Brian Bolwell, MD, on Challenges Leaders Face in Academic Medicine

Q: In our last Q&A, you addressed using a serving leadership style to lead through change. Remind us what you mean by serving leadership and why you believe it’s important.

Dr. Bolwell: Serving leadership is more of a viewpoint. It’s a belief that the team is more important than the leader as an individual. And that core belief leads to what I think are the central tasks of a good leader. First, you have to set and communicate a clear vision. That is harder than it sounds, especially since that vision tends to evolve over time as mine has for the Cancer Center.

Your next job is to be very involved in the process of recruitment. You want good people who understand or who are willing to understand the vision. Then, give them what they need to succeed, and remove barriers. Addressing challenges, which frequently are political, is a huge part of being a serving leader.

And if you do these things, your team will succeed. And that success needs recognition, and as a leader, you should be enabling but not participating in that recognition. It’s not about you.

That’s certainly the kind of leadership style I aspire to.

Q: What’s unique to leading an academic medical center?

Dr. Bolwell: Academic medicine rewards people who celebrate their own work. That’s how you get grants, that’s how you get promoted. Success is defined by individual accomplishment. But if you’re a serving leader, success is defined by the team. Those are two very different things.

I think that often in academic medicine people who excel individually are elevated into leadership roles that require very different skills, skills that aren’t practiced or rewarded in individual careers. Frequently, leaders in our field don’t do as well as they otherwise could because they’ve historically been rewarded for individualistic work. And that in my mind is exactly the wrong thing to do as a leader of a big organization.

Leadership is not in any way, shape or form about your own personal success. I’ve frequently said that I don’t think a leader should be first author on any paper once they have a leadership position, and I really believe that to be true. But that’s very hard for a lot of people to do. But if you’re going to lead successfully, you’ve got to let other people do that.

You’ve got to be okay recruiting really, really good people, even if it means that your own personal recognition will diminish.

Q: How do you go about setting a vision for an organization? You noted that it’s more complicated than it sounds.

Dr. Bolwell: Well, it is. I think you have to walk the walk, first. You’ve got to demonstrate to everyone what your own personal priorities are. Our focus is the delivery of great clinical care in a compassionate and empathetic way, and it’s my job to keep that front and center. It’s our single most important priority, and that’s why we care so much about access.

You also need to build a culture around those priorities. One of the things we do is circulate patient stories to everyone who works in the Cancer Center, from the front desk staff to researchers. It reminds people that there is a gravity to what we do, a seriousness, and it’s very important that our staff stay focused on the patient’s perspective. For patients, their cancer journey is far and away the most important thing in their lives. This isn’t like coming in to check up on a cold. This is life changing. So I think one of the crucial aspects of leading a cancer center is to continually elevate a culture that centers empathy and excellence.

Q: In our last interview you mentioned that you’ve read more than 40 books on the topic of leadership. What do you think those books miss that has been really important to your leadership style?

Dr. Bolwell: There are a few things, but one of the most important is courage. If you’re going to be an effective leader, you’ve got to do the right thing.

I remember being on weekend service with a very challenging attending during my fellowship. We had a very sick patient, and we needed something done. Everyone else was more than willing to wait until Monday. But this attending went into his office and made innumerable calls to other attendings in the organization to make sure the patient got what they needed right away. He was really passionate about that, and that moment reinforced in me that it is important to advocate for your patients.

He had the courage to do what needed to be done, even if it bothered other leaders on a weekend. In addition to advocating for patients and for your staff, being able to do what needs to be done generates respect, loyalty and trust from the people you serve.

Q: What’s your best advice to existing or aspiring physician leaders?

Dr. Bolwell: Study the subject. I mean, if you’re a leukemia doc, you had to study and know everything there is to know about leukemia. It’s the same with leadership. Some people make the mistake of not studying leadership and just assuming they know everything. I made that mistake myself in the beginning.

But the more you can learn about a topic, the better you can get. You can teach an old dog new tricks as long as the old dog wants to learn; if you want to be a better leader, you can if you work at it. That’s my best advice.