Wisdom Leadership Reviews

Wisdom Leadership Reviews

Wisdom Leadership cover

Wisdom Leadership Reviews

Wisdom Leadership in Academic Health Science Centers: Leading Positive Change
Edited by Margaret Plews-Ogan and Gene Beyt

"In their book, Wisdom Leadership in Academic Health Science Centers: Leading Positive Change, editors Margaret Plews-Ogan and Gene Beyt illustrate how academic health science centers can create a culture that closes the gap between what we should be doing for patients and the reality of what occurs, by nurturing the “thread” of humanity that connects healer to patient and teacher to student. Drawing on William Stafford’s poem “The Way It Is,” Plews-Ogan and Beyt argue that healthcare professionals should hold tight to this thread (“You don’t ever let go of the thread”) even as it is being frayed by the divisive debate over the Affordable Care Act, incentivized payment to providers and eroding consumer trust. The thread is wisdom leadership which has the potential to transform healthcare workers and thereby transform the culture of academic health science centers.

"The first in a five-volume series on enhancing the professional culture of academic health science centers,   Wisdom Leadership inspires readers to become their best selves by reconceputalizing the attributes of leadership to reflect and integrate wisdom. In this framework, wisdom transcends intelligence; is multi-dimensional, spanning knowledge, emotion, and moral behavior; and represents the pinnacle of human development. Drawing on work of business leadership gurus Ikujiro Nonaka and Hirotaka Takeuchi, Plews-Ogan and Beyt propose that wise leaders are those who are both thinkers and doers dedicated to patient-centered care and who focus on details without losing sight of the big picture. In other words, they create space for the exchange of knowledge, concerns, and shared goals. They bring people together and resolve conflicts. They nurture wisdom development in others from boots-on-the-ground workers to high executives, creating an environment of pervasive leadership.[1]

"Plews-Ogan and Beyt have carried this notion of wisdom to the healthcare arena and specifically to the culture of academic health science centers (AHSC). They link the same wisdom attributes of successful business leaders to successful leaders in AHSC. Wise leaders encourage healthcare providers to be “their best selves” by adopting affirming techniques such as reflection, increasing one’s tolerance for ambiguity and complexity, and fostering compassion. Transformation of complex healthcare settings is evidenced by effective communication skills, shared goals, shared knowledge, and mutual respect among healthcare teams and across the organization. In short, by actualizing the practices of wisdom, the practitioner becomes a transforming force in shaping a healthcare environment that is more positive, collaborative and patient-centered.

"The editors espouse that leaders in AHSCs can harness capacities for wisdom development and demonstrate this by weaving together stories, experiences, and insights from distinguished contributors from fields of medicine, management and leadership, and ethics. Drawing on the humanities, the editors introduce each chapter with a poem, story, or interview to spark moral imagination, elicit meaning, and connect on a human level the concepts explored within. For instance, there is a story about colleagues in Korea who despite the termination of monthly regional meetings continue to show up because of their need to exchange and compare ideas, successes, and failures.  There is another story recounting the leadership actions of one physician who rebuilt her distraught crisis intervention and care team devastated by a nursery-wide medication error that took the lives of several newborns. The reader is also privy to a physician’s lived experience of complexity theory, in which she learns that contrary to a linear model of cause and effect, the complex interaction of interdependent agents—physician-as-patient, unfamiliar clinician, and silent spouse—resulted in the delay of diagnosis and treatment of her pneumonia.

"This book is organized into three parts. Part one, the introduction and first chapter, familiarizes the reader to the complexities of leadership and management of complex AHSC and justifies wisdom as a worthy construct for framing an exploration of leadership. Monika Ardelt’s three-dimensional model conceptualizes wisdom as a state of being, accenting both character and behavior. The cognitive dimension seeks truth and meaning; the reflective dimension requires self-examination, insight, and awareness; and the compassionate dimension transcends self-absorption to express empathy and sympathy for others. Leaders in AHSC are charged with modeling and fostering attributes of wisdom as they nurture the formation of wise professionals and create the new fabric of our health care arena.

"Part Two focuses on the capacities of wisdom leadership: “finding and understanding the deeper meaning of things, reflection, compassion, understanding and applying right action in difficult circumstances, seeking out and fostering the best in ourselves and others, and understanding and embracing complexity.” Each of the seven chapters identifies helpful, practical techniques to operationalize these capacities. Some of these include having people reflect on a hand held object that symbolizes the meaning of their work and sharing that meaning with others in the group; promoting professionalism using physician peer supporters especially following adverse events; and using positivity strategies such as opening meetings with a positive story, assuming people interact with positive intent, and focusing on desired behaviors as opposed to unwanted ones.

"Part Three, consisting of only two chapters, provides a glimpse into what the journey to wisdom leadership might look like. First, Angel Barron Mc Bride, Indiana University School of Nursing, records this journey by following threads of evidence of wisdom leadership woven across all stages of one’s career. She illustrates how capacities for leadership vary in appearance from early development in which one learns the knowledge and clinical skills of entry level practice. The fledgling analyzes personal strengths and opportunities for growth, becomes socialized in the culture of healthcare, and learns strategies to manage stress. The seasoned practitioner builds a stable infrastructure and creates a vision for the future. She assumes responsibility for program development, challenging new thinking, and coaching her team. In the book’s final chapter, Wiley “Chip” Souba, Geisel School of Medicine, Dartmouth College, explores the phenomenology of wisdom, asserting that a journey of personal change must precede organizational or system transformation. He claims that many of our healthcare challenges stem from our resistance to let go of or revise our “engrained ways of being and acting.” Wise leaders, however, choose to make changes to their “being” that enhance their leadership effectiveness. Not unlike the phrase often attributed to Gandhi, “Be the change you wish to see in the world,” Sousa recommends four ways of exercising wisdom leadership by personifying the changes you wish to see in your institution. He suggests being mindful (awareness of one’s already-always-listening), being your word (having integrity), being a stand (being committed to a position), and being cause in the matter (having authenticity). In other words the wise leader is mindful of negatively distorting contexts through which he hears. He does what he says he will do and lives for a future that surpasses the quality of today. He replaces excuses with renewed responsibility and determination to overcome challenges and conceive a higher quality patient-centered tapestry of care.

"This book speaks especially to readers who will provide care in complex dynamic healthcare settings where relationally coordinated collaboration among care team members is essential for safe, efficient, high-quality patient-centered care. Wisdom Leadership will also engage readers who will potentially receive care—who envision health care that is compassionate and meaningful, and deserve a humanistic medical profession that knows what to do, and how to act as healers and leaders. This volume blends the theoretical with the practical. It generates positive mental images of benchmarks in progress, and contains practical skills that instill confidence and keep success within reach. These are turbulent times, but as William Stafford implores, while we cannot “stop time’s unfolding/ You don’t ever let go of the thread.” Wisdom Leadership should be required reading for all health care executives who wish to sustain the thread of humanity and weave wise leadership into contemporary healthcare."

~ Gordon Mosser, MD 
Senior Fellow, School of Public Health, University of Minnesota
Co-author of Understanding Teamwork in Health Care

[1] Ikujiro Nonaka and Hirotaka Takeuchi. The Wise Leader: How CEO’s Can Learn Practical Wisdom to Help Them Do What’s Right for their Companies and Society. Harvard Business Review. May 2011