Speaker: Hello and welcome to the AMA STEPS Forward® podcast series. We'll hear from health care leaders nationwide about real-world solutions to the challenges that practices are confronting today. Solutions that help put the joy back into medicine. AMA STEPS Forward® program is open access and free to all at stepsforward.org.
Dr Sinsky: My name is Christine Sinsky and I'm the vice president of professional satisfaction at the AMA. It is my pleasure to talk today with Dr Steve Swensen about a module that he's just co-authored on leadership and that's found on STEPS Forward®, which you can find at www.stepsforward.org. Welcome Steve. So glad you could join this.
Dr Swensen: Yeah, I look forward to visiting and I'm particularly grateful for your leadership on behalf of physicians in America and all the patients that they serve and the work you're doing here is very important and you're making a difference. Thank you.
Dr Sinsky: Well, thanks, Steve. Can you tell us a little bit about your role in leadership over the course of your career?
Dr Swensen: Well, I spent 35 years at Mayo Clinic and about four years ago, I transitioned to live in the Rocky Mountains. I'm still working here remotely and I, I, and my focus is almost exclusively on professional well-being in health care and 30 years, I had six different positions at Mayo. The most important was something we shared in common and that was being part of a care team that focused on patients and physicians lead those teams almost in, in almost all settings. And that's probably the most important leadership position I had learning about the role of leaders and organization design and policies and programs to engage staff and make them more resilient and partner with them for the best possible patient care. And in that role as head of leadership, I was in charge of, we had 4,700 staff physicians, but the main focus was on the 242 leaders that had a formal title, all physicians, and that's where we developed and, and then learned the value of five leadership behaviors, which we're going to talk about today.
Dr Sinsky: Great, great. Well, we're really fortunate to have you and have the wisdom that you've gained from that deep experience. You co-authored the, the STEPS Forward® module with a colleague Dr Tait Shanafelt, but perhaps you can introduce him to us. Tell us a little bit about your co-author.
Dr Swensen: Tait Shanafelt is a great person and is a wonderful partner in this work at Mayo Clinic. He's a leukemia doctor and he got interested in professional burnout. And at the time that we partnered, I was head of leadership development and Tait was a president of the staff of Mayo Clinic. And he was also involved in our survey process. For 30 years Mayo's been serving surveying all 65 000 now staff, including 4700 physicians. And so, the questions in there are something that is, that are, is critical to understanding how well all of the staff, whether you're a custodian or CEO or accountant or a physician are prepared to take care of patients. And so, in, in the, and so that's how our, that's when I met, met Tait and we went on to do the leadership behaviors, the index, the module for AMA, and we wrote a book about a dozen different things that we can do to improve the well-being of, of physicians in all health care workers.
Dr Sinsky: Great, great, well, you've mentioned the five leader behaviors, and I really like the fact that you've condensed this down into something simple and actionable. And so, I wonder if you can tell us more about the five leader behaviors and if possible, give a concrete example from your own experience.
Dr Swensen: So, the first behavior is recognize, Chris, thank you for your work today with this patient, it wasn't in your job description. The extra time you took was so valuable. And so, what, what, what I did in my own leadership was I started every meeting that I led at Mayo in the last 15 years with some sort of opportunity to recognize a member of the team that was there and in a story, we heard from a patient or a colleague. And, and that was a way to recognize and honor them without any big budget or fanfare or trophy. And, and so there are a thousand ways to appreciate people. It's a very powerful behavior of those five, the second to is to inform. And, and so to, to build trust with leaders and staff, you want to be transparent. You want to have them involved in participated management.
So, they feel like they're part of the team. And, and, and so they have some agency, they have some control over, over their, their destiny. And, and so the style that I used as a leader was to make sure that we harvested all of the ideas of the whole team. And then together we'd have figured out what was the best way to move forward. And so even if no one always got their own way, they felt like they were listened to and respected. The inquiry is basically to ask, it's to seek, to understand, seek first to understand, and you do that by asking questions. And, and so instead of just assuming that, you know, what millennials want or baby boomers want, or men want, or women want you ask them what matters to them. And the, the, one of my favorite questions to ask staff in, in, in regular settings, usually in the performance review annual conversation is: what brings you joy at work?
And they've reflected on that often had the answer later in, but, but by asking them what matters to them, then you can move forward a very important one of the five behaviors. The, the, the, the fourth behavior is develop. And, and so this is to help, um, each staff member reach their dream work in the organization or team or department or clinic that they're, they're part of. And, and so we, I would always ask in, in regular meetings when I supervise people, or when I had the privilege of being their leader, what were their goals for their year and, and what, and what would be their dream job look like at Mayo Clinic five years from now. And then we'd said figured out how we could do that together. And the fifth is inclusion to, to include people, regardless of genome or phenome or gender or orientation or creed, or how much melanin they have in their skin.
Dr Sinsky: What's a pearl of wisdom that you'd like to share?
Dr Swensen: I, I think something that I learned in my decades in medicine and in leadership is that the key to the success is to start with the patient and work backwards. And so, if you do that, it's a team sport, right? There's no physician that, that is able to do anything as best as possible, as well as possible without a whole integrated, supportive, psychologically safe team environment. And so, so the, the best leaders are ones that focus on the name on the front of the jersey, which is the patient and organization, and they don't focus on their name, which is on the back of the jersey and, and the, the ones that focus on the name and the back of the jersey, their name, are the ones that are set up for a short term or very unsuccessful team, because it's, if it, if it is not about the patient, it's not about the mission, the organization, then they're set up to fail. So, start with the patient and work backwards.
Dr Sinsky: Great, great, excellent. Steve, thanks so much for sharing your wisdom. Thanks to both you and Dr Shanafelt for co-authoring the STEPS Forward® module on the leader index and leader behaviors, and we so much appreciate all of that work.
Dr Swensen: Thank you, Chris.
Speaker: Thank you for listening to this episode from the AMA STEPS Forward® podcast series. AMA's STEPS Forward® program is open access and free to all at stepsforward.org. STEPS Forward® can help put the joy back into medicine by offering real-world solutions to the challenges that your practice is confronting today. We look forward to you joining us next time on the AMA STEPS Forward® podcast series, stepsforward.org.
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