Commencement Address by Bill George

“Challenges for the New Generation of Physician and Scientific Leaders”
Commencement Address by Bill George
Mayo Medical School and Mayo Graduate School

Introduction

Members of graduating class of physicians and scientists, President Noseworthy, Mayo Medical School and Mayo Graduate School leadership, and Mayo Board of Governors: it is a great honor for me to accept this honorary degree and the privilege of offering this commencement address. My talk today focuses on the challenges you will face as the new generation of physician and scientific leaders.

For the past two and one-half years, I have had the privilege of serving as a member of the Mayo Board of Trustees, and have had the opportunity to witness first-hand the commitment of Mayo’s leaders to the mission and values originally created by the Mayo brothers.

Just a week ago we celebrated the sesquicentennial of Mayo’s founding in 1864. Throughout its distinguished history, Mayo has become the world’s leading medical center, the source of treatment for ten million patients, and a center for scientific medical discovery. Through world wars and depressions, Mayo has never wavered from its mission and values to serve people in need of healing.

The Challenge for Today's Health Care Leaders

Today we are faced with a health care crisis: the declining health of our nation in a time of rising costs – an unsustainable situation that cannot continue. As the next generation of physicians and scientists, your challenge is to heal the sick and move health care upstream from disease care to health care – a health care that meets the needs of the whole human being and enables people to live full and productive lives. Only in tackling such daunting tasks can we restore the health of the American people. Only by restoring the health of the population can we make lifelong health care affordable and available to all. That is the challenge that your generation must undertake – and the challenge that Mayo must rise to in order to continue to lead the nation in health care.

The key to achieving these dual goals is leadership – your leadership. You are called to lead this new generation of physician and scientific leaders in new ways that keep the needs of people and values of Mayo at the core of everything you do. 

Outside of leading centers like Mayo and academic medical centers, there are far too few physicians and scientists in leadership roles today. They have been so busy practicing medicine and doing research that they have abdicated leadership to administrators who have never engaged in clinical practice or conducted scientific research. Without the benefit of the in-depth medical and scientific training and clinic experience in dealing directly with the full range of patients that you have had, many administrators attempt to develop tops-down, standardized systems devised for generic patients and population groups. Often these systems do not take into account the complexities of individual cases and the need for customized approaches to healing people.

Mayo's Approach to Leadership

Mayo has a unique approach to this issue which could be used by the full range of health systems, hospitals and payers: that is, to pair physician leaders with administrative leaders throughout the organization to collaborate to solve complex patient problems at both the individual level and the systems level, and then to challenge its physician leaders to be triple-shield leaders who excel in clinical practice, research and education.

I don’t want to oversimplify the challenges you face in becoming leaders.  The rigorous years of training required to become a skilled physician or scientist do not provide for early leadership opportunities so vital in learning how to lead through real-world experiences.

Through my leadership experiences and work with thousands of students, I have learned that leadership cannot be taught in the classroom. Rather, it must be learned through real world leadership opportunities that enable you to learn from your mistakes and successes, and develop your authentic leadership style.

Whether or not you see yourself as a leader, in truth we are all called to be leaders. Being a leader doesn’t require acquiring particular skills or traits. Rather, our leadership comes from within us: our life stories, the difficulties and crucibles we have faced, and our passions and motivations. Traditional leadership training programs using competency models, correcting your weaknesses, and emulating other leaders are not adequate for today’s leaders. Rather, each of us needs to lead in our unique, authentic way, using our gifts to serve others.

A Contingent Model of Authentic Physician and Scientific Leadership

What will it take for you to become an outstanding health care leader who can lead teams and organizations to fulfill a shared mission and achieve superior outcomes? Let me offer this contingent model of authentic leadership for you as physicians and scientists entering the heart of your career:

1. The Purpose of Your Leadership

Think back to the reason you went into medicine in the first place. Did you feel a calling to serve people through medicine and science? Were you influenced by health issues in your family, friends or your own life? How does your decision relate to your life story and the crucibles you have faced? I encourage you to write this down in depth, and refer back to your story and initial sense of calling on a regular basis as you enter practice. There will be many days when you will feel discouraged or worn down by the system, so you need this inspiration in front of you to build your resilience.

In this regard I would like to share with you my defining leadership experience. In my mid-40s I was en route to the top of Honeywell, happily married, with two sons going into high school. One day I was driving home on a beautiful fall day when I looked in the rear view mirror and saw a miserable person: me. Ask yourself, how can you be miserable when you seem to have everything going for you in life? I was losing sight of my True North to be a values-centered leader who makes a difference in the world; instead, I was playing the game of becoming CEO of Honeywell, saying just the right thing to get ahead. When I told my wife Penny what I was feeling, she said, "Bill, I've been trying to tell you this for a year but you refused to listen." Until that flash in the mirror, I was in denial about what was happening to me. Previously, I had turned down Medtronic three times to become president and COO. When I took a deep look at Medtronic, I realized it was the place where I should have been all along – a company where all employees are aligned around the mission of "restoring health, alleviating pain, and extending life." It led to the best twelve years of my professional life. By working together, Medtronic went from restoring 300,000 people per year to 10 million. Had I not experienced that “flash in the mirror,” I might never have walked through the open door of Medtronic.

2. Becoming a Servant Leader: from Your Head to Your Heart

Ask yourself, are you prepared to become a servant leader? What are your deeper motivations for serving? How do you balance them with the pressures you feel for financial security? How will you avoid being seduced by money, fame and power by focusing on your intrinsic desires to make a difference in the world as a servant leader?

To this point of your education, most rewards have resulted from your IQ and individual performance. In contrast, to be a servant leader, you need to develop your emotional intelligence, or EQ.  Research has demonstrated that above 120 IQ, EQ becomes the differentiating factor in leadership. Think about these four essential qualities of leaders: passion for your work, compassion for your patients, empathy for the people your lead, and the courage to make the difficult decisions that may run contrary to the views of others. Passion, compassion, empathy, courage: these are all matters of the heart. We cannot teach them in the classroom. But in order to be authentic leaders, we must learn them from our experiences.

As Buddhist monk Thich Nhat Hahn says, "The longest journey you will ever take is the 18” from your head to your heart." As a servant leader, your challenge is to integrate the knowledge of your head with the human qualities of your heart. If you keep your focus every day on the patients you are serving, you can become an authentic servant leader. When you complete this discernment you are ready to establish your leadership purpose, and to determine the values you will lead by.

3. Aligning and Empowering People around the Organization's Mission and Values

 Are the mission and values of your organization aligned with your personal mission and values? If not, what can you do to bring them into closer alignment? Consider the people you are leading and influencing every day: are you able to align them around your organization’s mission and values? Are you putting your values into practice every day?

Then examine your effectiveness in empowering others to lead. In today’s world, your job as a leader is not to exert power over others, but rather to empower them to lead. Empowered teams of leaders, like we have here at Mayo, will outperform a top-down, hierarchical organization every time. With all the pressures we feel in our daily work, we need to feel empowered in order to have the resilience to bounce back from disappointments, failures, and the unrelenting pressures of healing the sick.

4. Developing More Physician and Scientific Leaders

The future of this country's health care depends on developing more physician and scientific leaders like you. This requires giving you many more opportunities to lead earlier in your careers. Given the rigors of medical training, it is very difficult for you to find the time for leadership training and accepting leadership opportunities. However, it is essential if we want a health care system that views restoring people to full life and health as our reason for existence, not a massive tops-down system that treats patients like herding cattle in the most efficient way.

There are multiple ways to provide these leadership opportunities by engaging medical students, graduate students, residents and fellows in selection processes, search committees, and national and regional scientific meetings. Mass General has embarked on a leadership course for its residents built on my book, "True North," and the HBS course, "Authentic Leadership Development," which several of the residents have taken as joint MD/MBA students.

My advice to you is simply this: Step up to leadership now! Don't wait for that big leadership opportunity to come your way. No job is too small. Learning from early leadership experiences, especially those in which we fail or disappoint ourselves, is much more valuable than later experiences. Offer to lead whenever and wherever you see a need. Leadership is your choice, not your title. So don't wait to be asked to lead. Take on leadership challenges whenever you see the need.

5. Teamwork and Authentic Collaboration

The next element in this contingent model is authentic collaboration through teamwork. Mayo specializes in teamwork, but even we have a long way to go to use collaboration as a means to challenge each member of the health care team to perform at the highest level of their abilities. Physicians will remain at the center of the patient's team, but will be joined by advanced practice nurses and full range of allied health professionals such as acupuncturists, health coaches, diet and nutrition experts, exercise coaches, and mind-body specialists - all of whom will play essential roles in keeping people healthy.

6. Producing Sustainable Outcomes

The final element of your leadership is to produce sustainable outcomes in which tangible goals are created, carefully measured, and outcomes monitored on a regular basis. You get what you measure, so be careful that you measure only authentic outcomes, not inputs. Even modeled outcomes may not reflect the real world of patients with complex diseases.

If you pursue these six steps to authentic leadership as a physician or scientist, I feel confident that you will make outstanding contributions as an authentic leader. To sustain your leadership, it is essential that you maintain your resilience through regular practices to keep yourself healthy in mind, body and spirit.

The Fulfillment of Leadership

Let me close with this exercise: You are 97 years old and have but three hours to live. All your adult children and grandchildren are gathered around you, when your favorite granddaughter asks you, "What did you do to make a difference in the world?" What will you tell her? The time to think about this is now, not then.

In 1966 Robert F. Kennedy said, "Few will have the greatness to bend history itself, but each of us can commit ourselves to a series of actions to make this world a better place. The sum total of all these actions will write the history of your generation." Drs. Will and Charlie Mayo did indeed change the world. So can you. In so doing, you will find life's greatest fulfillment is making a difference in the lives of others.

Nobel Peace Prize laureate Albert Schweitzer offered this advice: "I don't know what your destiny will be but this much I do know: the only ones among you who will be truly happy are those who have sought and found how to serve."

It is my fervent hope that you will become an authentic leader, using your leadership gifts to serve others, enabling them to enjoy the fullness of life and health. My best wishes as you embark on lives of leadership and service.