Yeah. And you're going to need leadership in the ED.
Amber
Oh yeah, yeah. In the ED, and then, yeah, like, you know, in EM there's further opportunities for learning more about administration and operations, which is something that I'm definitely interested in now that I have like this foundation.
Pete
Wow, excellent.
So where did this all begin? Couple years ago, the three of us, Peter, Maya, and Rahul became my PE fellows at Quinnipiac and did a fellowship, and we ended up deciding to land on leadership and expand upon one of Rahul’s leadership courses and we took it and put some structure around it and put some students through the experience of being a little more vulnerable. Knowing when to speak up, putting some of those soft leadership skills to work. But it was funny on how all three of us came together and we all kind of had an itch or liking or an interest in in leadership. So it's wild how we kind of just landed there.
Maya
Well, and two things to say.
First, you know IPE being interprofessional education, right? The idea of how folks from multiple professions can learn from and about and with each other, which is really unique. Interprofessionalism is actually why I came to Quinnipiac, because that's how I've always worked as a social worker. Like you know, we're multidisciplinary, interdisciplinary, interprofessional was like a new term. But I was like, that's where I want to be. And so it's it's really delightful to be part of, lots of events here at the university that are, that are interprofessional.
But I think the other piece, that you bring up Pete, is sort of how we came together to get to that idea and Rahul, our design thinking expert can probably tell us a little bit more about that process, right. But coming up with all these different ideas we all came applied for that fellowship with different thoughts and then eventually we're able to like. This is what we're, this is what we can do and this is what we can do for students with the thought that that's going to help the system be better down the road, right, because we have a new generation of healthcare providers who can have maybe a different way of being with each other than even we've had in our own professional experiences. So. So yeah, that was a really great experience of coming together and making those decisions live.
Pete
Yeah, Rahul, what do you remember about that, way back when?
Rahul
So I'll go back to the beginning. So this was 2018, when I joined Quinnipiac, stepping into the world of teaching medical students full time, and I remember it's a beautiful campus walking around, looking at students and they're there. But as a student, their core priority was survival. They're surviving these flash cards, these tests, these exams, scores on the STEP, if that goes well, getting into a residency so they're not queuing up to take a course on leadership. But what I see is that as both as students and as the academic leaders, the entire focus was on the what like how can we get this knowledge, this content, get our scores and residency. Or on the academic side, how can we run a successful school that it wasn't that we're thinking about how to create the next generation of leaders, the next generation of healthcare professionals, the next reimagined and better healthcare system. We were so busy with the “what,” that we were losing track of the “why” and the “how” and the “who” for whom it exists and we do it with.
So I had a colleague at that time, Jennifer Drilling, a pathologist, who had cut her teeth in the Navy and we scoured around the world looking at the best leadership development programs. And we came up with a common theme in all of those programs about starting with the foundation leading oneself, then building up to teams, and then finally trying to understand and make an impact on the system. So we built our curriculum in the self, teams, and systems format and we bring it to life in 2019, somehow navigated through COVID in 2020 to keep it alive, even expand it a little bit. And then I went to Harvard Macy in 2021 in their educators program at the Harvard Macy Institute Program for Educators and came back in 2021 as a scholar with great dreams, and we're going to take it to the core curriculum, have lots of students in this, who will love it. And none of that happened.
Our class size went down to 3. So it was like 3 students. My co-faculty left the institution, and it was a no go in the core curriculum. So while every healthcare professional is a leader, it's not that they're queuing up to learn leadership in their training because they're so busy surviving.
So then came this fellowship, and I went back to Harvard Macy Institute in their Leading Innovations Program, where I learned design thinking and looking at things from an end user perspective. And the end user perspective here, which is the students, and the trainees, and you know, the early faculty perspective, is that we need to personalize this learning and we need to situate it in a way that works for us today, not ten years from now. And we need to do it in a community of like minded people who are going to support us and develop us and root for us when the chips are down or when the chips are up.
And so that's how we went from, you know, this core curricular dream to really meeting reality, which was a community of practice model that this can exist in a co-curricular and interprofessional space with a community of like minded people. So I'm glad that I met the two of you, then. And one of the things we learn in infectious disease training is when you're negotiating with the surgeon, how to make them think it is their idea to go to the operating room for an exploration, to find the pus that could exist inside. And so I'm so grateful that when we talked about it, the common thread that we had was: How can we build better teams that have stronger relationships? That's where we began and then, you know, we expanded to the full self, teams, systems, even on the interprofessional side. And I think this podcast is an extension of that because our promise to our listeners is that we want to give you something that's useful to you today and we want to give you something that's going to help make your life and the life of your people around you better. So we want to give you tools that you can use today and that can make your life and the lives of people around you better.
And then came Amber. So I'm going to pass the ball to Amber to tell us how we got involved and how we built this further.
Pete
Before we go there, could I clarify something? Were me and Maya the surgeon, and then you brought us in and made us go…
Rahul
Absolutely.
Pete
To the OR?
Rahul
Absolutely. As long as leadership is not the pus that we're looking for.
Maya
Exactly.
Amber
Oh my goodness.
Pete
I'm sorry. Go ahead, Amber.
Amber
No, no, that's great. Dr. Anand, you said something that really resonated with me about, you know, medical students surviving, right and like, not necessarily thinking that they need to take this leadership course or need to sit down and learn these things because they're too busy with, you know, thinking about all the things that they need to graduate and to move on to residency or whatever career goals, aspirations that they have. But you know, throughout this journey with leadership interacting with the course and students and throughout my medical school career, several students have trusted me with, you know, with their feelings about being placed in these situations where they're expected to be a leader but not necessarily feeling ready for those situations or knowing what to do or how to best go about it. You know where some examples include student government, student-led groups at the school, national, regional organizations that are student run. So there's all these things, free clinics, that we run like Bobcat health, right? Like there's there's so many things that students are expected to do, expected to run, they, but then they find themselves in a position and they're like, wait, what do I do? How do I do this? So that's why it's really important to have some of these tools in their pocket and to really be able to to have some kind of foundation to lean on when they're feeling that. So that's something that you know, we were able to do with the course. So right.
Rahul
Yeah, that's so true. And this can how one relates to these challenges, the tools that you may or may not possess to address these challenges, the people who you could gather with to tackle these challenges together and the sense of agency that you develop and in addressing these challenges can really define one's attitude when bigger challenges come up ahead. So I think having the tools to successfully address some of these challenges can make a student or a trainee, or someone early in their career really flourish rather than the other way around.
Amber
Yeah, I'm happy to talk about some of these tools as we get more, you know, sessions.
Rahul
Yeah, it's no different as a full-fledged healthcare professional because when we deal with systemic challenges and we're not able to come to terms with the system, that's a huge cause of burnout.
Pete
Yeah, very true.
Maya
And if I can just add too, just going back to our self, teams, system model, for me, teaching social workers and you know, Pete, you may have the same thing with nursing students and obviously we have lots of other professions within our schools too. But for me, I was teaching about, we teach about organizational theory to our MSW students. Most of them are going out to work in agencies in in Connecticut, either health or mental health agencies. And so we were teaching some basics about you know how organizations work and a little bit about leadership. But it wasn't really coming alive. And I think when we started talking about those relationship pieces, you know, which especially in social work like that's key to our ethics. But I hadn't completely made that connection until we kind of all started putting all those pieces together, so it's, I think it's changing if it's changing what I can bring to students, and I hope we're also changing what other faculty can bring to students and then also what right, what we can give you all to say, OK, I'm in this position. What the heck do I do? What the heck do I do with this now? Yeah, so.
Amber
So kind of a framework mindset.
Maya
Yeah, you need. You need that for sure.
Amber
Yeah.
Pete
Great. And I want to create the mental model for our listeners. We all know what we're talking about when we say self, teams, and systems.
So for the listener, if you have 3 concentric circles and you put yourself in the middle, you're building yourself personally and professionally. You bring in your best self to work or to school. The next circle is built up of, you know, working in teams. So that's interpersonal relationships. And then when you go to the 3rd circle, the outer circle it's impacting systems and belonging to a community that's larger than yourself and the teams. So I just wanted to create that so the listener can kind of visualize it the way they want to see it. Their own little circles.
So let's see here, next topic.
So Rahul. What does leadership mean to you?
Rahul
Yeah, I'll build on what you just said, Pete. So leadership, unlike what I had thought early in my career, it's not a title, it's not a position, it's if you look at the textbook definition, it's about influencing and working with others towards a goal that's greater than any one person themselves. When I think of it in healthcare, especially as a healthcare trainee or early career mid-career, I think leadership is about being one's best self personally and professionally first of all. Because that core domain in the middle, self, is really important. You cannot pour from an empty cup and connecting one's personal mission and values to the professional journey, and the projects and the causes we step up for is really important. It gives us the power to say hell yes to what we believe in and it gives us the power to say no to what doesn't matter as much to us. So that's the core circle, being one's best self personally and professionally.
Outside that is building meaningful relationships and being a follower and leader in effective teams. And then, in the circle that's outermost, is impacting systems because that's where our life's work comes in. Touching patients, doing projects that make an impact on the organizational community. And we work in a system that's very resistant to change.
And so, trying to impact systems by yourself is the road to burnout. And that's why the systems and community go hand in hand, because learning to embed oneself in a community of people that are working on the same cause and overtime, trying to build and contribute to that community, or communities, is a key piece of leadership.
So to sum up, for me, leadership is not a title or position. It's about being one's best self personally and professionally, building meaningful relationships and effective teams, and making an impact on the system while being embedded in a community of like-minded people.
Pete
Oh, that's great. And I have something in my story. You triggered it. I'll bring it back later.
Rahul
Let's hear it.
Maya
No, let's hear it now.
Pete
When I was a nurse manager, young, eager, I thought I was persistent and persuasive enough, and I was going to try to do it and fix it all myself. And I burned out. I actually got out of healthcare for a little while. And found myself coming back because I missed that connection. But, it did happen. You know, I put on a lot of weight. My blood pressure went up. I was trying to move the mountain, but I was all by myself. I thought everybody, you know, in healthcare was idealistic, like myself. I found out I was wrong.
Rahul
That's rough. And some lessons come by hearing others and their challenges, like we're trying to share, and some, these deep insights, come because we've experienced it. And then it becomes crystal clear that there is a different path which could get us there and you know, same here.
Pete
Yeah.
Rahul
I've had my journey as well, journeys at this point, so we can I think we can call ourselves mutually, we can call ourselves recovering frontline healthcare providers.
Maya
For sure. Yeah. I'm definitely also with someone who's like, I'm just going to get these things done. It'll get done more efficiently if I just do it myself. And so I would take all of that on. And actually the experience of having what you were sharing about your family's journey, like going through some serious caregiving with my family members, made me go, oh, you know what A) I can't do this myself, but also nobody's doing it themselves and taking care of these folks, either they're all working in teams. I got to work with those teams, plus my own teams. And yeah, you can't. You just can't do it. You can't do it all alone, no matter how sunny our dispositions may be.
Pete
I used to be a lot sunnier.
So leadership for me is grabbing into that vision and mission. I'm wondering if one, it's part of my personality, idealism, but also I went to the army right out of high school and it was all about the mission, and vision, and getting everybody on board. And I have, I guess, compassion and empathy for the team and I think I did that when I was a nurse manager and everyone just kept saying, oh, yeah, there you go, there's more work.
So you know, some of the lessons are tough to learn. Leadership also means having integrity and being honest. And sometimes I was, challenged, or my integrity was challenged. That's probably a better way to say it. And I’d become resistant at that time. So trying to learn how to navigate those roads and with communication, so I've been working on my communication skills ever since, to try to articulate exactly what I mean so other people can hear it.
But Amber, I would love to hear what you think leadership is. Or what it means to you?
Amber
Yeah. So, I mean, a lot of my real framework of leadership came from taking the course with Dr. Anand. So part of my answer coincides with his answer. But I'll frame it a little differently, but it has the same core meaning. You know, I think leadership is very multifaceted. There's a lot of things that go into the definition of like a strong leader, a good leader, right. But I think one thing to focus on or zero in on could be the team. I think a team tells you a lot about a leader. You know how that team is functioning. You know, there's this phrase: “Show me a team, I'll show you the leader.” Right. So how are they working together? How motivated are, motivated are they by the mission that they're working towards? How is the community? Do they do they feel like they belong there? Do they want to be there? And I think that that's a reflection of the leader who's leading that team. And then if you want to take it a a step further and think about like the self and the system based part of it, like you need to bring your best self to leading a team because I feel like, you, that's the only way to effectively like communicate, to effectively listen, to effectively delegate, to do anything you need to be able to be taking care of yourself and bring your best self forward. And then systems wise, like you can't, not one person can make an impact by themselves. You need to have a good team in order to see the change that you want to see, so I think it's all very, very intertwined. So that's my take.
Pete
I agree. All right, so I want, I'm curious. So we'll go back around, what's your secret to being a good leader?
Amber
My secret, my secret to being a good leader.
Pete
Well, it's not going to be a secret anymore but go ahead.
Amber
I think finding a good team. I think that it's really the team that makes it, you know, like I think. What is it that relate? Why is it that I need to be a leader in this situation or in this project, right? What's the core goal? And then finding a team who's also passionate about that goal, is also very invested in that mission. And then just working together towards that. So I think that that's the secret, not forcing anyone to be somewhere where they don't want to be is part is is a big part of it.
Pete
So what I'm hearing is culture and environment.
Amber
Yeah.
Pete
Have a lot to do with leadership and teamwork.
Amber
Absolutely.
Pete
Excellent. Very nice. Well, I guess you can kind of guess what my leadership secret is, and it's using humor. Try to bring levity to the situation, bring the stress down. Let people just get those endorphins moving.
Because it just tweaks the mindset just a little bit differently to get them to hear you, hopefully better. So then you can give the message. That's what I've learned. Some of the negatives of that, I think is sometimes you know I can overuse it and I've learned that humor, you can correct me if you think differently, that it is an indirect way of communicating your message. And I didn't, it never came to me, like I it didn’t come to you for a while. I was like, oh, maybe that's why I'm a little sarcastic too. That's my communication style. And it all stems, you know, back from childhood, you can have direct conflict, but it was, uh. So I use this as my tool to communicate and lead myself and around my family now.
So Maya. What's your secret?
Maya
I think there's a combination of initiative, like I'm going to be, but in a vulnerable way. Like I'm going to be the one to be brave and say, hey, I think this is the way we should go. And you might disagree with me, and you might say no, that let's no, here wait, there's something else to add, but being sometimes the one to be able to kind of open that conversation and say, OK, we got to get, we got to get something done. And I'm definitely of this group, like, I am the most impatient one. I'm always like, OK, come on, let's do this. Right. I know it. I know it about me. I'm known at home for, like, not letting people finish conversations because I'm like, wait, you're going to say this right? It's just who I am. You know, Mia culpa. But I think doing that in a way that A) is my own vulnerability, right? Because I'm actually not all that self confident. But I have, right? But you have to be. You have to be able to put yourself out there. And on the flip side, I think hearing from your team members and listening to your team members about where they're vulnerable, about where they're struggling because you don't know always, you can't always, just find a great team. Like I'm totally down with what you said, Amber, but half the time, you don't necessarily find the great team. You find a team who's struggling with each other, and then you have to build different relationships with each member of that team, a nd kind of figure out like all right, what motivates this person might be different than what motivates that person. So I need those individual relationships.And the team relationship.
I think that's where it gets. Tricky, right? Because you're not just managing. I'm like, it's not like I just have a connection with Peter and I just have a connection with Amber I just have a connection with Rahul. It's got to be all of us together, which is next. Right? That's that next circle of the, of our ecological model. If I can be social working. So, you know, moving outward to that. But I think there's some, that vulnerability piece becomes, I think really important. Which sounds contrary, don't have the right word, contrary to what you'd expect, right? You would expect someone to be like, “This is the way we should do things.” And it's much more like, “Hey, is this the way we should do things?” So I think that's a piece.
Pete
Thank you. Rahul, what's your secret?
Rahul
I'm building on what Maya said, because questioning those assumptions is what leads us to the secrets that we discover from our mistakes. And so I've certainly discovered from my mistakes.
Maya
Mhm.
Rahul
For me, the secret sauce of leadership is relationships. And again, I'd break it to the three domains. So with oneself, the biggest thing is connecting your personal mission and values to the professional causes and projects because it gives us the power to say hell yes and it's so rewarding that we believe in those causes that now we're not chasing titles or external rewards, we're really into the cause.
In the teams domain, we’re really task focused a lot of the time and I was very much like that, still am. You have more awareness than I do, Maya. But it's been that it's not going. You feel like you're pushing to get the tasks done, but being relationship center rather than task focused, is a much easier and more effective way of getting things done. Where you understand the people you work with and you can build trust and then things get done so much easier and better.
And then I think with the system, we come across these challenges, alerts, news, so many things are thrown at us. And so my secret of dealing with that is to stay within my locus of control. What is it that's in my locus of control? What's the next step I can take to address what matters most to me, and that's where I will focus my energy.
Pete
Yes, one thing I keep learning as I mature, not getting older, is the energy. Where do I want to spend my energy? Is this situation that I'm in, is it giving me energy or is it draining my energy? So I've been paying attention to that a lot more lately.
All right, so now on the flip side, I'll start, but an example of when leadership didn't turn out the way we anticipated or hoped for.
So I'll go back to my nurse manager example, so of course I wanted to change the world. I thought I could do it. Finding out that changing culture and mindsets is very, very difficult. Even if you have a good argument. Gaining trust is challenging, and it's a day in day out, kind of endeavor and you can lose that trust very quickly.
I had a lot of personal wear and tear, so my vision of what I could do, and what was, you know, me, keep trying to go in every day and working. You know, 12 to 16 hours a day, six days a week, when I was a manager and still nobody was happy, including myself, it wasn't worth it. It wasn't bringing my long term vision of being healthy, being there for the family and the kids, and enjoying life. It wasn't there, so I had to sidestep that that piece.
Let's see, Maya. What about something when leadership didn't go the way you had hoped?
Maya
Well, I'm going to take this back to the story that I think I told when we all met each other the first time. Which is that in my last hospital role, I was part of a phenomenal interprofessional, multidisciplinary team. We did amazing things for our patients. Everybody was smart. Everybody had strong personalities like you know, we got a lot done. But there were also things under the surface where there were some things that were really toxic. There were some relationships that really undermined our effectiveness and our effectiveness and our relationships with patients. And the folks who were titled to be leaders, never wanted to address it.
And so, I worked with this team directly for many years, and then I still work peripherally, peripherally with the program, so I'm in touch with the same folks. And after all this time, I hadn't seen a lot of change. And what stood out to me, and I think it ties back to what I said about sort of vulnerability and maybe courage, is the flip side of that, that when you're in a leadership role, you have to also be courageous enough to say to your team, whether you're a coworker or a manager, right? Something's not working here, something we need to talk about this and address this. We can't ignore whatever that whatever that problem is, because you're not working together, you know, as colleagues and within your team, you're not going to have success at getting the patients what they need. And in fact, you're going to have dissatisfaction from the patients and you're going to have, like, “I don't know if I want to get care here anymore,” kind of situations.
So you know, so I think that that remains a lesson and it's not that any, it's not like I would say, oh, there was a person who was responsible for that, or a person who was doing that. But you know, that dynamic was not changing, over a very long period of time. And so I think that's, you know, and I also I want to be empathetic to folks who are on the management and administration side, that there is a lot of, those are hard conversations to have, and we'd rather probably avoid them so.
Pete
Right, and I have struggles, like you know it, and what's that like first step, first approach? How do you how do you approach it? Because I don't want to aggravate them, I want to address it. I'm not looking for a conflict, but I know this is not the best way to get about this.
And I've learned that over the years I've got, well, all right. Amber's just having a bad day, and I'll see it, but I'll like I won't address it. You know Rahul’s a good guy, he never, he probably didn't mean it. That kind of stuff. And I would just let it go. So what I've learned over the years is as soon as you see it, just kind of say something, and keep it small, or it blows up.
Rahul
That's a huge issue for our trainees as well because there's a power differential. Even for young faculty, I think, you know, do I put my head down and keep doing what I'm doing well and finish my work and go home, or do I stick my neck out and address this? Yeah, that's an issue that comes up pretty regularly.
Maya
Yeah. Look, we work in a hierarchical system and I think it's something I'm sure we'll maybe you can spend more time talking about down the road, but, you know, I was thinking about just your talking about your army experience, which is also a very hierarchical system, right? And how do you? How do you, not move away from that, but not let that be the deciding factor in terms of how you think about leadership and decision making. But it's just like, oh, they say so, then I can't do that, you know, and that that that there's and there's also hierarchy across our disciplines too, that we don't like to admit to. But you know, we all have our areas of expertise, but within the system, right. Who gets to make the decisions? It's not usually social work, I can give lots of advice and support, right, but the reality is that that's how our system is structured at that point. So, you know, we're doing all this great interprofessional education stuff, but how we actually start to transition that into practice and share across our disciplines and like, value our different disciplines is a whole different world.
Rahul
Yeah. So when we begin any of our leadership courses, we ask our students on day one what would make this course a success for you. So back in 2021, four years ago, one of our fourth year Med students says, “What would make this a success for me is if I'm able to bring up what happens in these situations and manage that with my preceptor.” And so the first advice that, when we asked around we received, was tell that student not to bring it up and just go to the clerkship director or the program director, and we didn't really agree with that. We saw giving feedback, even if it's up the hierarchy, not as a feedback exercise, but really as a conflict exercise. And that made us build a whole interpersonal relationship piece into all our courses and curriculums after that. Because, to answer your question, addressing those pinches and conflicts doesn't begin when they're happening. It begins way back in time when relationships are first being built, and if they're not being built meaningfully, then it doesn't set the stage to bring up these little issues when they come up. And so, especially if you're in a power differential, or working up the hierarchy, having built a meaningful relationship over time is an essential ingredient to being able to bring up issues as they're happening.
Maya
And time, time is a key element also in this. When you have it, right, to build relationship and you can build relationships quickly but sometimes right it takes time for let someone get to know you and feel they can trust you. You know and be there listening before you're trying to bring about change. You know, but like, if you're working in the ICU or the ED, often you don't have the luxury of time.
Amber
Yeah.
Pete
Very true. So Rahul, what about a leadership example where things didn't go the way you would hope?
Rahul
Oh, I have so many. That's why I got interested in learning about leadership, because it wasn't working so well for me.
So I'm thinking of a time before Quinnipiac, and at that point I was 10 years out of residency, almost 20 years out of stepping into medical school for the first day. And I was working at a Community Hospital as the lead infection prevention person, hospital epidemiologist, infectious disease physician. And I had already been a certified physician executive at that time, so I should be like flying with leadership and deploying it to make great waves.
But instead of this being like a wonderful experience at the peak of my career, it was a situation where I was just working day and night. Every 3rd week of call beepers beeping at night, waking up my family, working every 3rd weekend, you know, dropping off my son. The first to be dropped off, the last to be picked up, beyond the pick up time, was basically a recipe for whole family burnout. So you have burnout in healthcare for people, we had whole family burnout, so it wasn't really wasn't working very well, this personal and professional synchronization.
And then in terms of collaborating and working with others, I was in so many teams, because in infectious diseases, we work with literally every floor, every department, whether it's inpatient, outpatient, nursing home, every setting. And true, we were touching a lot of people's lives in a good way, but then when it came to the interpersonal friction amongst some of the people I worked with really closely, I was scratching my head that you know, I have all this leadership training and we're doing all this good work, why are we so miserable when we have to work together? It really beat me. And then at the systems level, we were contributing a lot to the organization with infection prevention, but really not seeing any of the rewards, you know whether it's for in terms of being acknowledged, or in terms of the compensation, or career progression. So at a self and teams and systems level, it was a complete failure at all levels. And it got me thinking, you know, like the whole point of being in healthcare or the whole point of learning leadership is so we can make our own lives and the lives of people around us.
And I think again true, we were making the lives of patients better, but were we making our own lives better? And if people were working with? I'm not so sure. So I saw that as a failure of leadership and following those bread crumbs led me to the secret we talked about, that we can't be just so task focused all the time, we have to be relationship centered when we're taking on those tasks. And I think that's what I was missing, that led me to those failures.
Pete
Well, thank you. Very insightful. Amber.
Amber
So, you know, my experience in hospital systems is just beginning, right. Like I'm in my fourth year of medical school, so my experience is really mostly based on my rotations. Prior to medical school, I was an EMT, so I had some experience with the medical world, and then I worked in the ED as a scribe, so a little bit of experiences here and there.
But you know one thing that's sticking out to me in terms of like a time where I I thought leadership may not have been going as well as I had hoped was one of my rotations. You know, our rotations, some are better than the other, naturally. Like you have ups, you have downs. But on this specific one, and I think other students can resonate with this, it felt it felt very isolating. You know, I was, I felt like I was just there to kind of check a box. Like no one really cared if I was there, or if I wasn't there, they weren't really helping me find out like where I should go, where I should be, what I should be doing. But I was getting evaluated nonetheless. So it's like I had to kind of like figure it out for myself because I at the end of this rotation, I need an evaluation that determines my grade and whether I pass and move on. So, you know, there was a lot of, like, OK, well, I'll just put my best foot forward. And you know, I'm going to take care of my patients the best way I know how, and somebody will see. Maybe. So that was kind of how that rotation went and you know, I'll leave the outcome…ambiguous.
But it just, the take home point for me, was that now when I'm on rotations and I see third year, second year, even first year medical students who are there to shadow, like I do make it my responsibility to tell them what I know, what their place can be, what they can do, “Hey, do you wanna come with me?” Like just little things like that, to make them feel like they have somebody who they can turn to, that they feel like they're showing up to that location for a reason. And there's something for them to gain and take out of that experience. That's just one example.
Rahul
That's got to be rough. Yeah, I’m remembering, I am listening to your story and remembering my first week of internship in India and my surgery attending told me this thing that you're gonna have two kinds of experiences in the year ahead. One which will teach you how to be and then the other, the exact opposite, are going to teach you how not to be.
Amber
Mhm.
Rahul
And I think that stands true even today.
Amber
Yeah, exactly.
Pete
Oh yes, and I remember being on the floors and you watched the Med students just kind of walk around. They're trying to find something to do, like. Yeah, they're just.
Amber
Yeah.
Pete
Just looking around. Looking in charge this. Oh, this is interesting.
Amber
Yeah, because sometimes they don't know their place or what is expected of them. You might be thinking, oh, that Med student is not doing anything, but they might not know what they could do, you know. So.
Pete
Right. Very true. Well, thank you.
So my next question is, how is this exploration into leadership, how has it changed, or is it changing your your journey as you go along?
I can go first while you're thinking. I can see you, I can see a burning, the wheels turning there. So, what it helped me do is change my mental model. As we've said, and you said it before, I was in the army, so the hierarchy was there. And I think I brought that right into healthcare because it was comfortable, and it's structured, right, and it's delineated, and you kind of know, where you're you are in the pecking order.
But of course, you know at times I felt less than. I felt like I was the person just loading the trucks. As long as you got the trucks loaded, you're good to go, right? So, but what I've realized, and this fellowship has really solidified it for me, is realizing everyone's a person in their on their own personal journeys with their own history. And I used to just think, all right, that's just some nice story people are telling us. But it really sat with me this time. So now I listen and try to understand where everybody's coming from, no matter the role. I see you more as a person now, and not a doctor, a social worker or a Med student. So it's helped me connect a little better and not keep everybody in this silo. I guess if you want to, you know, in their role. I see them more as Rahul, Maya, and Amber, and not by your role. So that's helping me grow in my leadership. So now I'll pass it to you Maya.
Maya
Thinking two things and I probably, I'm not going to say either one well. I think connecting back to what you said about story, you know I I came to social work from being an English major, right? Like I came from being someone who just literally sat in my dorm room bed and read a lot of books and annoyed the math major who shared my room.
And so, that piece has always come kind of naturally, like listening to people, getting people to talk like that, you know, telling stories like that all, sort of, comes naturally. But thinking about how to use that as a leadership skill, I think was the piece that I hadn't really thought about or, you know, seen described that way. So now, kind of using that level of awareness and I'm at a moment in my career which I've avoided for a really long time, which is there's probably some steps ahead that are actually formal leadership roles. Like that I can't, I can't duck it much longer. I've really like I I like the boots on the ground place and I'm really happy to stay there. But I'm like, you know what? I'm going to have to be a little braver and probably do the next thing because my team is going to need it.
Right. Like you know, we have some succession to think about if I'm going to remain part of a team, so. I think thinking about how to like, let myself evolve and what I can use sort of as that moves forward is going to be. So it's an interesting place to be having these conversations as like it's really like in my face now like oh, I'm going to have to, I'm going to have to do some stuff, that I've managed to, you know, I'm always like kind of the power behind the throne, or to the right and the throne, and like helping other people get stuff done. And it's like, no, I'm actually going to have to be the forward facing person at some point. And I think that's the leap that happens across careers and trajectories. Like, Amber, you were talking about becoming a leader in your student organization, right? Like you had to make that leap from being OK I'll participate to being like, oh, no, I'm gonna sit on the exact board. I'm gonna help do the, you know, get the next thing done. That's a leap. So.
Pete
Yeah, great.
Rahul
Yeah. We're cheering you on, Maya. Go brave Maya.
Pete
So Rahul, how's your leadership changed over this journey?
Rahul
I think my answer is closer to yours. So on the surface it's changed me from this very task focused, self-centered, “I need to get this done” perspective, to a more grounded relationship-centered perspective. And in thinking about that perspective of relationships, it's made me think a little bit harder about “the why” and “the how,” of doing things, not just getting them done. And more importantly, it's made me realize how interconnected everything is and we are part of something much bigger ourselves and that's really freed me up to take these risks. And to be more effective in honoring others and listening to them and working with them.
So that's really been my change from this steady task-focused frame to a much more relationship-centered and impact-oriented frame.
Pete
I'm a very good taskmaster too, and I'm going to check boxes and, but yeah.
Maya
See, I've only gotten to know you guys, you know, recently and like, I don't know Rahul in any other way than as being like grounded in relationship-centered like that like that's all I know. So you're.
Pete
True.
Rahul
I have I have modes definitely, and I think that's part of being a leader that you have to have this range where in the beginning we may just have a default mode, but then as we find our footing in philosophy, we've built this range and can now use this range to be more effective.
Pete
Very true. All right. We want to hear from a student perspective. How is this leadership journey changed you so far, or is changing you? Or what can you anticipate?
Amber
Yeah, great question. And I think you know I I touched on some of these things in the beginning, so sorry getting ahead of myself there a little bit. But ditto to what everyone has said really, like I, I really resonate with what everyone has said. And I'm feeling those changes myself now as I'm transitioning from student to, oh my goodness, graduate, and hopefully resident in just a few weeks now. So you know, I think another big thing that I can add here is transitioning from working on developing my own leadership, to helping other people also find their full potential and develop there's. You know, I think that's one thing that I I'm seeing myself actively doing now. You know, sitting on executive boards, or sharing conversations with people about like what I've been doing the last few years, and engaging with this course and like, oh, how'd you do that? What, what? What tools like. And we end up having these very meaningful conversations about their own leadership journeys, and their leadership roles, or whatever they're nervous about, scared about, or wish they can do better and taking some of the tools and hacks, and applying it. So I think that you know, it's a very unique thing to be developing myself as a leader, but also you know taking other people with me on that journey. So very, very blessed for that.
Pete
Yeah, yeah, mentoring is excellent.
Amber
Yes.
Pete
It was very rewarding when you can see someone blossom.
Amber
Yeah.
Rahul
Ambers come back to mentor the first year medical students in our leadership courses now three years in a row, as a second year, as a third year and now as a fourth year.
Amber
You have to find someone to take the hat.
Maya
Succession, right?
Amber
But it's been it's been an honor, honestly. Like without the site, I probably would not have met those first years, second years, and third years and now we have very meaningful relationships and that really that that coaching mentor mentee relationship that they can use for whatever they want even aside from leadership like we talked about other things you know, about just being a student.
Pete
Yeah, yeah. Everyone likes to get a little help here and there.
Amber
Exactly.
Pete
So the next concept I wanted to bring up is something we go over every time we meet, especially with the students, is the Rose-Bud-Thorn concept and maybe, maybe pinches. I'll leave that for Rahul to explain. The Rose-Bud-Thorn concept is something that's you're very proud of or excited about, the Rose.
The bud is more about something that's just starting to begin, that you're hopeful for. And then Thorn, something that you're challenged with currently.
Rahul
Something that's pinching you.
Pete
Something that's really pinching you. So for the bud, I thought I'd start with Amber.
Amber
So something budding for me right now, let's see. So I am planning a conference. We're having a conference in March and so lots of meetings, lots of planning, but very excited and looking forward to that outcome. And I'll let you know how that conference goes next month.
Pete
Oh, excellent. So I guess a thorn for me is, and it's been a thorn for a while, is being able to ask better or more thoughtful questions. Especially when I get emotionally engaged, for better or for worse, because my default, which I've come to learn is, you know, my funny sarcastic side, or I totally shut down. So, because I don't want that conflict.
So that's something that's been a thorn in my side and I continue to use communication tools, leadership tools, trying to hit it from all different angles. So that's one thing for me.
Let’s go to Maya and her rose.
Maya
Wow, I've got a lot more buds than roses right at this moment. But, and I'm honest like I don't know if this is the place for this, but my rose is actually I've raised a pretty good young man who is launching out into college and literally we spent this weekend as a family, I guess this is a rose, we spent the weekend helping him finish a scholarship application that was actually all about leadership and he came up with this great analogy about, he's a bit of a musician, and he talked about being a dynamic lead singer, a lyricist, a reliable road crew, and a rock steady baseline.
And I thought that was so fantastic, right? That and it really speaks to all the stuff we're talking about, right? Like, yes, I can be the shining star and I can be me and I can shop, but I can also, like, support other people. And like the fact that I've got a kid who innately seems to know these things when we're.
Pete
Yeah.
Maya
I think is really is really a rose and it then makes me think about, OK then how do I share this with other, right other young students who are in the same boat.
Pete
Right, right. Excellent.
Rahul
Love it. We're dedicating this episode to him.
Pete
Rahul, can you explain the pinch a little bit, and then tell us a little pinch that you have?
Rahul
So a pinch is something that's hurting you, maybe bothering you. And it's still something you're feeling safe enough to share with the people around you, whether it's for support or advice, sometimes you ask for advice with a pinch.
So a pinch for me right now is my left shoulder has been hurting for a few weeks and I'm at the point where I've just started physical therapy and I'm hoping that that's gonna make it go away. And I don't have to go into more intricate procedures to deal with it. So it's been a pinch both because it hurts every time I raise my shoulder, and it's been a pinch because I've not been able to do some of my strength training for the shoulder and can now start to feel it. And so hoping it's going to get better soon. Sometimes the pinch can be emotional, you know, it can be something that someone said to you. There can be all sorts of pinches, but for me, I think I'm grateful that that's my pinch for today.
Pete
Excellent. So what is that one thorn in healthcare that you're hoping your leadership skills, tools, whatever you want to call them, that you can use to help you in the near future? I'll start with Amber because she's the youngest and doesn't have much history.
Maya
She's not jaded.
Amber
I think for me I mean the theme of my answers throughout this episode have been focused on community and culture and things of that nature. So I think for me just, you know, one thorn that I'm like looking to tackle with leadership skills is just that first step of creating or fostering this inclusive community where people feel safe. Safe to speak up, right. Safe to you know, bring up that pinch, or that conflict, that they that they see before it turns into something bigger. So that's one thing that, you know I'm pinpointing for now. For my thorn.
Pete
Great. OK. And one for me is again, on the asking, thoughtful open minded questions, but it's really to understand the other person's perspective better. I have discovered you know you had that quick judgment and then I can't let go of it. So you just kind of and you, you ask them a very or I ask a very direct question, and kind of miss all the context. So I'm trying to slow down, explain myself better with more context before I ask maybe a difficult question or something like that. And be more patient with my communication. I tend to be a taskmaster. I want to get it done. Go quick. And I jump from the beginning right to the end and I lose people in the middle. So that's one thing I'm working on in healthcare because I think being able to communicate better and bring people along your journey so they can help understand and get them to where you hope right? We're for better outcomes for everybody. Of course, we all want patients to have better outcomes, but we shouldn't be depleted of our own personal energy by the end. So, let's see, Maya.
Maya
What was the question again? I'm looking at the mountain.
Pete
The thorn in healthcare.
Maya
The thorn. You know, I came into this work to be an advocate for kids and family with chronic illness. Like that's where this started for me and my work, my scholarship, everything is really connected to patient voice and making sure that people's voices are heard because when people's voices aren't heard, I think that's right, where a lot of the disparities happen and when action doesn't happen for folks who can't help get their needs identified and that happens in individual visits, right? I only have 3 minutes to get my concern out to my provider before they're ready to move on, you know, not they're ready to move and they have to move on. You know, it's not. It's not the fault of the provider necessarily. But time is very crunched, but also right as Amber was talking about. You know, communities and culture and those pieces, like who has a voice and whose voice isn't being listened to, so to me like that's the thorn that I want to fix. I don't know quite how to fix that other than every healthcare professional that we train differently, right will maybe help change that, change the model of healthcare we have right now. But I think we need more concrete steps and I'm going to count on Peter for that.
Pete
Excellent. Rahul, what's that one thorn for healthcare that you're thinking about?
Rahul
I think I'm going to go with more, something more concrete. So for me, one challenge that I'm looking to address is in my clinician role, I'm transitioning out of my role as the director of infectious diseases at a Community Health Center where I am right now. And so, starting to build a little space to explore what the next journey is going to be in that clinician leader role. And I'm struggling with whether I should go to another larger healthcare system and try to do things at scale with others and to have an impact. Or is it now time to start to build something that's much smaller but is in more in line with the vision that we have that we've just talked about of healthcare and giving this whole person care to patients and not just addressing sickness and disease, but really helping the whole person and having those wonderful teams. So I'm really struggling with it at this point and I've given myself a few months to explore those options, before converging on what is the one best path ahead.
Pete
Yeah. Thanks for sharing. All right.
Maya
That’s exciting and scary and terrifying. Yeah. Yeah, yeah, we're here for you.
Rahul
And terrifying. At the same time.
Pete
Yeah. And we totally understand it. All right, So what are some takeaways from this podcast as we start to wrap this up from spending this this time together? Anyone got something top of mind? Or we can go around the room?
Amber
I think a key take away for me is just being open to other people's perspectives. You know, sitting here, getting to know you all. It's just truly inspiring and you can learn so much from just learning about someone's journey and what they're thinking and their perspective on things. So one take away for me.
Rahul
I'll echo that I think that for me, the take away has been what Peter said and has embodied and created a space for us in this episode, which is just learning about each other as a person. And if we can just do that in our little interactions every day, it's going to make us so much better as people and leaders.
And then for our listeners, I think my take away is everything we do in this podcast is going to come back to something in self, or interpersonal and teams, and systems, and it's going to be done in a way that helps you become a better leader today. That's our promise to you.
Pete
Nice. I guess mine is, because I was the moderator, don't let your fears stop you. Because I thought this actually became a very comfortable podcast and is going to hopefully be edited and done very well by the end, but you know, I had all my fears clouding me in the beginning there. Uh, let's see.
Maya
Actually, I'll add on to that, Peter, that you know I was talking about sort of the evolution of our leadership and how scary it is. It can feel right. And Rahul, you're talking about sort of making that whatever that next decision ends up being or some combination of decision that you end up making. But sort of that, that ability to feel the feelings. Yes. I'm anxious. Yes, I'm scared. Yes, I don't. I don't know how to handle this pinch. I don't know how to handle this conflict, but being able to kind of take that, take that leap, I think there's bravery and courage in all of this. I guess those are synonyms, to be able to kind of take whatever our next steps are and hopefully we're giving that to our listeners as well.
Pete
Yeah.
Maya
I guess I'm hoping also this develops to be a conversation like it's not like, oh, we're experts and we're telling you this stuff, but also that that you know, however, that happens, you know, as this develops that we're hearing from folks at all different levels and from all different professional backgrounds and experiences. So that, right, it's conversation, it's not. Hey, we figured it out and we're going to tell you, but that we're, you know, we're still I think all of us have framed ourselves as learners. So we're right in with our listeners.
Pete
Right. We have a couple of decades of experience. That's all. That's what I tell my students.
Rahul
Couple of decades of learning from our mistakes. That's right. It's still learning from more mistakes, yeah.
Pete
Yeah.
Rahul
Every time that that's the beauty of this field, that every time I get to interact with either an expert or with a student, I get to learn so much more and often it's the students who ask the greatest questions, which we have no answers to and send us on journeys. So if you're listening, and if you have a question for us, a topic, an expert you would want us to bring on, please reach out to us and we'd love to go on that journey with you.
Pete
Excellent. All right. Well, thank you all. Three of us, all four of us. Thank you.
As today's moderator, thank you for participating in this conversation about leadership and healthcare from different interprofessional perspectives, net various times in our career journeys. Be sure to subscribe to the podcast for more relationship-centered leadership. Stay well until next time. Cheers to being our best selves, building relationships and teams, and making an impact on the healthcare system where we can. Thank you.
Brooklynn
Thank you for listening to our show. Learning to Lead is a production of the Quinnipiac University podcast studio, in partnership with the Schools of Medicine, Nursing and Health Sciences.
Creators of this show are Rahul Anand, Maya Doyle, Peter Longley, Amber Vargas and Brooklynn Weber.
The student producer is Brooklynn Weber, and the executive producer is David DesRoches.
Connect with us on social media @LearningToLeadPod or email us at LearningToLeadPod@quinnipiac.edu.