What Being a Doctor Did — and Didn’t — Teach Me About Leadership

This piece appeared in the The Wall Street Journal on April 11, 2017.


I spent 11 years after medical school training for my first career as a surgeon and scientist, and received little formal preparation for my eventual career as an institutional leader.

Extensive training makes sense for a role in which you literally hold patients’ lives in your hands. But beyond the necessary technical skills, becoming a surgeon is a matter of absorbing deep and urgent responsibility for another’s life into a core part of yourself.

In some ways, that training has helped me in my current administrative role. Certain lessons from surgery do translate clearly: you focus on outcomes, look for solutions no matter what the challenge, and always take accountability for your decisions.

Other lessons don’t translate as readily. In surgery, the best opportunity to get the best results is to get it right the first time. Surgeons face intense pressure to complete their procedures thoroughly and correctly in one shot. Going back a second time can lead to a poor outcome. Under these conditions, quick decisions and actions are the norm.

The predominantly one-shot approach, though, is 180 degrees off when it comes to making decisions in a leadership position. My job today as dean of the Stanford University School of Medicine requires that I cultivate dialogue, build trust, incorporate feedback and move forward together.

One early reckoning with this came from something unexpected: neckwear. My first leadership position was as a department chair at Johns Hopkins Medicine. The institution had a time-honored tradition:Each department had its own special pattern of ties and scarves that faculty wore on one day of the week, demonstrating collegiality and pride.

My department had a problem: Our pattern was, to put it bluntly, unattractive, and nobody seemed to like it. I decided to change it, and thought for sure that my colleagues would applaud this decision. I was wrong. Though few appreciated the aesthetic of the old neckwear, they deeply valued the tradition it represented. Naively, I had thought that the quick and resolute decision-making that is often the mark of a good surgeon would also be valued as a leader.

The neckwear lesson taught me a lot about how to really listen to those I lead – to be aware of all that factors into their roles and contributes to their identities as professionals, and as people.

Many challenges of leadership may seem less urgent than those of a surgeon, but the opportunities to make an impact are substantial. From being on both sides of the operating room, I’ve learned that without close and considered collaboration, it’s impossible to run an organization, much less lead one.