Editor’s Note: Valuable advice to use while becoming an effective orthopedic leader.
The value of having an Executive Leadership Coach can’t be overstated. All women in leadership posts and especially those who aspire for more need this type of input. Mentors can coach but don’t have the level of training to effectively help improve your leadership skills.
New to my own leadership position, I was given the responsibility to direct combined clinics involving other specialties. Although the chairs of the involved departments agreed in theory to support my efforts, they actually only did to varying degrees or even not at all. I suspect they feared loss of control.
It was brought to my attention on a Friday afternoon that a surgeon in one of the non-orthopedic clinics I directed, was signing off on notes for patient visits done by his fellow when he was not present in the clinic. It was clearly documented that he was in the operating room when these visits occurred. This amounted to fraudulent billing in a clinic I was responsible for.
Not being the head of his department, I attempted to reach his chair via email, phone and text that evening and over the weekend. On Monday morning, I called the chair’s secretary leaving a message saying it was urgent that he call me. By midday, the chair had not responded.
Fraudulent Medicare billing must be addressed as soon as it is discovered. The lack of the involved chair’s response led me to the next step, which was calling the Chief Compliance Officer. The Compliance Officer, in turn, called the involved department chair. I then received a call from the enraged chair who told me how angry he was that I had not spoken to him first before making the report. He said that I had overstepped my authority.
I “lost it” and surprised myself by screaming at him. It must have surprised my secretary, too, as she closed my door. I explained that I had reached out to him multiple times & he was unresponsive. I had wanted to include him in my conversation with the Chief Compliance Officer but his lack of responsiveness made it impossible. It became my responsibility to report to the compliance officer as soon as an offense of this type was brought to my attention. I made it clear that I was was not going to let him spin it any other way and that his prior and repeated efforts to undermine my leadership by twisting facts would not happen this time. I would expose his lies if he tried to evade his responsibility. When I was finished, he made no comments and was silent. I told him that if he had nothing further to say, our conversation was over.
I later met with my leadership coach and described what had transpired. She asked how I felt and if I had handled the situation well? I said I actually felt ambivalent about how I handled it because I had lost my composure. I don’t like losing my emotional control because it very rarely happens. I was unsettled by it. She then said, “He is a bully. He flexes his bully muscle all the time. You don’t have one. Yet, you out bullied him this time. You don’t feel good about it because you deviated from your authentic self. You reached down to his level.” She was correct. She then helped me to learn skills to address his bullying behavior without descending to his level.
Another useful leadership skill I learned from another of my coaches has stuck with me. When you must go into a conversation with a colleague about a serious issue, complication, or infraction, it is helpful to first think about the positive qualities the person has. This changes your frame of mind and makes remediating the problem easier.
Two final recommendations for women in orthopedics during their early career years:
1. Work an 80% position. This gives you cushion time to have children, conduct research & publish. You will then not fall behind academically & professionally. It is necessary to become a full professor to qualify for leadership positions so you must lay the groundwork early.
2. Find a niche within your specialty where you can become an expert. You will be sought after.
3. Later, consider obtaining an MBA so you can deal effectively with others with MBA’s. Being a surgeon does not make your opinions about business issues respected. You need the credentials to work effectively with administrators and executives. The financial side of medicine looms large and will influence your career in its entirety.