Dr. Howell
While preparing for National Hospitalist Day, I began reflecting on how fortunate I am to be a hospitalist and on the aspects of leadership that have allowed me to successfully navigate more than 20 years as a hospitalist leader. I thought I’d share them with you. Yours may vary!
10. Be a workhorse rather than a show horse.
I’ve found that being regularly reliable is more important than being sporadically spectacular. Being consistently reliable builds trust and a strong personal brand, which is especially important in our collaborative and relationship-based world of the hospital. I believe my reputation as a workhorse is one reason I was chosen to open the COVID-19 field hospital in March 2020 at the Baltimore Convention Center.
Even though I am a workhorse, I still stretch as a leader and have stretch goals. I occasionally go into show-horse mode when I give lectures or present important work. But in general, I favor the workhorse approach.
9. Hospital medicine is a team sport.
By definition, leaders work with others—and in hospital medicine, usually a lot of others. There’s a difference between leading a group of individuals versus forging people into a team. A team works collaboratively to reach a unified goal, whereas groups are people who may have a common goal (or interest) but do not intentionally coordinate efforts. Teams are more productive in reaching shared goals, more resilient, and in my experience, more likely to open opportunities for me as their leader.
8. Invest in people.
This is the corollary to building a strong team. Mentorship and sponsorship help people grow as professionals and individuals and, in turn, have helped me grow immensely as a leader. I find it personally rewarding to see people succeed, but the return on investment in my professional career has been huge. Investing in others has allowed me to expand my professional network into new and high-impact ventures. When I invest in others, they also invest in me.
7. Take calculated risks.
I find it hard to grow as a leader if I don’t venture out of my comfort zone. These are the stretch goals I talked about before. Some of the biggest leadership jumps came from taking some professional risks. For example, I had a very successful, single-hospital, hospitalist group. I could have stayed in that single hospital for the rest of my career, which was a common practice at my institution. Instead, I took a professional risk by opening a second hospitalist group in another hospital.
Fortunately, that second hospital medicine group was a huge success and paved the way for a much larger institutional role, overseeing eight physician groups in four hospitals. While not all risks pay off, when they do, they are well worth it!
6. Find a pathway to resilience.
Medicine can be stressful, and the pandemic has made the stressors worse both inside and outside of the hospital. Add leadership responsibilities, and I find I need to be very proactive in my self-care to avoid burnout. I work hard to exercise, eat well, and get sleep. The most important self-care activity for me is staying connected to my family. I make time for walks with my wife Heather every day (with our dogs Duffy and Sperry too!), and I strive to eat dinner with my kids frequently. I can’t be home for dinner every day—after all, patient care is a round-the-clock vocation—but I still manage to eat with Heather and my children more days than not.
I also have hobbies. Many of you know I like boats and Jeeps, and I spend time tinkering on or exploring nature with both. Sometimes boats and Jeeps have to wait days or weeks to be revisited, but I can take a moment during a busy hospital (or SHM!) day to daydream about my next adventure.
5. Be grateful.
I am so very lucky that physicians are well respected by (most of) society. I’m grateful for the patience my family has for those late-night calls and missed events. I am especially grateful for the trust and close bond I’ve developed with many patients. Medicine is not easy, but I am thankful for the special role I’m allowed to play.
During my most recent ward-attending block, we helped a dying patient transition to hospice. It was extremely heart-wrenching. But I got a call from the patient’s daughter, thanking us for supporting her mother and her siblings during those dark times. I am so thankful for those patients who validate that what we do is meaningful, even when all we can do is listen.
4. Manage conflict.
I don’t like conflict. When a car wants to merge into my lane in front of me, I feel stressed! Who would have thought that much of my success as a hospitalist leader would be the result of effectively managing conflict? From negotiations where “everyone wins” to “playing hardball” and walking away, I have learned to flex my negotiation style. Because I am seen as an effective negotiator and manager of conflict, I’ve been tasked with managing partnerships with emergency departments (ED), hospital administrators, and more.
I knew I had managed the ED conflict well when the ED director at one point stood up in front of hospital administration to support our overworked hospitalists. He said, “I don’t know how many hospitalists are too many, but I can assure you we are a long way from that today. I favor funding more hospitalists.”
3. Give.
Give away authority, give away time, give away some of your opportunities to others. I’ve even given away my free parking to a colleague! What did I get in return? A whole lot more than parking. I got colleagues who have my back, I got introduced to opportunities that would have been invisible to me otherwise, and I got a network of people willing to share information because they knew I had their best interests at heart.
2. Be ethical and transparent.
This needs no explanation. Especially in these dark times, where trust is low and misinformation is high, being ethical and transparent is critical. Start early and build that trust. This is a core step to transforming a group of people into a unified team. They need to trust in you as a leader.
1. Find and live by your core values.
I’ve developed three fundamental core values that I live by:
- Make the world a better place.
- Be ethical and transparent.
- Invest in people.
You’ll see two of those core values are also two of my top 10 leadership tips. They are so important they merit two mentions. When followed, they almost always create outcomes that lead to my first core value. It sounds corny, but I use these to guide difficult decisions frequently.
Here are a couple of examples. Baltimore needed doctors to help hospitals during the omicron surge, so what did I do? “Get in there, Howell! You want to make the world a better place.” So, I volunteered to see patients at my old hospital for seven days in early January.
There was a cushy lecture invite at a cool location. One of my colleagues might have been a better fit, but did I snap that up myself anyway? No, I wanted to invest in people, so I connected my colleague to the request. The result? She has become an international hospital medicine celebrity.
These are just two examples of how my core values played an active and important role in my leadership growth. I’m a strong advocate of finding one’s core values, explicitly stating them, and then doing one’s best to live by them. You’ll find this not only makes you a stronger leader, but also a more compassionate, resilient human being.