The document discusses the need for leadership in anesthesiology as the healthcare landscape changes with new technologies and rising costs. It emphasizes that anesthesiologists are well-suited for leadership roles due to their holistic view of patient care and experience working in teams across the hospital. The author outlines strategies they have implemented in their department to develop the next generation of physician leaders, including strategic planning, mentorship programs, and ensuring new faculty have protected time for research and leadership activities.

1. Why we need Anesthesia Leadership
in the changing landscape of
Healthcare
Colin J.L. McCartney
Professor and Chair
The Ottawa Hospital and uOttawa

2. Conflicts of Interest
• None

4. Medical Leadership in Canadian
Healthcare
• Subtly different from US
• More influencer than power broker
• Can be exposed to “mutiny in the ranks”
• Still requires a vision, persistence, resolve
• This is a work in progress for me

5. Why we need leadership
• North American healthcare no longer the best
• Changes in Healthcare looming e.g.
personalized medicine, artificial intelligence
etc.
• Physicians and others at the coalface need to
be leading the change

6. Commonwealth Fund Ranking 2014

9. Why are anesthesiologists good
leaders in medicine?
• Holistic view
• Always work in teams
• Work right across hospital and university
• Think first as a physician and then as
anesthesiologist

10. Anesthesiology leadership
• Leaders in perioperative care
• Leaders in care of the critically ill
• Leaders in pain medicine
• Leaders in managing teams
• Leaders in quality and safety

11. What we need in anesthesia
• Grasp the opportunity to lead perioperative care
and pain medicine
• Act like physicians and not only anesthesiologists
• Leaders who are involved right across medicine at
both hospital and university levels (if you’re not
at the table, you might be on the menu)
• Lead in education and research in the areas
above

12. What I need you to do
• Step up to lead positive change: get involved
• Focus our efforts on others: our patients, our
learners and work with our political leaders
• Be critical in a constructive way
• Develop our “followership”
• Support our provincial and national societies
• Support our research and developing the next
generation of great anesthesiologists

13. Role of the Leader
• Develop a vision (with others)
• Challenge the status quo
• Accept risk (difficult for anesthesiologists!)
• Have nobility
• Be transparent
• Have integrity (be yourself)
• Have courage

14. Who are natural leaders?
• Leaders are “made not born”
• Both extroverts and introverts
• Not necessarily the person with the title
• Leaders at every level of medicine from
undergraduate through to post-certification
• A passion for positive change
• ”Willingness to get involved” Angela Enright

15. Leadership and the importance of the
first follower

16. Characteristics of a leader
• Servant leadership: Vision, Passion, Honesty,
Integrity, Humility Transparency, Courage,
Challenge others, Accept risk, Nobility
• Listen
• Be the optimist
• Seek advice (often): we all need a coach
• “Be the light” for the academic mission
• Make mistakes (but learn from them)

17. leader

18. Ron Miller: Rovenstine Lecture 2009
• Opportunities in perioperative medicine
• Not all current opportunities will be
remunerated well
• Importance of research in anesthesia,
perioperative and pain medicine
• Answer the big questions
• ”we are all trying to find our way but some are
looking at the stars”

20. What have we done in Ottawa?
• Strategic planning process in 2014-15
• Strategic hiring process “Get the right people
on the bus”
• New faculty mentorship process: help our new
recruits to academic success

21. Strategic Planning

22. Strategic Imperatives
• Enable the best patient outcomes
• Advance the full potential of anesthesiology
• Active Stewardship of Team Members
• Responsible Stewardship of our resources

23. Quadruple Aim

24. Getting the Right People on the Bus
• Set the tone: Strategic planning,
Democratization of Process, Maintain
momentum
• Careful selection criteria for new faculty
• Explicit mention of mentorship planning
process
• Formal interview process

25. Three Criteria for Success
• The Individual: rigorous selection process (two
way process)
• Mentorship: three year plan developed with
faculty advisor and mentor
• Time: 1 day per week for non-clinical activities

26. Faculty Mentorship and Development

27. Multipliers: How the Best Leaders
Make Everyone Smarter
Liz Wiseman

28. Benjamin Disraeli 1804-1881
• “When I left the dining room after sitting next
to Mr. Gladstone, I thought he was the
cleverest man in England. But after sitting next
to Mr. Disraeli, I thought I was the cleverest
woman in England”

29. Multipliers

30. Mission and Guiding Principles:
Appoint the Best and Help Them to
Success
• “The Department of Anesthesiology at the University of Ottawa is
committed to growing as a leading University Department of
Anesthesiology, both in Canada, and internationally. Key to this goal
is supportive investment in the people who comprise our
department. As such, we have created an early career faculty
development and mentorship program to enhance the success and
development of new faculty to become outstanding academic
anesthesiologists. This program aims to provide a supportive,
collaborative, and collegial environment to ensure the success of
each new faculty member. Inherent in this mission is the explicit
recognition that individual success will require Department-wide
support and our successes will be shared successes. The aim of this
program is to appoint the best and help you to success.”

31. Mentorship Plan Structure
• Areas for professional development include
leadership, scholarship, education and clinical
care
• One primary goal or three secondary goals to be
achieved
• Goals are to be Specific, Measurable, Attainable,
Realistic and Timely (SMART)
• Review at every six months with faculty advisor
• Aim to achieve promotion to Assistant Professor
at end of three years

32. Advice from my mentors
• Pursue your passion
• Set goals
• Take time to invest in your passion
• Find great mentors
• Think of others before yourself
• Surround yourself with positive people
• Look after your health and your family

34. Advice from great leaders
• Change takes time
• Build trust first (takes years not months)
• Protect and support what is already good
• Use the power of the group to institute
change

35. Advice from my mentors
• Pursue your passion
• Set goals
• Take time to invest in your passion
• Find great mentors
• Think of others before yourself
• Surround yourself with positive people
• Look after your health and your family

36. Early Results
• Engaged junior faculty
• Faculty have requested to join program
• Care required with early overload
• Care required to maintain environment of
support
• Thought required for extension of process

37. My priorities:
• Departmental strategic plan
• Departmental structure to leverage our
talents and contribute to patient care
• Pain medicine
• CBD and education
• Mentorship program
• My family and maintain health

38. What we need in anesthesia
• Grasp the opportunity to lead perioperative care
and pain medicine
• Act like physicians and not only anesthesiologists
• Leaders who are involved right across medicine at
both hospital and university levels (if you’re not
at the table, you might be on the menu)
• Lead in education and research in the areas
above

40. Suggested reading:
• 5 Levels of Leadership: John Maxwell
• Good to Great and the Social Sectors: Jim
Collins
• Multipliers: Liz Wiseman
• The Advantage: Patrick Lencioni
• Churchill: Roy Jenkins

41. Leadership Challenges 1:
Communication
When I was a new minister, a seasoned
minister came into my office. She said, “How’s
your day going?” I said, “I am so frustrated. I
have the newsletter to work on, my sermon to
write, and all these other things to do- but
people keep calling with all these
interruptions.” She said, “The interruptions
are your ministry. The rest is just paperwork.”
Michelle Crouch

42. Leadership Challenges 2: Balancing
Department and Hospital
• Think vertically and horizontally

43. Leadership Challenges 3:
Managing Disruptive Behaviour
• Give timely feedback
• Align with institutional code of conduct
• Vital to manage microaggressions to reduce
greater issues of toxicity
• Follow Vanderbilt model for professionalism
• Document carefully but if no recurrence……
• Forgive and forget: everyone has a bad day

44. Vanderbilt Professionalism Model
Hickson et al Acad Med 2007

45. My Failures
• Block room at general campus
• Balancing “support” and “micromanagement”

46. My priorities:
• Departmental strategic plan
• Departmental structure to leverage our
talents and contribute to patient care
• Pain medicine
• CBD and education
• Mentorship program
• My family and maintain health

47. Leadership Challenge 4: Balancing
work and family
• Put family first every
time
• A firm foundation
allows to take on
necessary challenges
at work
• Take time for yourself
• Enjoy the challenges

48. Guidance for future leaders
• Be yourself
• Train for leadership: conflict resolution/crucial
conversations
• Follow your passion
• Keep saying yes/get involved
• Think outside the specialty
• Serve your patients not your CEO/Dean (and
therefore also your colleagues)

49. Other Resources:
• https://www.kevinmd.com/blog/2018/
08/5-reasons-you-should-put-
physicians-in-charge-of-hospitals.html
• https://www.kevinmd.com/blog/2015/
12/6-tips-great-physician-leader.html
• http://www.edmariano.com/archives/8
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