Karen J. Nichols

Physician Leadership


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every numerical detail of the topics of concern he wanted to discuss. He knew every board score for every discipline for every year, the annual average GPA by class, the trend for course and board pass rates, the match/placement percentage, every bit of numerical data that could be gleaned from the operation of the COM. A true numbers person.

      The next chair started out with a story to illustrate the culture of this COM. He continued to regale me with stories about students, faculty, administrations, and especially about past deans! He knew which deans worked on campus on weekends and which ones left campus the minute the president's car drove away. I didn't get a chance to ask questions, as his stories went on and on. He certainly lived in narratives.

      Another chair took a different tack. When I asked about the most difficult challenges facing the COM, he never got to the end of that answer. “X is an issue, Y is an issue, Z is an issue, but actually A, B, and C also cause a lot of challenges.” He kept comparing and contrasting a variety of possible answers until our time ran out. Sheesh!

      A different approach from another chair appeared to me to be focused on the tortoise tactic for COM management: slow and steady wins the race. Stay the course! The COM is doing well; the COM has lots of applicants, the COM has a great reputation. Why change?

      As I worked my way through the meetings with all the chairs, I was struck by how differently each one presented themselves and how differently they answered my questions, assuming I got the chance to ask my questions. Not only did I quickly realize that my concerns about having a lot to learn about the COM were accurate, I also came to appreciate that I had as much if not more to learn about how to work with these chairs.

      The further problem was that I didn't truly appreciate the variation of the approaches of these chairs, why they took the approaches they did, and what I should do to use those differences to the best advantage for the COM. My initial reaction was that I heard what they said, I understood their points, and I thought the fairest thing was to treat them all the same. Who could disagree with being uniform? Frankly, I was annoyed by the ones who had a different approach than the one I was used to or desired. But I was the dean! They would have to learn how to deal with me! How wrong I was!!

      What I had to learn was, there is more to leadership than telling people what to do. Not only were there different personality and approach types, but I needed to learn what those types were, what did those different types bring to the table, and so on. And while I thought I knew my own style, that wasn't true, either. As a doctor in practice for 17 years, I really had never had to consider that there were different approaches. I had just decided what to do in my private practice and did it. It slowly began to occur to me that maybe I had been missing an important piece of why I had such difficulty in getting my hospital and organization committees to work efficiently. Maybe the other committee members were coming with as many different approaches as the new dean (me) found in her chairs. Who knew? Obviously, I had to learn something about personality types and approaches. Where was the roadmap when I needed it?

      OK, let's be a little introspective here and start with the dean. The recommendation to “know yourself” is nothing new. The statement “The unexamined life is not worth living” is attributed to Socrates (Plato 399 BCE). I must admit that when I read that statement years ago, I did not really understand it. I interpreted that the admonition was to recommend that I engage in what is known as “navel gazing,” or considering who I am and what I am doing. The accurate and more helpful implication goes much further into understanding the basis for our multifaceted personalities.

       Knowing others is intelligence.

       Knowing yourself is true wisdom.

       Mastering others requires strength.

       Mastering yourself requires true power.

      I also like this statement by Warren Bennis: “Becoming a leader is synonymous with becoming yourself. It is that simple. It is that difficult” (Bennis 2009, xxxvii). In my opinion, his statement is spot on, because “becoming yourself” has to be preceded by “knowing yourself.” Truly understanding yourself is difficult and very important. If you know how you approach and how you react to situations, it is easier to be comfortable with that reality so you can accept and become who you are.

       “Ok! I get it! I'll give it a shot. Let's get started!”

      There are several instruments to assess personality approaches and are referenced in the following resource section. The most longstanding and highly utilized personality assessment instrument is the Myers‐Briggs Type Indicator (MBTI). The basic idea is that there are four personality characteristics that have dichotomous options. I/E (introvert/extrovert), N/S (intuitive/sensing), T/F (thinking/feeling), and J/P (judging/perceiving) (Myers‐Briggs and Myers 1980; Myers‐Briggs 1993). With four different letters in each of the dichotomous choices, there are 16 combinations. The most predictive of behavior is the middle pair. Therefore, most analysts look at the middle pair of letters together. There are abbreviated versions of the MBTI survey instrument online so you can get a taste of the concept. However, if you want to dive in, it is most helpful to get the full MBTI picture with the purchased and professionally assessed version, as each person's categorization of the four characteristics will fall along a continuum. For example, while I categorize as an extrovert, I am fairly close on the continuum to crossing the line that would then classify me as an introvert.

       “OK, now I know my full type, but I don't know what type other people might be. How do I figure that out? It's not likely that everyone has done these assessments, and wouldn't it be prying to ask everyone what type they are anyway?”

      Yes, so let's look back at the chairs I introduced earlier. The first chair bowled me over with intensity and eagerness to talk. Not being impolite, just being more of an (E) extrovert. The next chair seemed almost uninterested in the discussion, speaking only when spoken to and not volunteering unasked but applicable information. He was not disinterested or lacking in ideas, just demonstrating more of an introvert (I) approach.

      Then came along the statistics‐focused chair (most likely ST) and then the stories/people‐focused (most likely NF) chair. Here were two very different emphases selected from the exact same shared experiences.

      How about that chair who never seemed to settle on a final determination of what were the most significant issues for the COM? I have come to learn that is much more of a “P‐perceiving” approach as opposed to a “J‐judging” approach in the MBTI spectrum. As a strong J, I was always frustrated by the person who could not seem to pick an answer. After studying more about personality approaches, I came to see that the strong P was doing a more thorough job of bringing up some additional viable options in a situation, even better than I did.