Leadership is a behavior: how change, vision, and courage shape the leaders of tomorrow
15 March 2021
The topic of leadership has sold millions of books and inspired countless theories and methodologies. Yet the qualities of successful leadership are mostly unchanged across generations, cultures, and professions. At a fascinating and lively networking event during AO Davos Courses 2020, AO President Robert McGuire; AO Community Development Commission Chairperson Jeffrey Wang, AO Education Institute Advisory Committee Chairperson Teija Lund, and AO CMF Community Development Commission Chair Sabine Girod came together to talk about leadership.
"We’re all physicians, we’re all scientists," said Jeffrey Wang in his opening remarks. "If I am going to do a spine procedure, I have to look at the evidence and see what supports my view. There’s just as much science—if not more—in leadership."
Wang cited Abraham Lincoln, Mahatma Gandhi, and Nelson Mandela as examples of three leaders who—all living in different times, different cultures, and different socioeconomic regions—emerged as strong world leaders. "They had their own style but shared common leadership qualities."
Referencing the book Good to Great by Jim Collins, Wang summarized the premise that great organizations require "level-five leaders." What separates level-five leaders is their willingness to put the interest of the organization first.
"That principle really resonated with me because if you take your own ego out of it, you contribute to your organization and people will see that,” he said. “If you know of a CEO who is always out there on television, they’re probably level four because they care a bit more about being seen as a leader, whereas the level-five person puts the organization first."
Picking up on this concept, McGuire added professionalism to the qualities.
"The professional is competent—they have the skills and expertise—but leadership embodies their attitude to others. Leaders have compassion and respect for the people they are leading,” he explained. “As a leader, if you are hearing different responses from the people below you, then you need to really listen and think, 'maybe I’m not on the right track and might need to change plans,' and you have to communicate that in a way that is timely and open."
"Leaders are visionaries in their field," McGuire added. "They have the courage to take a calculated risk and embrace change."
Change can be daunting for any organization and strong leaders are able to take their colleagues with them on that journey. Referring to The Golden Circle by Simon Sinek, Lund observed that the problem is that very few individuals or organizations know why they do what they do.
"They might be able to explain what they do or how they do it, but why they do it is not clear to them. It is the job of the leader to be crystal clear in setting out the vision. We all know that leadership is a blend of competence and character. People might follow a competent leader because they have to, but people follow a leader of character because they want to."
What is your superpower?
In identifying the characteristics that set leaders apart, Wang suggests looking inward.
"You can’t just read a book and alter your behavior. The advice I always give to my residents and fellows is, ‘Find your superpower!’” he said. “Think about what’s going to work for you and be honest about your own skillset. Look at where you can improve and figure out what things you can do better than anyone else, then build your leadership skills around that."
Lund echoed the sentiment "because people will realize when you are trying to be something you’re not. Authenticity is an important leadership habit. I’ve actually learned a lot from bad leadership experiences I’d rather forget."
Drawing on his own experience, McGuire emphasized the importance of becoming a good listener.
"Once you do that, you develop tremendous respect for those around you because you’re paying attention to them,” he said. “I will never forget in a meeting one man came up to me and said, 'This is the first meeting where you actually looked at the people asking the questions.'”
If leadership is a behavior, one hot question arising from the Q and A session was the role of organizational behaviors in nurturing talent. In particular, Girod highlighted that while women make up half of medical students, only 9 percent of academic surgeons and 4 percent of academic leaders, deans, department chairs, or chiefs of divisions are female.
"I don’t think that has to do with the ability of women to be leaders, but it has a little bit to do with the culture that we live in,” Girod said. “How do we create an inclusive leadership vision?"
Diversity is a key principle for McGuire in his current position.
"The diversity of organizations is changing, and this is something we need to embrace and nurture. We have the AO Access initiative which is also looking at mentorship—we all need some help along the way and mentoring can be key to that,” he said."
The panel also discussed the concept of reverse mentoring, based on the idea of organizations learning from marginalized groups by listening to their points of view and understanding the role of unconscious bias.
In a similar vein, the barriers faced by younger surgeons in challenging established practice was also highlighted, and the panel encouraged new professionals to "come with solutions, not just problems" and band together to make their voices heard among organizations that tend to be hierarchical. Ultimately, the message in diversifying leadership was one of openness—both to alternative perspectives and to change and evolution.
Robert McGuire concluded with a learning from AO history: "The AO is built on a fellowship of purpose, based on this friendship we all have as a group. That judgement, the ability to appreciate challenge, we all have that. It is ultimately the courage to do what is right, at the right time. The only thing that is truly constant in everything we do, is change itself."