What do a compass, a mirror and a Swiss Army knife have to do with pediatric leadership? Dr. Kanekal Gautham, Pediatrician-in-Chief at Nemours Children’s Hospital, Florida, makes the connections and provides key principles of leadership in pediatrics.
This episode was recorded live at the Pediatric Academic Societies Meeting (PAS) in Toronto, Canada on May 3, 2024.
Watch on YouTube.
Guest:
Kanekal Suresh Gautham, MD, Chair of Pediatrics and Pediatrician-in-Chief, Nemours Children’s Hospital, Florida
Host: Carol Vassar
Producers: Carol Vassar, Joe Gillespie and Sebastian Riella
TRANSCRIPT
Carol Vassar, podcast host/producer:
Welcome to Well Beyond Medicine, the Nemours Children’s Health Podcast. Each week we’ll explore anything and everything related to the 80% of child health impacts that occur outside the doctor’s office. I’m your host, Carol Vassar. And now that you are here, let’s go.
Music:
Let’s go…Well Beyond Medicine
And we are on the go live at the Pediatric Academic Society’s meeting, PAS 2024 in Toronto Canada. Joining me right now is Dr. Gautham. Dr. Gautham is the chair of Pediatrics and Pediatrician in Chief for Nemours Children’s Health. Welcome sir.
Dr. Kanekal Gautham, Nemours Children’s Health:
Thank you very much.
Carol Vassar, podcast host/producer:
We’re so glad you’re here today. You have a presentation that’s coming up. It’s about leadership in pediatrics. Let’s talk about what your general definition of leadership is and then your definition of leadership in pediatrics itself.
Dr. Kanekal Gautham, Nemours Children’s Health:
Thanks for the question. If I had to pick one definition of leadership in general and in pediatrics, it would be service. Service of the people that you oversee and service of the people that you report to. Ultimately, it’s about serving the needs of the people we take care of, which are the patients, the families, the learners that come to us for education and training. And all of us as colleagues, we have to take care of each other. So that would be my definition of leadership.
Carol Vassar, podcast host/producer:
Is that something we need to remind ourselves of? Because often in healthcare, we’re all leaders and we’re all serving.
Dr. Kanekal Gautham, Nemours Children’s Health:
I think the reminding ourselves periodically about what leader leadership is about and why we are here as leaders is critical because leaders often lose their way. There is a well-known book by Bill George called True North, and that whole book is about the importance of keeping focus on your mission and not losing sight of the real reason why an organization or a company exists. And for us, it’s about, like I said, taking care of patients, learners and about each other as colleagues.
Carol Vassar, podcast host/producer:
It’s interesting you should say True North because I love the presentation title you are presenting. It is called the Compass, the Mirror and the Swiss Army Knife. Now these are everyday tools we use for measuring what direction we’re going in and all sorts of other things that we’re doing in our lives, and it’s a very visual title. Talk about that title and how it relates to the principles of pediatric leadership.
Dr. Kanekal Gautham, Nemours Children’s Health:
Thank you. This is a title that I came up with when I started teaching leadership for the Canadian Medical Association. They have a physician leadership group that provides training in various leadership and qualities called the Canadian Medical Association, and they have a framework called Leads, L-E-A-D-S. So I have the good fortune to teach in many of the workshops and seminars. So came up with this title, which represents the three objects that leaders should know, and it represents the principles of leadership. The compass obviously represents true North and the mission of why we exist as an organization. The mirror is a symbol of the importance of self-awareness and self-management for leaders. So, leaders who don’t have self-awareness have not opened to feedback, so they cannot regulate the performance as the situation needs. And then the Swiss army knife is a representation of the multiple skills and talents that a leader should have and the fact that every situation requires a different tool from the Swiss army knife.
So sometimes a leader has to be very authoritative and strict. Sometimes, they have to be more tender and more like a coach and a supporter. Sometimes they have to use very quantitative skills. For example, when doing a financial analysis or a workload assessment, and sometimes they have to have used more qualitative skills like relationship building, change management, conflict resolution, negotiation skills. A leader who just has one tool in her or his armamentarium is like a cartoon that I saw long back in the New Yorker. It was a Swiss army knife, but every tool was a corkscrew and the label for the cartoon said French army knife. So a leader should not be a French army knife, they should be a Swiss army knife and know which tool to use for which situation.
Carol Vassar, podcast host/producer:
And not everyone comes equipped with the tools. We’ll talk about that in a little while, how we can develop those tools. But one of the principles in medicine that we know doesn’t change, is that everything changes. And we’re seeing the advent of artificial intelligence. We’re seeing that contest between value-based care versus fee-for-service. What skills are needed in healthcare leaders today and tomorrow, especially in the area of pediatrics?
Dr. Kanekal Gautham, Nemours Children’s Health:
I would say the skills that leaders need to deal with situations like as thought you described, are adaptability. The ability to live comfortably within paradox, and the ability to function in spite of uncertainty. So without these skills, if you are a very black and white thinker as a leader, you’re not going to do well, but you have to be adaptable to the context changing around you, and have to shift while not losing sight of true, North. And you have to be comfortable with paradox. For example, we have to accomplish both mission and margin. If you ignore one of the two, you are living in a black and white world. So, the ability to function in gray is very important for that leader.
Carol Vassar, podcast host/producer:
Do the skills needed for leading a clinical team differ from those from someone leading a research team or maybe an executive team? Talk about that.
Dr. Kanekal Gautham, Nemours Children’s Health:
That’s a good question. I think for all these roles, you need a mixture of what Ron Heifetz and colleagues call, technical skills and adaptive skills. So if you’re leading this clinical team and you are a Hemo/Onc Division Chief, you better know how to take care of children with cancer and blood disorders. Otherwise, you’ll not earn the respect of your team. But at the same time, you need adaptive skills to manage conflict between the gain members or to advocate for greater resources for your division and other soft skills that you need. For a leading executive teams of leader, that’s a special level of challenge because leading people is different from leading leaders. So, for example, as a division chief in my previous role at Texas Children’s, I was a neonatologist, I knew the subject, and I was the leader for the neonatologists and the nurse practitioners.
But now, as the Chair of Pediatrics, I have to lead division chiefs, and I have to lead divisions where I’m not a subject matter expert. For example, I’m not an expert in rheumatology, I’m not an expert in cancer, and I’m not an expert in neurosciences, but I have to manage the leaders of these divisions. So, I have to have the humility to know that I don’t know the subject matter. But I am there to support you as the division chief and help you succeed. And I’m here to help you navigate the organizational context so that you get the resources and the support that you need. I see that as my role. So, leading leaders is a different ball game than just leading a team.
Carol Vassar, podcast host/producer:
Let’s talk about, you’ve mentioned soft skills a couple of times. Are there specific leadership skills that simply cannot be taught?
Dr. Kanekal Gautham, Nemours Children’s Health:
I don’t think so. I think most leadership skills can be learned and acquired through proper training and going to workshops. Working with a coach can be very, very important. And the soft skills like the communication, relationship building, conflict mediation, those can be learned with practice. Some people might need more practice and more coaching than others. For some, it comes naturally. And yeah, I think most leadership skills can be learned. If not, if you are incapable of learning those skills, you’ll probably not be a good fit in a leadership role. And unfortunately, in many leadership positions, there are people who don’t try to acquire their skills, they don’t make an effort. So they’re like the French army knife that I mentioned. And it creates a lot of problems for the organization, for the staff, and for the patients and family.
Carol Vassar, podcast host/producer:
How did you learn the leadership skills that you’ve gained through the years?
Dr. Kanekal Gautham, Nemours Children’s Health:
I would still say I’m a student. I continue to learn every day. Many years ago, when I took a master’s course at Dartmouth, at the Dartmouth Institute for Health Policy and Clinical Practice, I did a directed reading course with my mentor, Paul Batalden, who was a visionary teacher and an expert in quality improvement and leadership. He made me read a couple of books. One of them was a book called Servant Leadership by Robert Greenleaf. So that really profoundly imprinted on me at a very formative stage in my career the importance of learning the theory and the science of leadership. And we had a very rich discussion. And subsequently too, Paul would continue to mentor me. I still talk to him once in a way, and he’s retired now. And eventually, I started with teaching leadership. But because of the directed reading course, to me, I’ve always been interested in the theory and the science of leadership, not just the operational aspects of leadership.
Carol Vassar, podcast host/producer:
Is it important for somebody who wants to be a leader or maybe is starting out in their leadership journey, for them to have a mentor?
Dr. Kanekal Gautham, Nemours Children’s Health:
Absolutely. I think having a mentor and a coach is very, very important. And not to boast, but I do serve as a mentor for many leaders across the country that I know personally, or sometimes they reach out to me. And just today I had an hour and a half lunch with a new leader who has been appointed as the Chief of Neonatology, and they were having some challenges. So he and I spoke, and he basically sought my advice and coaching, and I was able to guide him. And I committed to serving as a long-distance mentor for him going forward. So I personally go to my teachers and my mentors when I am dealing with challenges, but I also serve as a coach and mentor to people who I can help.
Carol Vassar, podcast host/producer:
I find it interesting that you still have a mentor, though he’s retired, that you look to, that you go to when you have questions or issues. How often… I’m sorry. How important is it for people to maintain that mentor relationship over time?
Dr. Kanekal Gautham, Nemours Children’s Health:
I think it’s critical because when you think that you are fully developed and complete as a leader, you make a mistake because it’s a learning journey. Because every day there’s a new challenge and there’s a new situation that you didn’t anticipate. So, you need to keep learning. So, I’m not only reaching out to my mentors, but I’m also reading books. Or if there’s a specific situation, I have to look up reading materials of books. So I would encourage any leader to think of themselves as a lifelong learner, continuously sharpen their skills going forward. It’s like exercise. If you stop exercising, you’ll get out of shape.
Carol Vassar, podcast host/producer:
You’ve mentioned a couple of things. Mentorship, seeking a mentor, some of the books that have helped you in your leadership journey. We have people who are watching all around us right now at this conference, potential healthcare leaders that are watching online right now, watching, listening. How do you think the best way is for them to go about gaining those leadership skills that we’ve talked about thus far?
Dr. Kanekal Gautham, Nemours Children’s Health:
I would say sign up for a workshop or a course on leadership. You could come to our workshop on Sunday, that would be a good start. But there are many courses you can take from well-known institutions. There are hundreds of books on leadership that you can read. Find a leadership coach, find a mentor. And most importantly, be open to feedback from the people that you work with, the people that you lead and the people that you report to. Just be open to suggestions from them. Don’t close yourself off. And also, learn to read nonverbal cues and watch for certain signals of what people are telling you that is not in words or actions. So, constantly have that curiosity about how you’re doing, what can you do better, and what you’re doing well.
Carol Vassar, podcast host/producer:
Aside from your presentation on Sunday, which I know is going to be fabulous, what are you excited about, as we are here at PAS in Toronto this year?
Dr. Kanekal Gautham, Nemours Children’s Health:
To me, this is one of the premier pediatric meetings, and I try to come every for a few reasons. One is the quality of the science that you get is really, really important, and it’s cutting edge research that you’ll find out. I go to a lot of sessions on how to be a better teacher. I just attended a session on how to use gamification when you’re teaching. So how to use games as a form of teaching. So, I love to learn how to be a better teacher. That’s my other passion.
And the third thing is networking, catching up with friends, mentors, and mentees, and forming new connections. So, I started tweeting about two years ago. I’ve never been on social media, but I’m using Twitter to educate people and share things that I’ve learned. Because of that, I knew having a whole set of social media friends that I’ve never met in person. And when I come to this conference, I meet them, and I see them, and I introduce myself, or they come up and say hello. So, that’s been a whole new layer of friendship that I’ve acquired due to my Twitter presence.
Carol Vassar, podcast host/producer:
I’m going to ask you a very Nemours question. When I say the term, “well beyond medicine,” what do you think of?
Dr. Kanekal Gautham, Nemours Children’s Health:
I think of our visionary CEO, who is pushing for wellness in children and their families as a way of preventing illness and promoting health and well-being. Because most hospitals and most health systems are focused on treating illness and curing disease and their revenue and their survival depends on curing illness. But Dr. Moss has been bold in staking a claim and saying, “No, we are going to focus on wellness.” Because that’s the future with the value-based payments because how expensive our healthcare system is in the US is unsustainable. It eats up a huge proportion of our gross domestic product, and the runaway costs of healthcare and medications and procedures is unsustainable, so it’s going to bankrupt the nation.
So I think the vision of Nemours and Dr. Moss and the direction in which he’s taking the ship are cutting edge, but that’s exactly what the country and the world need. It’s a risky direction, and it’s been this focus on wellness while our hospitals and clinics make money from illness has been compared to analogy of a man standing with one leg in a different boat, like a man standing with one leg in two different boats, and the boats are going in different direction. But that’s what I meant by leaders have to be comfortable with paradox. So you have to treat illness and disease, but at the same time, focus on wellness and promoting it. Because that’s the long-range bet that will pay off for children. And if you have healthy children, you’ll have a whole generation of healthy adults. You are productive and will increase the economy, and will be good for their countries.
Carol Vassar, podcast host/producer:
Lots for future leaders who are here at PAS and who are watching today to think about. Dr. Gautham, thank you so much for joining us-
Dr. Kanekal Gautham, Nemours Children’s Health:
Thank you for inviting us.
Carol Vassar, podcast host/producer:
… on the Well Beyond Medicine Podcast. We will be back actually in just about 45 minutes, somewhere around 6:30. Broadcasting live from the Pediatric Academic Society’s meeting, again in Toronto with Dr. Matthew Davis, Executive Vice President and Enterprise Position and Chief. And Chief Scientific Officer here at Nemours. I’m Carol Vassar. Thank you so much for joining us. And remember, we can change children’s health for good well beyond medicine.
Music:
Let’s go….Well Beyond Medicine
