This document appears to be from a seminar given by leadership coach Leda Karabela at Stanford Medical School. The seminar discusses several topics related to change, including: - Physician morale is low due to loss of autonomy, bureaucratic red tape, and emotional burnout. - Younger generations like Millennials value confidence, connection, and openness to change, while older generations are seen to have a better work ethic. - Finding work you enjoy and connecting with a community can help deal with "tricky" situations. Different leadership styles should be considered depending on the person and situation. - Adapting to change and having an open perspective are important for individuals and organizations.

1. STANFORD MEDICAL SCHOOL
GASTROENTEROLOGY FELLOW SEMINAR
LI KA SHING CENTER FOR LEARNING AND
KNOWLEDGE STANFORD MEDICAL CENTER
LEDA KARABELA, P.C.C. LEADERSHIP COACH
WWW.YHESITATE.COM
NOV. 16, 2011 1

2. .
2
“Τα Πάντα Ρεί” (Ta Panda Rhee) *
Or
Some of The Things That Make You
Uncomfortable

3. IF YOU DON’T UNDERSTAND WHY I
ASK YOU SOMETHING, THEN,
DON’T ANSWER ME!
Questions
3

4. Some Background:
Coaching… &
Performance
“…She (the coach) never tells
you what to do. Instead, he
suggests to you, in an
extraordinarily inarticulate
fashion, what you want to do
yourself…."
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5. 5

6. Can You Handle It?
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7. Change: Facts and Data
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8. Sci-Fi or Reality?
8

9. Data & Apps Are King
9

10. VCs fleeing healthcare like female co-workers from Herman Cain!
“The primary reason
given for why firms are
running away from
healthcare is the vastly
more complex
regulatory environment
that has created a dark
cloud over the
biopharma and medical
device industries.”
CNN Money/Fortune Nov. 14, 2011 10

11. AND THE MOOD OF THE DAY IS…
Consequences
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12. Physician Morale Survey sponsored by the American
College of Physician Executives• Low reimbursement rates and
loss of autonomy were the top
two reasons for poor morale.
• Bureaucratic red tape, patient
overload, loss of respect and the
medical liability environment
were among the other reasons
physicians cited.
• Those work problems caused
fatigue in 77% of physicians,
emotional burnout in 67% and
marital/family discord or
depression in about one in three
physician respondents.
ACPE surveyed 1,200 physician executives - most seeing patients-
JANUARY 15, 2007 ISSUE OF AMERICAN MEDICAL NEWS.
WWW.AMEDNEWS.COM
• Physicians appear to be suffering
from relatively low morale
• Higher levels of frustration with
patients are associated with a
variety of non-patient factors,
including physician age, number
of work hours per week,
physician distress, and medicine
sub-specialty practice. to the
future management of
healthcare. *
• Nearly half of all medical
students report burnout **
12
US National Library of Medicine National Institutes of Health
* Characteristics of physicians who report frustration with
patients: an analysis of survey data. Krebs EE, Garrett JM,
Konrad TR.
** (Medical Student Stress Study by Dyrbye and colleagues 545
Minnesota medical students surveyed 2007

13. Singing The Blues
• "Our expenses continue to climb, our income drops, patients are
noncompliant and yet we are supposed to provide expert care 24/7 and be
perfect 100% of the time.“
• "Any job that requires an individual to listen to complaints for years on end
is unhealthy.“
• "I am concerned about the work ethic and general ethics of many
physicians today. All want very large $$$ but some don't really want to
work for it.“
• "In my 50 years in medicine I have seen the field degrade from being a
calling to a profession to a trade to a job.“
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14. No Wonder…
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15. 15

16. The Ups
16Drama & Kurt Vonnegut: http://sivers.org/drama

17. The Downs
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18. The Reality
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19. The World
and You
19

20. Just Count
20

21. How do you
deal with the
“tricky” stuff
in your life?
21

22. Back to the Basics: Needs That Drive Us
Certainty
Uncertainty
Significance
Connection
Growth/Need to Grow
Contribution
22

23. 23

24. PATIENTS?
PARTNERS?
TEAM?
YOU?
Who/What are YOUR walls?
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25. Let’s Start with You!
MILLENIAL:
• Confident.
• Connected.
• Open to Change.
Study by Pew Research Center, a nonpartisan “fact tank” that provides information on the issues, attitudes and trends shaping America and
the world. www.pewresearch.org/millennials. 25

26. 26
Others: Who Are They?

27. Values
• Nearly six-in-ten respondents cited work ethic as one of the
big sources of differences between young and old.
• Asked who has the better work ethic, about three-fourths of
respondents said that older people do. By similar margins,
survey respondents also found older adults have the upper
hand when it comes to moral values and their respect for
others.
• When it comes to each of these traits—work ethic, moral
values, respect for others—young adults agree that older
adults have the better of it. In short, millennials may be a self-
confident generation, but they display little appetite for
claims of moral superiority. 27

28. Back To You!
“Brand You, Inc. “
• Yo-Yo model vs. “40 year Womb to Tomb”
• Know your options. (What work feeds your soul).
• Find work you really enjoy. (You’ll be bored otherwise)
• Beware of perfectionism! Don’t fear failure, fear not trying.
• Think outside the box! “Recognize that the Innovation Age is quickly
building on and replacing the Information Age.” Daniel Pink
• Connect with a community of others you value and relate to. If you don’t
have that group now, find it or cultivate it – beginning now!
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29. Tune In To
“Your” People • Provide psychological safety
– Spark imagination, encourage
learning and create a safe zone
• Shield People
– Reduce mental & emotional
load and offer freedom to try
new things
• Make small gestures
– “thank you” a real neglected
form of compensation
“Authority figures who
ignore and stomp on their
subordinates’ humanity
sometimes generate quick
gains. But in the long run,
such shortsightedness
undermines creativity,
efficiency, and
commitment.”
McKinsey Quarterly, Aug. 2010, Why Good Bosses Tune Into Their People, Bob Stanton, Stanford University 29

30. Your _________
• What are his or her strengths?
• What are the triggers that activate those
strengths?
• What is his or her learning style?
“To question someone else’s reasoning is not a sign of
mistrust but a valuable opportunity for learning.”.
Chris Argyris, James B. Conant Professor at the Harvard graduate schools of business and education.
30

31. Style Matters
 Coercive: “Do what I say” demanding immediate
compliance
 Authoritative: “Come with me” mobilizing people to
act, offering choice for actions
 Affiliative: “People come first” building commitment,
team harmony/morale
 Democratic: gives voice /high on fresh ideas
 Pace Setting: exemplifies himself & sets high
standards , demands excellence
 Coaching: developing people for the future
Harvard Business Review , April 2000 Daniel Goleman: Leadership That Gets Results
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32. 32

33. Unorthodox Rx
• Positive Emotion (the pleasant life/well being)
• Engagement (did time stop for you)
• Relationships (and how we share life with other
people)
• Meaning (believing and serving something bigger
than yourself)
• Accomplishment/achievement (what you choose to
do for its own sake – without anyone forcing you to
do it).
33Martin Seligman: Flourish: A Visionary New Understanding of Happiness and Well-being

34. NO “I” IN TASK
Adopting a more inclusive/open perspective
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35. It is not the strongest of the species that
“…“It is not the
strongest of the species
that survives, nor the
most intelligent. It is the
one that is the most
adaptable to change…”
Charles Darwin
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36. HERACLITUS IS FAMOUS FOR HIS
INSISTENCE ON EVER-PRESENT
CHANGE IN THE UNIVERSE, AS
STATED IN HIS FAMOUS SAYING,
"NO MAN EVER STEPS IN THE SAME
RIVER TWICE".
Τα πάντα ρεί: "All things move and nothing remains still“ *
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37. 2c or not 2c
Open enough not to dismiss the
possibilities?
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38. Thank You!
Leda Karabela
www.yhesitate.com
leda@yhesitate.com
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