My impressions of why we need to develop and support great leaders in anesthesiology and pain medicine

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

3. Are you a natural leader?
A. Yes
B. No
C. Not sure

4. Why we need leadership
• Canadian healthcare no longer the best
• Changes in Canadian Healthcare looming
• Physicians need to be leading the change

5. Commonwealth Fund Ranking 2014

8. 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

9. 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

10. What we need in anesthesia
• Grasp the opportunity to lead perioperative care
and pain medicine in Canada
• 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

11. Barriers to leadership in anesthesia?
A. Lack of mentorship
B. Lack of remuneration
C. Lack of opportunities
D. A+B
E. A+B+C

12. What gives me this platform?
• No training
• No previous experience
• A passion for best care of our patients: clinical
care, education and research
• A belief in challenging the system in a
constructive manner
• Being comfortable with discomfort

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
• 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
• In Ottawa: Dan Dubois, Leo Jeyeraj, Dan McIsaac,
Jason McVicar, Patrick Wong and many others

15. leader

16. 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”

18. 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

19. Strategic Planning

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

21. Enable the Best Patient Outcomes

22. Advance the Full Potential of
Anesthesiology

23. Active Stewardship of Team Members

24. Quadruple Aim

25. 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

26. 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

27. Faculty Mentorship and Development

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

29. 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.

30. Multipliers

31. Wiseman L et al Academic Medicine 2014

32. 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.”

33. 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

34. Mentor vs faculty advisor
• Mentor: a trusted colleague who gives
confidential advice on career guidance. Not
necessarily more senior or in same specialty.
• Faculty advisor: individual who creates and
assesses success with academic plan
• My own mentors: Vincent Chan, Joel Katz, Bob
Byrick, Brian Kavanagh, Beverly Orser and others

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

37. 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

38. 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

39. 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

40. What we need in anesthesia
• Grasp the opportunity to lead perioperative care
and pain medicine in Canada
• 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

41. What we need 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
• Support the leadership structure in medicine to
encourage participation

43. Are you a natural leader?
A. Yes
B. No
C. Not sure

44. 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”

45. 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