Leadership and Professional Development

“Nothing about us without us” (Latin: ”Nihil de nobis, sine nobis”)

Hospitalists are at the forefront of decisions, innovations, and system-improvement projects that impact hospitalized patients. However, many of our decisions—while centered on patient care—fail to include their perspectives or views.

In his book Total Leadership, Stewart Friedman describes the importance of identifying and engaging key stakeholders.¹ Friedman exhorts leaders to engage stakeholders in conversations to “confirm or correct your current understanding of stakeholder expectations.” In other words, instead of assuming what stakeholders want, ask and verify before proceeding.

Although hospitalists frequently include stakeholders such as nurses, pharmacists, and therapists in system-improvement initiatives, engaging patients is less common.

Why do we omit patients as stakeholders? There are considerable barriers to seeking patient input. The busy hospital environment or the acuity of a patient’s illness may, for instance, limit engagement between hospital caregivers and patients. Further, the power imbalance between physicians and patients may make it uncomfortable for the patient to offer direct feedback.

However, the importance of patient input is increasingly recognized by researchers. For example, community-based participatory research “involves community members or recipients of interventions in all phases of the research process.”² Similarly, we believe hospitalists should engage patients when designing new clinical initiatives.

Examples from some institutions provide further support of this concept. The Dana Farber Cancer Institute created a patient and family advisory council in response to the loss of trust over errors and in the face of community outrage over an impending joint venture. While the scope was initially limited to the collection of feedback regarding patient satisfaction and preferences, the council evolved to become an integral part of organizational decision making. Patient contributions were subsequently assimilated into policies, continuous improvement teams, and even search committees. Additional benefits included patient-generated initiatives such as “patient rounds.”³ Specifically soliciting input from hospitalized patients to inform hospital-based interventions may be uncommon, but this practice holds the potential to yield vital insights.⁴

We have experienced this benefit at our institution. For example, before implementing an inpatient addiction medicine consult service, we asked hospitalized patients struggling with addiction about their needs. The patient voice highlighted a lack of trust for hospital providers and led directly to the inclusion of peer-recovery mentors as part of the consulting team.⁵

Many organizations, including our own, have instituted a patient/family advisory committee comprising former patients and family members who participate voluntarily in projects and provide input. This resource can serve as an excellent platform for patient involvement. At the University of Michigan, the patient and family advisory council provides input on every major institutional decision, from the construction of a new building to the introduction of a new clinical service. This “hardwired” practice ensures that patients’ voices and views are incorporated into major health system decisions.

In order to engage patients as stakeholders, we recommend: (1) Be sensitive to the power imbalance between clinicians and patients and recognize that hospitalized patients may not feel comfortable providing direct feedback. (2) Familiarize yourself with your institution’s patient/family advisory committee. If one does not exist, consider soliciting responses from patients via interviews and/or postdischarge surveys. (3) Deliberately seek the opinions, experience, and values of patients or their representatives. (4) For projects aimed at improving patient experience, include patients among your key stakeholders.

Involving patients as stakeholders requires effort; however, it has potential to reap valuable rewards, making healthcare improvements more effective, inclusive, and healing.

The authors wish to thank Jeffrey S. Stewart for his contributions and feedback on this topic and manuscript.

The authors have nothing to disclose.

“Nothing about us without us” (Latin: ”Nihil de nobis, sine nobis”)

Hospitalists are at the forefront of decisions, innovations, and system-improvement projects that impact hospitalized patients. However, many of our decisions—while centered on patient care—fail to include their perspectives or views.

In his book Total Leadership, Stewart Friedman describes the importance of identifying and engaging key stakeholders.¹ Friedman exhorts leaders to engage stakeholders in conversations to “confirm or correct your current understanding of stakeholder expectations.” In other words, instead of assuming what stakeholders want, ask and verify before proceeding.

Although hospitalists frequently include stakeholders such as nurses, pharmacists, and therapists in system-improvement initiatives, engaging patients is less common.

Why do we omit patients as stakeholders? There are considerable barriers to seeking patient input. The busy hospital environment or the acuity of a patient’s illness may, for instance, limit engagement between hospital caregivers and patients. Further, the power imbalance between physicians and patients may make it uncomfortable for the patient to offer direct feedback.

However, the importance of patient input is increasingly recognized by researchers. For example, community-based participatory research “involves community members or recipients of interventions in all phases of the research process.”² Similarly, we believe hospitalists should engage patients when designing new clinical initiatives.

Examples from some institutions provide further support of this concept. The Dana Farber Cancer Institute created a patient and family advisory council in response to the loss of trust over errors and in the face of community outrage over an impending joint venture. While the scope was initially limited to the collection of feedback regarding patient satisfaction and preferences, the council evolved to become an integral part of organizational decision making. Patient contributions were subsequently assimilated into policies, continuous improvement teams, and even search committees. Additional benefits included patient-generated initiatives such as “patient rounds.”³ Specifically soliciting input from hospitalized patients to inform hospital-based interventions may be uncommon, but this practice holds the potential to yield vital insights.⁴

We have experienced this benefit at our institution. For example, before implementing an inpatient addiction medicine consult service, we asked hospitalized patients struggling with addiction about their needs. The patient voice highlighted a lack of trust for hospital providers and led directly to the inclusion of peer-recovery mentors as part of the consulting team.⁵

Many organizations, including our own, have instituted a patient/family advisory committee comprising former patients and family members who participate voluntarily in projects and provide input. This resource can serve as an excellent platform for patient involvement. At the University of Michigan, the patient and family advisory council provides input on every major institutional decision, from the construction of a new building to the introduction of a new clinical service. This “hardwired” practice ensures that patients’ voices and views are incorporated into major health system decisions.

In order to engage patients as stakeholders, we recommend: (1) Be sensitive to the power imbalance between clinicians and patients and recognize that hospitalized patients may not feel comfortable providing direct feedback. (2) Familiarize yourself with your institution’s patient/family advisory committee. If one does not exist, consider soliciting responses from patients via interviews and/or postdischarge surveys. (3) Deliberately seek the opinions, experience, and values of patients or their representatives. (4) For projects aimed at improving patient experience, include patients among your key stakeholders.

Involving patients as stakeholders requires effort; however, it has potential to reap valuable rewards, making healthcare improvements more effective, inclusive, and healing.

The authors wish to thank Jeffrey S. Stewart for his contributions and feedback on this topic and manuscript.

The authors have nothing to disclose.

“Nothing about us without us” (Latin: ”Nihil de nobis, sine nobis”)

Hospitalists are at the forefront of decisions, innovations, and system-improvement projects that impact hospitalized patients. However, many of our decisions—while centered on patient care—fail to include their perspectives or views.

In his book Total Leadership, Stewart Friedman describes the importance of identifying and engaging key stakeholders.¹ Friedman exhorts leaders to engage stakeholders in conversations to “confirm or correct your current understanding of stakeholder expectations.” In other words, instead of assuming what stakeholders want, ask and verify before proceeding.

Although hospitalists frequently include stakeholders such as nurses, pharmacists, and therapists in system-improvement initiatives, engaging patients is less common.

Why do we omit patients as stakeholders? There are considerable barriers to seeking patient input. The busy hospital environment or the acuity of a patient’s illness may, for instance, limit engagement between hospital caregivers and patients. Further, the power imbalance between physicians and patients may make it uncomfortable for the patient to offer direct feedback.

However, the importance of patient input is increasingly recognized by researchers. For example, community-based participatory research “involves community members or recipients of interventions in all phases of the research process.”² Similarly, we believe hospitalists should engage patients when designing new clinical initiatives.

Examples from some institutions provide further support of this concept. The Dana Farber Cancer Institute created a patient and family advisory council in response to the loss of trust over errors and in the face of community outrage over an impending joint venture. While the scope was initially limited to the collection of feedback regarding patient satisfaction and preferences, the council evolved to become an integral part of organizational decision making. Patient contributions were subsequently assimilated into policies, continuous improvement teams, and even search committees. Additional benefits included patient-generated initiatives such as “patient rounds.”³ Specifically soliciting input from hospitalized patients to inform hospital-based interventions may be uncommon, but this practice holds the potential to yield vital insights.⁴

We have experienced this benefit at our institution. For example, before implementing an inpatient addiction medicine consult service, we asked hospitalized patients struggling with addiction about their needs. The patient voice highlighted a lack of trust for hospital providers and led directly to the inclusion of peer-recovery mentors as part of the consulting team.⁵

Many organizations, including our own, have instituted a patient/family advisory committee comprising former patients and family members who participate voluntarily in projects and provide input. This resource can serve as an excellent platform for patient involvement. At the University of Michigan, the patient and family advisory council provides input on every major institutional decision, from the construction of a new building to the introduction of a new clinical service. This “hardwired” practice ensures that patients’ voices and views are incorporated into major health system decisions.

In order to engage patients as stakeholders, we recommend: (1) Be sensitive to the power imbalance between clinicians and patients and recognize that hospitalized patients may not feel comfortable providing direct feedback. (2) Familiarize yourself with your institution’s patient/family advisory committee. If one does not exist, consider soliciting responses from patients via interviews and/or postdischarge surveys. (3) Deliberately seek the opinions, experience, and values of patients or their representatives. (4) For projects aimed at improving patient experience, include patients among your key stakeholders.

Involving patients as stakeholders requires effort; however, it has potential to reap valuable rewards, making healthcare improvements more effective, inclusive, and healing.

The authors wish to thank Jeffrey S. Stewart for his contributions and feedback on this topic and manuscript.

The authors have nothing to disclose.

“Knowing yourself is the beginning of all wisdom.”—Aristotle

On the wards, your white coat and stethoscope signal your role as a healthcare provider. These external symbols of your work represent your expertise, experience, and commitment to service, and your patients look to these signals for comfort and reassurance. But when you are running a meeting, managing projects, or leading people in your organization, how do others know what you have to offer? Although signaling your values, skills, and intentions is as important in leadership as it is in the clinical setting, few clinicians spend time reflecting on how best to do this. Crafting a strong, consistent personal leadership brand can help.

As described by Norm Smallwood and Dave Ulrich, a personal leadership brand is the external projection of your strengths and interests, which demonstrates how you create value for others.^1,2 In other words, a personal leadership brand helps constituents, stakeholders, and potential partners understand what you offer as a leader. Having a brand keeps you on track as a leader and helps get you noticed for future opportunities by helping you shape and meet expectations in a way that is deliberate, dynamic, and authentic.

Building your personal leadership brand is an exercise in reflection. Leaders should challenge themselves to answer the following questions:

• What do I have to offer, and what do others appreciate about me?
• What are my values?
• Where am I trying to go?
• How does my path align with organizational goals?

The answers to these simple questions can help you create your personal leadership brand. First, reflect on what you want to be known for, your values, and how you are currently perceived. Then, identify the results you are aiming to produce, aligning them with your strengths and organizational goals. Write these down, and share your reflections with trusted peers and your mentoring team. Shape your thoughts into a personal vision statement with a focus on what you put out into the world to help you stay true to yourself while producing the desired results. For example, a vision statement for a gifted communicator with a background in quality improvement may be: “I will use my strong communication skills to address complex problems impacting our hospital to reduce cost and improve quality with the goal of building a career as a health system leader.” Finally, be authentic, and share your personal brand in an articulate and succinct way to help others understand your place in the structure and narrative of an organization.

Your personal leadership brand should not be static; rather, it is a process that should iterate over time. Ask for direct feedback from trusted advisers and allies at regular intervals. Investigate whether your organization offers a formal structure, such as a “360 Evaluation,” to get perspective on how your unique strengths, skills, and goals are perceived. Then, explore and clarify discrepancies between where you think you are and how others see you. Approaching these conversations with humility will keep you aligned with your values, which makes it easier for others to be invested in your development.

A strong personal leadership brand is a force multiplier, providing clarity within teams and helping align a leader’s assets and values with organizational goals. It is a solid external signal of what others can expect from your work and will help you focus on your strengths while identifying areas for growth. A personal leadership brand is formed through reflection and, at its core, its authenticity. In the words of Paracelsus, a Renaissance physician, astrologer, and alchemist, “Be not another, if you can be yourself.”³

“Knowing yourself is the beginning of all wisdom.”—Aristotle

On the wards, your white coat and stethoscope signal your role as a healthcare provider. These external symbols of your work represent your expertise, experience, and commitment to service, and your patients look to these signals for comfort and reassurance. But when you are running a meeting, managing projects, or leading people in your organization, how do others know what you have to offer? Although signaling your values, skills, and intentions is as important in leadership as it is in the clinical setting, few clinicians spend time reflecting on how best to do this. Crafting a strong, consistent personal leadership brand can help.

As described by Norm Smallwood and Dave Ulrich, a personal leadership brand is the external projection of your strengths and interests, which demonstrates how you create value for others.^1,2 In other words, a personal leadership brand helps constituents, stakeholders, and potential partners understand what you offer as a leader. Having a brand keeps you on track as a leader and helps get you noticed for future opportunities by helping you shape and meet expectations in a way that is deliberate, dynamic, and authentic.

Building your personal leadership brand is an exercise in reflection. Leaders should challenge themselves to answer the following questions:

• What do I have to offer, and what do others appreciate about me?
• What are my values?
• Where am I trying to go?
• How does my path align with organizational goals?

The answers to these simple questions can help you create your personal leadership brand. First, reflect on what you want to be known for, your values, and how you are currently perceived. Then, identify the results you are aiming to produce, aligning them with your strengths and organizational goals. Write these down, and share your reflections with trusted peers and your mentoring team. Shape your thoughts into a personal vision statement with a focus on what you put out into the world to help you stay true to yourself while producing the desired results. For example, a vision statement for a gifted communicator with a background in quality improvement may be: “I will use my strong communication skills to address complex problems impacting our hospital to reduce cost and improve quality with the goal of building a career as a health system leader.” Finally, be authentic, and share your personal brand in an articulate and succinct way to help others understand your place in the structure and narrative of an organization.

Your personal leadership brand should not be static; rather, it is a process that should iterate over time. Ask for direct feedback from trusted advisers and allies at regular intervals. Investigate whether your organization offers a formal structure, such as a “360 Evaluation,” to get perspective on how your unique strengths, skills, and goals are perceived. Then, explore and clarify discrepancies between where you think you are and how others see you. Approaching these conversations with humility will keep you aligned with your values, which makes it easier for others to be invested in your development.

A strong personal leadership brand is a force multiplier, providing clarity within teams and helping align a leader’s assets and values with organizational goals. It is a solid external signal of what others can expect from your work and will help you focus on your strengths while identifying areas for growth. A personal leadership brand is formed through reflection and, at its core, its authenticity. In the words of Paracelsus, a Renaissance physician, astrologer, and alchemist, “Be not another, if you can be yourself.”³

“Knowing yourself is the beginning of all wisdom.”—Aristotle

On the wards, your white coat and stethoscope signal your role as a healthcare provider. These external symbols of your work represent your expertise, experience, and commitment to service, and your patients look to these signals for comfort and reassurance. But when you are running a meeting, managing projects, or leading people in your organization, how do others know what you have to offer? Although signaling your values, skills, and intentions is as important in leadership as it is in the clinical setting, few clinicians spend time reflecting on how best to do this. Crafting a strong, consistent personal leadership brand can help.

As described by Norm Smallwood and Dave Ulrich, a personal leadership brand is the external projection of your strengths and interests, which demonstrates how you create value for others.^1,2 In other words, a personal leadership brand helps constituents, stakeholders, and potential partners understand what you offer as a leader. Having a brand keeps you on track as a leader and helps get you noticed for future opportunities by helping you shape and meet expectations in a way that is deliberate, dynamic, and authentic.

Building your personal leadership brand is an exercise in reflection. Leaders should challenge themselves to answer the following questions:

• What do I have to offer, and what do others appreciate about me?
• What are my values?
• Where am I trying to go?
• How does my path align with organizational goals?

The answers to these simple questions can help you create your personal leadership brand. First, reflect on what you want to be known for, your values, and how you are currently perceived. Then, identify the results you are aiming to produce, aligning them with your strengths and organizational goals. Write these down, and share your reflections with trusted peers and your mentoring team. Shape your thoughts into a personal vision statement with a focus on what you put out into the world to help you stay true to yourself while producing the desired results. For example, a vision statement for a gifted communicator with a background in quality improvement may be: “I will use my strong communication skills to address complex problems impacting our hospital to reduce cost and improve quality with the goal of building a career as a health system leader.” Finally, be authentic, and share your personal brand in an articulate and succinct way to help others understand your place in the structure and narrative of an organization.

Your personal leadership brand should not be static; rather, it is a process that should iterate over time. Ask for direct feedback from trusted advisers and allies at regular intervals. Investigate whether your organization offers a formal structure, such as a “360 Evaluation,” to get perspective on how your unique strengths, skills, and goals are perceived. Then, explore and clarify discrepancies between where you think you are and how others see you. Approaching these conversations with humility will keep you aligned with your values, which makes it easier for others to be invested in your development.

A strong personal leadership brand is a force multiplier, providing clarity within teams and helping align a leader’s assets and values with organizational goals. It is a solid external signal of what others can expect from your work and will help you focus on your strengths while identifying areas for growth. A personal leadership brand is formed through reflection and, at its core, its authenticity. In the words of Paracelsus, a Renaissance physician, astrologer, and alchemist, “Be not another, if you can be yourself.”³

“Takers believe in a zero-sum world, and they end up creating one where bosses, colleagues and clients don’t trust them. Givers build deeper and broader relationships—people are rooting for them instead of gunning for them.”

—Adam Grant

To succeed in a hospital, leaders need a generous supply of social and political capital. House officers learn this very quickly, especially when they are relying on other members of the healthcare team to obtain tests and studies for their patients and calling for specialty consultations. To be successful and efficient, building relationships and trust is key. Such capital, unfortunately, takes time to develop. Therefore, healthcare leaders and clinicians at all levels of training need to make an everyday investment of goodwill and friendliness with those they encounter. The dividends may be slow in coming, but they are substantial and sustained. Friends give you the benefit of the doubt—and help you when you are most in need.

Having friends (or friendly colleagues) at work is beneficial both professionally and personally. The benefits of social interactions have been studied for years and even more so in recent times with the dramatic increase in the use of handheld devices. Eye contact between casual acquaintances passing each other in the hallway is replaced with eyes focused downward on smartphones. The result? We are becoming more socially isolated. Our personal solution? When we see professional colleagues (or patients and families in the hallways of our hospital), we nod in acknowledgement with appropriate eye contact and say “Good morning” or “Hello” even if we don’t know them—even if their eyes are focused on their devices as they walk past you in the hallway. You get a gold star if you remember the names of the professional colleagues you see frequently in the hallways or around the hospital.

This isn’t soft science; it’s backed by hard data. When we conduct site visits of different hospitals around the country to help them improve their care quality and performance, we informally divide hospitals into two groups: The “How ya doin’?” hospitals vs the “Rec-Ignore” hospitals (in which employees recognize a colleague in the hallway but choose to not acknowledge them). Most prefer to work at a “How ya doin’?” hospital. Being friendly has been linked to increased team spirit and morale, knowledge sharing, trust, prevention of burnout, and sense of a positive working environment. It also makes you feel better about yourself—and makes other people feel similarly as well.

We’ll share an example from a search for a new department chair. The dean went on reverse site visits to meet the two finalists in their home institutions and asked them for tours of their hospitals. Candidate A walked around and it seemed like everyone knew her. She smiled and said hello to the people she came in contact with during the tour. Not so for candidate B—just the opposite. Guess which candidate the dean hired?

Put away your phone, interact with your colleagues, and learn to make small talk, and not just with your supervisors or peers. Chitchat is an important “social lubricant,” fostering a sense of community and teamwork. It helps bring down the divides that come from organizational hierarchies. It helps endear you to your staff.

Developing a reputation as a nice person who is quick with a smile and even quicker with a “How ya doin’?” pays off in the end. This reputation also makes it easier to give bad news, something that all leaders must do at some point. So make a friend before you need one—it usually will pay dividends.

“Takers believe in a zero-sum world, and they end up creating one where bosses, colleagues and clients don’t trust them. Givers build deeper and broader relationships—people are rooting for them instead of gunning for them.”

—Adam Grant

To succeed in a hospital, leaders need a generous supply of social and political capital. House officers learn this very quickly, especially when they are relying on other members of the healthcare team to obtain tests and studies for their patients and calling for specialty consultations. To be successful and efficient, building relationships and trust is key. Such capital, unfortunately, takes time to develop. Therefore, healthcare leaders and clinicians at all levels of training need to make an everyday investment of goodwill and friendliness with those they encounter. The dividends may be slow in coming, but they are substantial and sustained. Friends give you the benefit of the doubt—and help you when you are most in need.

Having friends (or friendly colleagues) at work is beneficial both professionally and personally. The benefits of social interactions have been studied for years and even more so in recent times with the dramatic increase in the use of handheld devices. Eye contact between casual acquaintances passing each other in the hallway is replaced with eyes focused downward on smartphones. The result? We are becoming more socially isolated. Our personal solution? When we see professional colleagues (or patients and families in the hallways of our hospital), we nod in acknowledgement with appropriate eye contact and say “Good morning” or “Hello” even if we don’t know them—even if their eyes are focused on their devices as they walk past you in the hallway. You get a gold star if you remember the names of the professional colleagues you see frequently in the hallways or around the hospital.

This isn’t soft science; it’s backed by hard data. When we conduct site visits of different hospitals around the country to help them improve their care quality and performance, we informally divide hospitals into two groups: The “How ya doin’?” hospitals vs the “Rec-Ignore” hospitals (in which employees recognize a colleague in the hallway but choose to not acknowledge them). Most prefer to work at a “How ya doin’?” hospital. Being friendly has been linked to increased team spirit and morale, knowledge sharing, trust, prevention of burnout, and sense of a positive working environment. It also makes you feel better about yourself—and makes other people feel similarly as well.

We’ll share an example from a search for a new department chair. The dean went on reverse site visits to meet the two finalists in their home institutions and asked them for tours of their hospitals. Candidate A walked around and it seemed like everyone knew her. She smiled and said hello to the people she came in contact with during the tour. Not so for candidate B—just the opposite. Guess which candidate the dean hired?

Put away your phone, interact with your colleagues, and learn to make small talk, and not just with your supervisors or peers. Chitchat is an important “social lubricant,” fostering a sense of community and teamwork. It helps bring down the divides that come from organizational hierarchies. It helps endear you to your staff.

Developing a reputation as a nice person who is quick with a smile and even quicker with a “How ya doin’?” pays off in the end. This reputation also makes it easier to give bad news, something that all leaders must do at some point. So make a friend before you need one—it usually will pay dividends.

“Takers believe in a zero-sum world, and they end up creating one where bosses, colleagues and clients don’t trust them. Givers build deeper and broader relationships—people are rooting for them instead of gunning for them.”

—Adam Grant

To succeed in a hospital, leaders need a generous supply of social and political capital. House officers learn this very quickly, especially when they are relying on other members of the healthcare team to obtain tests and studies for their patients and calling for specialty consultations. To be successful and efficient, building relationships and trust is key. Such capital, unfortunately, takes time to develop. Therefore, healthcare leaders and clinicians at all levels of training need to make an everyday investment of goodwill and friendliness with those they encounter. The dividends may be slow in coming, but they are substantial and sustained. Friends give you the benefit of the doubt—and help you when you are most in need.

Having friends (or friendly colleagues) at work is beneficial both professionally and personally. The benefits of social interactions have been studied for years and even more so in recent times with the dramatic increase in the use of handheld devices. Eye contact between casual acquaintances passing each other in the hallway is replaced with eyes focused downward on smartphones. The result? We are becoming more socially isolated. Our personal solution? When we see professional colleagues (or patients and families in the hallways of our hospital), we nod in acknowledgement with appropriate eye contact and say “Good morning” or “Hello” even if we don’t know them—even if their eyes are focused on their devices as they walk past you in the hallway. You get a gold star if you remember the names of the professional colleagues you see frequently in the hallways or around the hospital.

This isn’t soft science; it’s backed by hard data. When we conduct site visits of different hospitals around the country to help them improve their care quality and performance, we informally divide hospitals into two groups: The “How ya doin’?” hospitals vs the “Rec-Ignore” hospitals (in which employees recognize a colleague in the hallway but choose to not acknowledge them). Most prefer to work at a “How ya doin’?” hospital. Being friendly has been linked to increased team spirit and morale, knowledge sharing, trust, prevention of burnout, and sense of a positive working environment. It also makes you feel better about yourself—and makes other people feel similarly as well.

We’ll share an example from a search for a new department chair. The dean went on reverse site visits to meet the two finalists in their home institutions and asked them for tours of their hospitals. Candidate A walked around and it seemed like everyone knew her. She smiled and said hello to the people she came in contact with during the tour. Not so for candidate B—just the opposite. Guess which candidate the dean hired?

Put away your phone, interact with your colleagues, and learn to make small talk, and not just with your supervisors or peers. Chitchat is an important “social lubricant,” fostering a sense of community and teamwork. It helps bring down the divides that come from organizational hierarchies. It helps endear you to your staff.

Developing a reputation as a nice person who is quick with a smile and even quicker with a “How ya doin’?” pays off in the end. This reputation also makes it easier to give bad news, something that all leaders must do at some point. So make a friend before you need one—it usually will pay dividends.

“Without meeting leadership skills, one joins the ranks of so many others who bear the responsibility for the meeting ‘problem’ and are the cause of so much frustration in the workplace.”¹ Physicians, like so many others, often feel that team meetings are inefficient, a waste of time, and mentally draining. It does not have to be this way. There are evidence-based strategies that can make meetings truly work and actually enjoyable to attend.² This is particularly important because eliminating meetings is a false solution. Hospitals need team meetings to promote coordination, collaboration, communication, and consensus decision-making. While no one individual can solve the meetings problem, each of us can find a meeting we lead and make it work better.

First, recognize that, as a leader, you are a steward of others’ time. As a steward, be intentional when designing meetings. Think carefully about who needs to be there, how much time to spend on the meeting, and how the meeting should be run. Dysfunction increases with meeting size, so invite attendees wisely; include only those essential to the meeting. For individuals not in the core group, offer them the opportunity to share their input premeeting if desired, share good meeting minutes with them, and welcome them to attend future meetings if desired. Consider “representative voices”—openly asking certain attendees to represent a group of stakeholders. Use a timed agenda to invite certain people for part, but not all, of the meeting.

Keep your meetings lean and deliberate. Avoid defaulting to one-hour meetings out of habit. Parkinson’s Law suggests that people will fill the time allotted to a particular task. If a meeting can be done in 30 minutes but is scheduled for 60 minutes, chances are that people will use the full hour. If a decision is reached faster than anticipated, end the meeting early. Refer back to your steward mindset and schedule meeting time with intention.

Meetings are often experienced psychologically like we experience interruptions. Thus, when attendees arrive at a meeting, express gratitude. Your job is to keep attendees active and engaged; therefore, facilitate the meeting actively and creatively. Try out different techniques such as devoting a few minutes to silent, written brainstorming. Leveraging silence gives attendees the opportunity to think on their own before contributing to the discussion and results in nearly twice the number of ideas.³ Perhaps members can be assigned explicit roles such as devil’s advocate, or each attendee can be assigned a specific agenda item, invoking responsibility and participation. If you always sit during meetings, try standing. If you have never tried a walking meeting, give it a go. Attendees appreciate mixing things up.

Lastly, remember to check-in with attendees to see how things are going. Never get too comfortable as a meeting leader, especially since meeting frustration abounds. Asking your team for feedback will carry over to other aspects of your role. You will be seen as a conscientious leader, open to exploration and professional development. This builds trust and creates a positive, collaborative work environment.

While you cannot control how others run their meetings, you do have the ability to make a meeting that you lead truly work. Be intentional with your role as a meeting facilitator and focus on the whole experience. Evaluate and learn from your team, show others that you care about your meetings so that they begin to care about theirs too.

“Without meeting leadership skills, one joins the ranks of so many others who bear the responsibility for the meeting ‘problem’ and are the cause of so much frustration in the workplace.”¹ Physicians, like so many others, often feel that team meetings are inefficient, a waste of time, and mentally draining. It does not have to be this way. There are evidence-based strategies that can make meetings truly work and actually enjoyable to attend.² This is particularly important because eliminating meetings is a false solution. Hospitals need team meetings to promote coordination, collaboration, communication, and consensus decision-making. While no one individual can solve the meetings problem, each of us can find a meeting we lead and make it work better.

First, recognize that, as a leader, you are a steward of others’ time. As a steward, be intentional when designing meetings. Think carefully about who needs to be there, how much time to spend on the meeting, and how the meeting should be run. Dysfunction increases with meeting size, so invite attendees wisely; include only those essential to the meeting. For individuals not in the core group, offer them the opportunity to share their input premeeting if desired, share good meeting minutes with them, and welcome them to attend future meetings if desired. Consider “representative voices”—openly asking certain attendees to represent a group of stakeholders. Use a timed agenda to invite certain people for part, but not all, of the meeting.

Keep your meetings lean and deliberate. Avoid defaulting to one-hour meetings out of habit. Parkinson’s Law suggests that people will fill the time allotted to a particular task. If a meeting can be done in 30 minutes but is scheduled for 60 minutes, chances are that people will use the full hour. If a decision is reached faster than anticipated, end the meeting early. Refer back to your steward mindset and schedule meeting time with intention.

Meetings are often experienced psychologically like we experience interruptions. Thus, when attendees arrive at a meeting, express gratitude. Your job is to keep attendees active and engaged; therefore, facilitate the meeting actively and creatively. Try out different techniques such as devoting a few minutes to silent, written brainstorming. Leveraging silence gives attendees the opportunity to think on their own before contributing to the discussion and results in nearly twice the number of ideas.³ Perhaps members can be assigned explicit roles such as devil’s advocate, or each attendee can be assigned a specific agenda item, invoking responsibility and participation. If you always sit during meetings, try standing. If you have never tried a walking meeting, give it a go. Attendees appreciate mixing things up.

Lastly, remember to check-in with attendees to see how things are going. Never get too comfortable as a meeting leader, especially since meeting frustration abounds. Asking your team for feedback will carry over to other aspects of your role. You will be seen as a conscientious leader, open to exploration and professional development. This builds trust and creates a positive, collaborative work environment.

While you cannot control how others run their meetings, you do have the ability to make a meeting that you lead truly work. Be intentional with your role as a meeting facilitator and focus on the whole experience. Evaluate and learn from your team, show others that you care about your meetings so that they begin to care about theirs too.

“Without meeting leadership skills, one joins the ranks of so many others who bear the responsibility for the meeting ‘problem’ and are the cause of so much frustration in the workplace.”¹ Physicians, like so many others, often feel that team meetings are inefficient, a waste of time, and mentally draining. It does not have to be this way. There are evidence-based strategies that can make meetings truly work and actually enjoyable to attend.² This is particularly important because eliminating meetings is a false solution. Hospitals need team meetings to promote coordination, collaboration, communication, and consensus decision-making. While no one individual can solve the meetings problem, each of us can find a meeting we lead and make it work better.

First, recognize that, as a leader, you are a steward of others’ time. As a steward, be intentional when designing meetings. Think carefully about who needs to be there, how much time to spend on the meeting, and how the meeting should be run. Dysfunction increases with meeting size, so invite attendees wisely; include only those essential to the meeting. For individuals not in the core group, offer them the opportunity to share their input premeeting if desired, share good meeting minutes with them, and welcome them to attend future meetings if desired. Consider “representative voices”—openly asking certain attendees to represent a group of stakeholders. Use a timed agenda to invite certain people for part, but not all, of the meeting.

Keep your meetings lean and deliberate. Avoid defaulting to one-hour meetings out of habit. Parkinson’s Law suggests that people will fill the time allotted to a particular task. If a meeting can be done in 30 minutes but is scheduled for 60 minutes, chances are that people will use the full hour. If a decision is reached faster than anticipated, end the meeting early. Refer back to your steward mindset and schedule meeting time with intention.

Meetings are often experienced psychologically like we experience interruptions. Thus, when attendees arrive at a meeting, express gratitude. Your job is to keep attendees active and engaged; therefore, facilitate the meeting actively and creatively. Try out different techniques such as devoting a few minutes to silent, written brainstorming. Leveraging silence gives attendees the opportunity to think on their own before contributing to the discussion and results in nearly twice the number of ideas.³ Perhaps members can be assigned explicit roles such as devil’s advocate, or each attendee can be assigned a specific agenda item, invoking responsibility and participation. If you always sit during meetings, try standing. If you have never tried a walking meeting, give it a go. Attendees appreciate mixing things up.

Lastly, remember to check-in with attendees to see how things are going. Never get too comfortable as a meeting leader, especially since meeting frustration abounds. Asking your team for feedback will carry over to other aspects of your role. You will be seen as a conscientious leader, open to exploration and professional development. This builds trust and creates a positive, collaborative work environment.

While you cannot control how others run their meetings, you do have the ability to make a meeting that you lead truly work. Be intentional with your role as a meeting facilitator and focus on the whole experience. Evaluate and learn from your team, show others that you care about your meetings so that they begin to care about theirs too.

“We are what we repeatedly do. Excellence, then, is not an act, but a habit.”
—Will Durant

We are a collection of our habits—the routine, repetitive, subconscious behaviors we perform on a daily basis. Some of these behaviors are positive, others less so. Habits allow us to perform tasks automatically, without the need for active decision making. Amidst a constantly changing clinical environment, cultivating consistent habits can improve our adherence to best practices and free cognitive effort toward more challenging diagnostic or therapeutic tasks.

Establishing habits requires practice and intentionality. First, identify those habits that are desirable in your personal and professional life. Next, find a method to develop the habit. Then, hold yourself accountable as you work to embed the habit. Simple? Not quite.

In “The Power of Habit,” author Charles Duhigg introduces habit loops as a way to successfully develop this practice.¹ Habit loops—sequences comprising a cue, routine, and reward—are integral to developing routines that support professional and personal aspects of hospitalist life. Consider a hospitalist seeking to develop a prerounds routine to increase efficiency and limit missed patient information. First, the clinician should identify a cue to start the routine, such as sitting down to log in at a specific workstation. Second, a sequence of actions is “chunked” into a consistent order, such as a review of vital signs, clinical notes, and patient labs. After the routine is completed, the clinician should finish with a reward, such as a cup of coffee after rounds. Want to set up a habit for ensuring learning goals are set with trainees at the beginning of every block? Set a calendar reminder for this on the first day, standardize how you communicate goals, and reward yourself with a team lunch at the end of the rotation. What if it’s a busy first day on service? Doesn’t matter. As Clay Christensen notes in “How Will You Measure Your Life?,” making one commitment to a habit is easier than deciding whether or not to engage in the routine every time new circumstances arise.² The intentionality that comes with this act ensures consistency in the practice.

As a busy hospitalist, establishing habits for personal and professional development requires cues and rewards. For example, do you want to cement a habit of reading the latest journal articles or carving out time each day to reflect on your work? Then cultivate the routine by creating a cue, such as a dashboard on a wall to visualize how many articles you’ve read this week or whether you’ve paused to reflect on your rotation. Reinforce the routine by creating a reward: a walk outside, time with family, or another activity you enjoy. Pair the same reward with the same routine to strengthen the habit loop.

A few additional tips for cultivating habits: it is useful to pair an existing reliable habit, or “anchor habit,” with a new one, such as a short meditation after brushing your teeth.³ Doing so reinforces behaviors in a positive way. You may use the same principles to lose unwanted habits (eg, checking e-mail excessively) by removing cues, such as turning off notifications or using airplane mode and rewarding yourself when you see the behavior through.

Habits are larger than behaviors; they can impact your personal and professional life in important ways. By actively creating habits that align with your long-term priorities, you can create a safety net if and when change arrives. Understanding the psychology of habits and employing cues and rewards effectively can lead hospitalists to create positive routines that improve their clinical practice and personal lives.

“We are what we repeatedly do. Excellence, then, is not an act, but a habit.”
—Will Durant

We are a collection of our habits—the routine, repetitive, subconscious behaviors we perform on a daily basis. Some of these behaviors are positive, others less so. Habits allow us to perform tasks automatically, without the need for active decision making. Amidst a constantly changing clinical environment, cultivating consistent habits can improve our adherence to best practices and free cognitive effort toward more challenging diagnostic or therapeutic tasks.

Establishing habits requires practice and intentionality. First, identify those habits that are desirable in your personal and professional life. Next, find a method to develop the habit. Then, hold yourself accountable as you work to embed the habit. Simple? Not quite.

In “The Power of Habit,” author Charles Duhigg introduces habit loops as a way to successfully develop this practice.¹ Habit loops—sequences comprising a cue, routine, and reward—are integral to developing routines that support professional and personal aspects of hospitalist life. Consider a hospitalist seeking to develop a prerounds routine to increase efficiency and limit missed patient information. First, the clinician should identify a cue to start the routine, such as sitting down to log in at a specific workstation. Second, a sequence of actions is “chunked” into a consistent order, such as a review of vital signs, clinical notes, and patient labs. After the routine is completed, the clinician should finish with a reward, such as a cup of coffee after rounds. Want to set up a habit for ensuring learning goals are set with trainees at the beginning of every block? Set a calendar reminder for this on the first day, standardize how you communicate goals, and reward yourself with a team lunch at the end of the rotation. What if it’s a busy first day on service? Doesn’t matter. As Clay Christensen notes in “How Will You Measure Your Life?,” making one commitment to a habit is easier than deciding whether or not to engage in the routine every time new circumstances arise.² The intentionality that comes with this act ensures consistency in the practice.

As a busy hospitalist, establishing habits for personal and professional development requires cues and rewards. For example, do you want to cement a habit of reading the latest journal articles or carving out time each day to reflect on your work? Then cultivate the routine by creating a cue, such as a dashboard on a wall to visualize how many articles you’ve read this week or whether you’ve paused to reflect on your rotation. Reinforce the routine by creating a reward: a walk outside, time with family, or another activity you enjoy. Pair the same reward with the same routine to strengthen the habit loop.

A few additional tips for cultivating habits: it is useful to pair an existing reliable habit, or “anchor habit,” with a new one, such as a short meditation after brushing your teeth.³ Doing so reinforces behaviors in a positive way. You may use the same principles to lose unwanted habits (eg, checking e-mail excessively) by removing cues, such as turning off notifications or using airplane mode and rewarding yourself when you see the behavior through.

Habits are larger than behaviors; they can impact your personal and professional life in important ways. By actively creating habits that align with your long-term priorities, you can create a safety net if and when change arrives. Understanding the psychology of habits and employing cues and rewards effectively can lead hospitalists to create positive routines that improve their clinical practice and personal lives.

“We are what we repeatedly do. Excellence, then, is not an act, but a habit.”
—Will Durant

We are a collection of our habits—the routine, repetitive, subconscious behaviors we perform on a daily basis. Some of these behaviors are positive, others less so. Habits allow us to perform tasks automatically, without the need for active decision making. Amidst a constantly changing clinical environment, cultivating consistent habits can improve our adherence to best practices and free cognitive effort toward more challenging diagnostic or therapeutic tasks.

Establishing habits requires practice and intentionality. First, identify those habits that are desirable in your personal and professional life. Next, find a method to develop the habit. Then, hold yourself accountable as you work to embed the habit. Simple? Not quite.

In “The Power of Habit,” author Charles Duhigg introduces habit loops as a way to successfully develop this practice.¹ Habit loops—sequences comprising a cue, routine, and reward—are integral to developing routines that support professional and personal aspects of hospitalist life. Consider a hospitalist seeking to develop a prerounds routine to increase efficiency and limit missed patient information. First, the clinician should identify a cue to start the routine, such as sitting down to log in at a specific workstation. Second, a sequence of actions is “chunked” into a consistent order, such as a review of vital signs, clinical notes, and patient labs. After the routine is completed, the clinician should finish with a reward, such as a cup of coffee after rounds. Want to set up a habit for ensuring learning goals are set with trainees at the beginning of every block? Set a calendar reminder for this on the first day, standardize how you communicate goals, and reward yourself with a team lunch at the end of the rotation. What if it’s a busy first day on service? Doesn’t matter. As Clay Christensen notes in “How Will You Measure Your Life?,” making one commitment to a habit is easier than deciding whether or not to engage in the routine every time new circumstances arise.² The intentionality that comes with this act ensures consistency in the practice.

As a busy hospitalist, establishing habits for personal and professional development requires cues and rewards. For example, do you want to cement a habit of reading the latest journal articles or carving out time each day to reflect on your work? Then cultivate the routine by creating a cue, such as a dashboard on a wall to visualize how many articles you’ve read this week or whether you’ve paused to reflect on your rotation. Reinforce the routine by creating a reward: a walk outside, time with family, or another activity you enjoy. Pair the same reward with the same routine to strengthen the habit loop.

A few additional tips for cultivating habits: it is useful to pair an existing reliable habit, or “anchor habit,” with a new one, such as a short meditation after brushing your teeth.³ Doing so reinforces behaviors in a positive way. You may use the same principles to lose unwanted habits (eg, checking e-mail excessively) by removing cues, such as turning off notifications or using airplane mode and rewarding yourself when you see the behavior through.

Habits are larger than behaviors; they can impact your personal and professional life in important ways. By actively creating habits that align with your long-term priorities, you can create a safety net if and when change arrives. Understanding the psychology of habits and employing cues and rewards effectively can lead hospitalists to create positive routines that improve their clinical practice and personal lives.