1. Bolwell, Brian J. MD, FACP

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One of the benefits of academic medicine is the ongoing opportunity to learn. We have ubiquitous opportunities to attend lectures. Usually they're about science or new research, but sometimes they're about quality, operations, or other organizational and national imperatives. So we have the opportunity to hear a lot of speakers. Some are skilled at delivering a talk, and some less so. What differentiates and defines a good speaker?

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One key to giving a good talk is to connect with the audience. If you forge such a connection, then your audience is engaged. They are in it with you, hungry for the information you have to impart. You might use humor to achieve this connection. You might tell a patient story or give a few examples of case studies in an effort to make the science or data real, to make it human.


Beyond presenting, it's your job to "read the room." As you are giving the talk, you need to absorb non-verbal cues about how the audience is reacting. Are they engaged? Are they following your train of thought? If not, why not? Are your topics too complicated? Or maybe too elementary with this audience? If you can read the room, then you can adjust the talk accordingly in real time. It's important to build an instant relationship and be able to pivot when the audience demands it.


Connecting with an audience is just one example of the importance of forming relationships in a professional setting. But, in reality, relationships are always important and essential to almost everything we do. They are certainly important for leadership, and we are all leaders to some degree. Whatever we are leading-a lab, a road trip with friends, or a big cancer center-the key to success is to form trusted human relationships. I have learned that this is probably the single most important principle of leadership.


Work and life are, to a large degree, a series of relationships. In a cancer center, they are all important. Relationships with patients are imperative, but so are relationships with the workforce. You also need to have good relationships with organizational leaders, the community that you serve, suppliers, philanthropic donors, cancer-related organizations, the government (in academic medicine this could mean the NIH and NCI), and colleagues that live near you, as well as those across the country and world. As noted in one of my favorite quotes from a book I frequently reference, The World's Most Powerful Leadership Principle: How to Become a Servant Leader by James Hunter, "People do not care what you know until they know that you care." It's hard for the people who work for you to give you their best effort if your view of leadership is only to give them orders. You will see much better performance and engagement if you develop relationships with them.


So how do you forge such relationships? By establishing trust. By keeping your word. By delivering on promises. By being honest. Not by being autocratic. Not by expecting people to do what you tell them to do because you are the boss.


Yet so many leaders get this wrong. You all know this. You see them-autocratic, self-centered leaders. You see them at national meetings, acting avuncular and dismissive. Maybe you see them in your own organization. You see them on search committees, where frequently the committee never makes mention of leadership skills, and they try to bully the committee towards their favored candidate. You observe their behavior, and I guarantee everyone also notices their ineffectual leadership.


Why are leadership skills relatively uncommon in medicine? I think it is because we do not talk about it. We do not teach it. We do not make it a priority. The vast majority of literature about leadership is about the corporate world, not the medical world (although the two are increasingly intertwined). Most importantly, it seems to be undervalued in medicine. So much of medical accolades and rewards go to individual accomplishments and not to the accomplishments of the team or the group. Leadership is about serving others, forming relationships, and not seeking credit. Therefore, most leaders in medicine are poorly equipped to be leaders, because their career has been built around personal success and not about shared credit. They may be accomplished academically, but they do not have tools or resources to help them develop true leadership skills.


We are all leaders in some way or another, and if you are reading this you probably would like to be a better leader. What can you do to develop your own personal leadership skill set? Simple-work on developing relationships with your team and work on serving them. Try to walk in their shoes and see things from their perspective. Listen. Ask for advice. Ask questions. Listen. Be honest. Keep your word. Build your own character. Care about them. Nobody is perfect-develop the skill of forgiveness. Listen. Act humble. Say "I don't know." Listen-really listen to them. And act on what you hear. Do not ignore what you hear. Follow up. If you say you are going to address a problem, then address the problem and don't quit until the problem is resolved. Grow your own emotional intelligence. Be aware of non-verbal cues. Pause and try to understand the context of the words of the other person. Oh, and don't forget to listen.


This cannot be faked. People are intuitive and can sense a counterfeit. Many leaders act warm and fuzzy yet will backstab other people at the drop of a hat. Relationships cannot be phony. Phoniness is a fast path towards employee disengagement. Relationships must be real. Relationships must be based on trust and honesty. People may not always agree with you, but if you have valued relationships in your organization and are credible, real, and trusted, then usually you can influence and create a highly functioning team.


The next time you are attending a lecture, think about whether the lecturer is connecting with the audience. If they are, how are they doing it? Observe. See if you can learn how they have forged a connection with the audience. The more you read the room when you give talks, the better you'll get at delivering engaging talks, which is developing a relationship of sorts. Relationship building is useful for lectures, for leadership, for work at all levels, and for your life.


The bottom line is that if you want to be a better leader, work on developing better relationships. And, guess what? That is the best part of the job.


BRIAN J. BOLWELL, MD, FACP, is Chairman of the Taussig Cancer Institute and Professor of Medicine at the Cleveland Clinic Lerner School of Medicine.


Straight Talk: Today's Cancer Centers

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