Farewell Message from the Director: Lessons Learned
Today is my last day as Cancer Center Director. I am currently in the 13th year of my 10-year commitment as Director, and although this has been a richly satisfying period, I look forward to returning to full-time research and teaching. On August 15 Tom Loughran assumes these responsibilities, and I am confident that the future of the Center is in excellent hands. Tom is a distinguished physician-scientist, an experienced administrator and a person of integrity.
The long-time chairman of the Cancer Center’s External Advisory Committee, Joseph Simone, after a distinguished career that included CEO of St. Jude’s and Physician-in-Chief at Memorial Sloan-Kettering, published some of the lessons he learned during his career (“Simone’s Maxims”, attached). In that tradition, I share with you some of the “Lessons Learned” from family, friends, public figures and experience during my time as Director of the UVA Cancer Center.
MISSION, STRATEGY, EXECUTION, and LOOKING IN THE MIRROR
Plans are nothing; planning is everything. Dwight D. Eisenhower.
The purpose of strategic planning is self-discovery. The plans by themselves are generally useless in a rapidly changing world. But by understanding yourself and your environment, you can be nimble and adapt appropriately. Honest self-assessment is an essential foundation for a successful strategy and its implementation.
A corollary is, Institutions, like people, achieve success by being the best at who they really are.
Never eat anything bigger than your head.
We often are told that we can achieve anything, if we really want it. But does anyone really believe that? Self-knowledge (personal and institutional) allows one to match goals and capabilities and to distinguish “stretch goals” from irrational optimism.
“Culture” eats “Strategy” for breakfast. Peter Drucker
If you have the right strategy and the wrong culture for that strategy you will fail.
There are many paths to success. But constantly changing directions is a sure path to failure.
Failure rarely occurs catastrophically. More commonly it occurs slowly, by erosion, and thus is difficult to identify and reverse.
ORGANIZATION OF ACADEMIC MEDICAL CENTERS
“Accountability” and “Oppressive Regulation” differ mostly by who is doing it.
If you are setting rules and goals, you are holding your employees “accountable.” If you are the recipient of these rules and goals, you are being “regulated.” In any event, there is too much of it. Corporate organizational models are inappropriate for academic institutions; they turn professionals into proletariat. Regulations are a necessary evil and should be minimized. Demands for various accountability reports should be limited to those that are actually used for decision making. Unnecessary data collection, reports and re-retraining are unnecessary evils.
A corollary is: Distinguish between metrics and targets. If you aim only for the metric, you won't reach your target. Aaron Weber. For example, if the metric of evaluation is “time it takes for a patient to see a nurse” you don’t achieve the target of “first-class patient care” by stationing a nurse at the front door.
The academic environment is not linear and it especially is not vertical.
Functional academic programs and teams minimize hierarchy. The best ideas and initiatives often come from those closest to the operational realities, and effective organizations will encourage them to “trickle up.”
“Control” and “Success” are not synonyms.
Similarly, “Management” or “Administration” are not synonymous with “Leadership.” Especially in an academic environment, where almost everyone is a self-motivated, entrepreneurial professional, the institution and its leaders should facilitate the creativity and energy of its personnel. Excessive control stifles the spirit that leads to excellence. Alignment of goals can best be achieved with leadership, incentives, and recruitment.
No one is an effective mind-reader.
It is important that everyone, regardless of their position in the academic hierarchy, feel empowered to speak their minds. As UVA continues its decades-long evolution from a school for southern white males into a culturally diverse institution, differences in personality and inter-personal communication style establish a rich ground for miscommunication and misunderstanding. We celebrate diversity based on ethnicity, gender and race, but do not acknowledge that this is accompanied by diversity of personality. Normative behavior in New York is not identical to traditionally normative behavior among the first families of Virginia. The lines between assertiveness, aggressiveness and abusiveness are not always clear-cut, nor are the lines between politeness, obtuseness and concealment. When someone crosses that last line, their colleagues should feel not only empowered but obligated to give them appropriate and on-the-spot feedback.
A corollary is: Prompt, clear feedback nips grievances in the bud.
You don’t achieve success by solving problems. You achieve success by building programs. Jack Welch
A corollary is: Don’t let urgent needs interfere with meeting vital needs.
Recruitment should build on strength and grow toward need.
Building inter-disciplinary programs is the special mission of a Cancer Center. Programs are best built by organic growth. By building on existing strengths, it is possible to achieve the critical mass necessary to cover all the specialties, generate synergies, and sustain programs. Moreover, strong programs can identify the best candidates and create a kind of “gravitational field” that attracts them. Recruitment is essential for successful program building, and it is better to attract individuals who are drawn to work with existing centers of excellence. The alternative is to bribe people to come, a recruitment strategy that will shortly lead to bankruptcy and will not recruit individuals likely to stay after their package runs out.
A critical mass has enough neutron emitters and not too many neutron absorbers.
First class people recruit first class people; second-class people recruit third-class people. Joe Simone.
Even when recruitment is oriented toward building a specific program or team, the quality of the individual is paramount. Optimal balancing of programmatic goals with the recruitment of talented individuals requires exceptional judgment, but two factors should be kept in mind:
- The goal is not just to recruit the best person, but to recruit the person who can be most successful in the specific environment.
- Programmatic goals are transient but talent persists. Never recruit a second-rate talent just to fill a programmatic need, unless you are sure you can get rid of him or her later.
A corollary is: If you want the institution to improve, recruit people who are better than you. This takes courage; many people in leadership positions prefer to recruit subordinates rather than people who challenge them.
“Collegiality” and “Collaborativeness” are not synonyms.
We are justifiably proud of the collegial atmosphere at UVA. However, this asset has not been leveraged into substantial numbers of collaborative activities. This raises the question of whether our collegiality is based in part on a veneer of politeness that deflects the direct and sometimes difficult exchanges that can be necessary for teams to work together productively. Encouraging a frank exchange of views, irrespective of rank or age, is a hallmark of the research environment and needs to be part of the wider institutional culture.
“High achiever” and “High maintenance” are not antonyms.
Sometimes people who are passionate about their work, driven and focused can be difficult to deal with. However, these are qualities that often are necessary to bring about real change, especially in a change-resistant environment. Fostering a culture which engages “high maintenance” individuals who can contribute positively to the institutional mission is a necessary challenge for any leader. Babe Ruth was an obnoxious boor, but the Yankees would not have won the World Series without him. Steve Jobs was an impossibly demanding boss, but was the driver of Apple’s success.
A verbal agreement isn’t worth the paper it’s written on.
If it’s important, get it in writing. If it’s a contract, have a lawyer look it over. This is not necessarily related to “trust.” Written agreements are less likely to contain significant misunderstandings. Moreover, the person you negotiate with may not be around next year – or next week.
A corollary is: Trust but Verify. Ronald Reagan.
Leadership is mostly about service.
One of the most satisfying aspects of holding a leadership position in an academic environment is the opportunity to help other people succeed. In a talent-rich environment, such as UVA, this is an easy satisfaction to achieve.
A secret is something you learn about tomorrow instead of today.
Once a secret is (inevitably) revealed, the community of trust becomes weakened. Without trust and openness, it becomes difficult to achieve the frank communication necessary for strategic planning and for collaboration.
Eating what you hate or eating too much of what you love…either can give you indigestion.
There’s never enough time, there’s never enough money, and nothing ever fits. David Weber.
Your procrastination is never as subtle as you think it is. Joel Weber.
Don’t be afraid to ask for advice; your mentor becomes your advocate.
The Young Turks become the Old Turkeys.
Michael J Weber, PhD
Director, Cancer Center
Weaver Professor of Oncology
Professor of Microbiology, Immunology and Cancer Biology
University of Virginia