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Leadership Corner: The Leadership Challenge

By Dr. Grace Wang
Leadership and Diversity Committee

The SVS Leadership and Diversity Committee has been exploring the science and evidence behind leadership in health care. As we all adapt to the changes in health care, it has become increasingly clear that no matter what the future brings, vascular surgeons need to position themselves in the center, leading the process of change.

Because leadership skills are not often taught in medical school or residency, the committee felt it was important and timely to increase exposure to the topic. This new column will appear every other month, highlighting the behaviors and attributes that define great leadership and sharing the perspective of SVS members who are “leading the way” to the future.

What defines success in leadership? The Leadership Challenge, by Kouzes and Posner presents the findings of 25 years of research on leadership. Regardless of profession or culture the authors find that successful leaders consistently and routinely engage in five “practices:”

1. Modeling the Way: Leading by example, with consistency, credibility and integrity.

2. Inspiring a Shared Vision: Envisioning a positive future and appealing to the shared goals of others.

3. Challenging the Process: Having the courage to question the status quo and thoughtfully test new paradigms.

4. Enabling Others to Act: Optimizing teams and team members by delegating power and authority so they can reach new heights of success.

5. Encouraging the Heart: Taking the time to celebrate key accomplishments and ensure the team stays connected to the mission or purpose.

Kouzes and Posner contend that leadership is defined by a constellation of behaviors, and thus, can be observed, and learned. By consistently and routinely engaging and modeling these behaviors, people are able to achieve their highest level of influence and success. Interestingly, it is also noted that leadership cannot be truly acquired from reading a book or sitting in lectures. The authors emphasize that leadership is learned mostly through observation, experience and mentorship.

It is with this backdrop of information that I set about to interview my division chief and current SVS president, Dr. Ron Fairman, about his thoughts on leadership. While I knew Ron had many stories that highlight leadership qualities, I asked him to speak specifically on what it was like to come back to Penn in 1995 after being the chair of surgery with a large clinical practice in a community teaching hospital in Philadelphia.

“I did not come back to Penn as a leader; in fact, I came back and started my career all over again as an assistant professor of surgery faced with recreating my academic profile. It was a daunting and at times sobering experience, but it was motivating at a time in my life when I was seeking a new challenge. Although I had many supporters who welcomed me back at Penn, it was clear that not everyone was enthusiastic about my return. Candidly, I had reached a point in my clinical career where vascular surgery (doing another open aorta or another carotid endarterectomy), while gratifying, no longer stimulated me the way that it had, despite my role in teaching Penn residents.

“Returning to Penn offered me the opportunity to initiate Phase I and II endovascular aortic aneurysm and carotid stenting clinical trials under the steady and behind-the-scenes mentorship of Clyde Barker. In a short period of time, Jeff Carpenter, Mike Golden, Joe Bavaria, Rich Baum, Omaida Velazquez, Ed Woo and I built one of the largest aortic endovascular programs in the country.

“Although there were some at Penn who questioned our credentials, Clyde Barker remained staunchly supportive and had the university clout to empower us. There are many styles to leadership; I was drawn to the Barker leadership model, unobtrusively and consistently supporting us, ultimately allowing us to change the vascular practice algorithms at Penn.

“Barker as a mentor created a safe, supportive environment for us to challenge the status quo at Penn. I am often asked how the collaborative relationship with cardiac surgery at Penn came to genesis. The answer is simple: we always understood that we would accomplish far more academically and clinically by working together.

“Two other individuals also deserve mention: Drs. Frank Veith and Frank Criado. By virtue of his yearly New York symposium, Frank Veith has supported and promoted the academic careers of innumerable physicians by giving us the opportunity to speak at his meeting. Although he does not take credit for all he has done to support young vascular surgeons, his leadership credentials are unrivaled.

“I would be remiss if I did not also mention a unique and talented physician, Frank Criado, who came to Penn and offered us consultation in 1995. Frank was so far ahead of the curve back then; I was in shock when I visited his practice in Baltimore and saw what he was doing every day. I understood how he had transformed his practice and I wanted to do the same at Penn.”

With regard to the SVS and the future of vascular surgery, Ron submitted that he could see a vital role for each of the Kouzes and Posner practices. Peter Lawrence and Bruce Perler in the last two SVS presidential addresses, he noted, have emphasized the critical importance of setting a high bar for ourselves regarding ethics and core values in our profession, which exemplify appropriate care and modeling the way.

Ron has an inspired vision for the future of SVS, one that encompasses even greater advances in quality and education, and a deepening, meaningful integration with other organizations and professionals that share our core values and mission.

“We should seek out and expect collaborative relationships based on parity,” he said. “Although we are relatively small compared to other scientific organizations, the SVS should never take a back seat in forging relationships with much larger organizations. I am incredibly fortunate to serve as president of the SVS with the support of a brilliant and dedicated leadership team of SVS officers and our entire Chicago office run by Ken Slaw and Patricia Burton.”

Challenging the process effectively will be critical to our success. Ron notes that our field has changed dramatically over the past 25 years, and continues to evolve. We continue to advance as clinicians, learning new techniques, testing innovative technologies and using clinical research as a vehicle to provide information about what will result in high value quality care and the best outcomes for our patients. Ron also sees continued growth and depth in engaging SVS members across the profession, with the work of SVS. Our best work comes from enabling the work of others, especially our young members, who will lead the way to the future.

Finally, spending just a few minutes with Ron, you can’t help but feel “your heart encouraged.” Ron’s balanced, thoughtful wisdom as well as his positive, collaborative approach truly exemplify the thesis of Kouzes and Posner’s work. Spending time with Ron inspires you to keep striving to excel to new heights. Perhaps most importantly, Ron always brings you back to mission or purpose.

In his words, “Ultimately, one’s goals shift and it becomes more about promoting the success of your faculty and trainees, who clearly represent our aspirations for the future of our specialty.”

Thanks to Kenneth M. Slaw, Ph.D. for his contributions to the content and resources for this column.