Leading for a Change Blog Moved

May 11, 2012

This blog moved to a new home. The Leader’s Toolbox has a new website!! Future blogs can be found on www.theleaderstoolbox.com/blog.  Look forward to seeing you there.


Healthcare reform: Leadership at the local level…a case study

October 28, 2011

The context

The head of The family Medicine Department, University of Minnesota has a long history of developing physicians who have been influential in the field. He is committed to developing a self-sustainable program that will continue despite the external challenges. But the latest round of challenges before him is immense. Family Medicine lies at the cornerstone of healthcare reform. Yet state budgets to support Family Medicine resident education have been slashed by two-thirds. Hospitals and other healthcare systems that utilize and support resident training are unable to fill the void. Faculty have not received pay increases in several years, despite being asked to do far more. Indeed the business model of simultaneously providing care to the indigent and developing the next generation physicians is in jeopardy.

The intervention

The head of the department of Family Medicine decided he needs greater leadership support from his people. He provided three days of Strategic Leadership Tools™ training from The Leader’s Toolbox, Inc. followed by the formation of Toolbox teams who are expected to utilize the learning to address some of the department and clinics most pressing issues. These teams receive coaching support to ensure they use the tools correctly and focus on the right issues. The first teams addressed were tasked to develop plans and recommendations around the question: How do we building strong local leadership teams that can more quickly and effectively implement change. A second group will focus on the challenges of creating advanced family medicine practices given the new healthcare environment. The results Read the rest of this entry »


Three Critical Competencies for Healthcare Reform

August 19, 2011

The fundamental Challenge of Healthcare Reform

Imagine that you, a non-physician, were given a white coat and told to diagnose and subsequently treat a patient who was close to death. That analogy is similar to physicians who almost universally have no formal or practical experience to lead and implement massive change. It is actually worse than that.

Now imagine that you are an accomplished tennis player. The road hasn’t been easy. There were countless hours of practice, tournaments, and individual coaching. You learned the rules and decorum which everyone agrees and adheres to. Then one day you are selected to be on the soccer team of a foreign country. No longer is success based solely on your individual performance or capabilities. This is truly a team sport. There are new rules, language, and skills which are generally followed. In some countries when the fans are unhappy with the result they are not only rude, but sometimes come out to the field ready to do battle.

This describes the transition faced by many healthcare leaders. They are all individually accomplished and have received recognition and often their leadership posts because of their technical capacities. But the game, language, rules, and the nature of the interaction with the players have changed. BUT TYPICALLY NOT THE SKILLSET OF THE PHYSICIAN LEADERS!

Already overworked, less appreciated by their professional peers, and overwhelmed by the task in front of them, physician leaders on the front line juggle the challenge of meeting the requirements of the current game, treating patients and meeting the financial objectives, and build the capacity to play in a new, yet undefined game. Once exception: The rules of soccer have been defined. The rules of engagement and winning are clear. Read the rest of this entry »


July 1, 2011

I am pleased to share with you that Getting It Done: Field Tested Strategies for Clinical and Financial Success was published yesterday by the publishing arm of the American College of Physician Executives. I contributed a chapter that describes how a highly successful clinical organization overcame the years of animosity with the hospital organization with which it had decades of rivalry. The improved relationship served as a new foundation for the two organizations to build a new hospital. There are many similar and instructive examples in the book to show how collaboration and significantly improve outcomes and financial success. The book is available from Amazon.


The Great Minnesota Budget Shutdown: A leadership void

June 30, 2011

Minnesota welcomes you

Here in Minnesota we are just hours away from a government shutdown. The two political parties are playing chicken with one another and it appears that the citizenry is about to lose. The night before the deadline, the two sides called it a night…and no new talks are scheduled. For those of us who have lived here for several decades we cannot understand how we got to this point. Before I moved here I always wondered what kinds of people could tolerate that awful climate and wondered whether there was actually civilization so far north. We have a saying. “It’s harder to get people to come to Minnesota than to get rid of them.”

What made this such a wonderful place despite the climate is the willingness of people to see a larger good and to work toward the benefit of the whole. At the end of the day people were willing to come together for the greater good. Perhaps it was part of the culture of the predominately Scandinavian culture, whatever it was, this was a great State. We had great government, schools, infrastructure, theater, etc.

Now each party espouses similar values, but the actions seem otherwise. We have moved from a government working philosophy of pragmatism to dogmatism. Each side has a worldview that they want to realize and in the process miss the value of the other. As a result of the two sides digging in, the real issues are not being tackled. If the amount of time people had to spend for the preparation of the shutdown could have been used on some real issues, more progress could have been made. Read the rest of this entry »



April 27, 2011

The biggest issue I see amongst the coachees I see in my practice: How to get out of the survival trap. The challenge: How to take on the more important work, leave the lessor work behind…and still meet the expectations of the boss.

Most people:

  • Don’t think they can take on any more work
  • Feel that much of what they do is less important…but expected to be completed anyway
  • See there are longer range issues to be addressed, but these are not valued by their managers
  • Feel there is no way out of the box Read the rest of this entry »

Myers Briggs, Leadership, Love, and Power

March 25, 2011

Many studies have been undertaken to determine whether a particular leadership style is most beneficial for leadership success. There seems to be a correlation to the type of leadership work that needs to be performed with the type of style the leader most beneficially can possess. The implication is that the primary style of the leader needs to modulate to fit the needs of the circumstances being faced. Unfortunately few people have the capacity to change their inherent stripes…even adapting one’s style to accommodate the needs of someone else may in and of itself be daunting enough. In other words, the identification of style is a rather ineffective means to help leaders improve their capacity. It may provide some interesting insight, but few have the capacity to use the information in a meaningful way. Read the rest of this entry »