took the one less traveled by,
And that has made all the difference.”
—Robert Frost
Foreword
This might be the first book you will read about leadership, but if you are like me, a collection of books about leadership sits on one or more shelves somewhere in your home. The number of titles has likely increased over the years. The path to becoming a better leader is somewhat like finding the Templar Treasure in the movie National Treasure. There is always another clue—another book offering pearls of wisdom. I have my favorite authors, like John Maxwell and John Kotter, who've provided me with clues along the path.
One type of clue to better leadership has been missing. Until reading I hadn't actually thought about the absence of a book about leadership written for physicians by a physician. I have only one that comes close, Designed to Adapt by John Kenagy, MD. It isn't specifically a guide to prepare physicians for leadership roles but does offer the reader an opportunity to improve their leadership skills while outlining a model for improving our health care system.
Within the pages of my book collection and stuffed into other notebooks and files are my favorite go‐to leadership tools—part of the quest for the leadership treasure. I pull them out and use them when I'm experiencing a specific problem. The challenge with having too many tools in too many locations is the passage of time. It is easy to forget them if unused. In which book was that 2 × 2 table about decision‐making? It's always fun to discover them again and wish you hadn't forgotten about them in the first place.
I don't think I'm going to forget about this book. Why is that? The first is the author. Dr. Karen Nichols is an amazing individual. For me and many others, she is a combination of colleague, friend, mentor, and coach. She seems to possess boundless energy and always has time to listen and help others. Her sense of purpose never seems to waver, and her impact on others continues to grow, mostly because she lives leadership—exactly as described in her book.
The true leader is constantly growing—a lifelong learner trying to improve how they help and motivate others to do things they might not otherwise do. One might think we don't need another book about leadership, particularly a book describing yet another new leadership model. Most of us just need to get better at the basics. That is exactly what makes different.
It is written for physicians by a physician—providing very practical information on how to become a leader or how to become a better leader. I think the topic found its author in this work—an author who embodies the best of leadership in daily life. The construct is essentially a how‐to guide, filled with a summary of the best and most useful tools from other recognized works and original materials from the author applied to challenging situations that physician leaders will face. Along the way, the author weaves in the story of her remarkable life. She is passionate about osteopathic medicine and promoting women in leadership.
Its collective chapters remind me of one of those multipurpose tools that can help you out in many situations. You just have to know how each tool works and practice using them. For me, it may no longer be necessary to search through my books, files, and notebooks to look for a long‐lost clue. Dr. Nichols has assembled many of them in one location.
Karen has been writing this book her whole life. I learned (and remembered) a lot by reading it, and I am sure you will as well! You can't master it all, but a person wanting to be a stronger leader can keep trying. Perhaps derived from this work there is a great course ahead! I know that I would attend.
Robert A. Cain, DO
March 2021
Introduction: Best Practice in Medicine and Leadership Are Not Always the Same
You have been in practice a few years and you are invited to serve on a committee, in the hospital or in the practice group or in a health system. You serve with distinction, and you are asked to chair the next committee that is formed.
“Finally!” you think, “My talents and leadership skills have been recognized!”
But something goes wrong.
The committee doesn't listen to what you say. The committee wants to do something different than what is very clearly the right direction. The committee even questions your leadership! What is wrong with them? The committee achieves a semblance of the goal, and yet it's not the best it could be. Lesson learned. Get better committee members the next time.
The next time comes. You are again appointed to head up a committee. This time, you are more careful about whom you select for committee members. Of course, you don't get to select all the committee members, and now you know which people share a similar view of the situation and its focus.
It doesn't go well again! They don't LISTEN!! The people who had a similar view of the situation got swayed by those who didn't. What's that old joke? It's a zombie solution – it works, but badly. Another missed opportunity.
THIS time you're ready for the next new committee. You push to get all the best people appointed to the committee. They agree with your view; they will follow what you say, and you can get this moved through quickly.
They followed your lead, implemented your plan, pretty much, and guess what? Another zombie solution! You were the leader – you are a respected doctor, after all! What is wrong with these people??
You decide it is time to talk to your very kind and wise mentor.
“I don't get it! I know what I'm doing. I understand the situation. I explain it clearly, and it's still not working! I don't know how to get better committee members so we can get better work done!”
The mentor takes a moment for a deep breath. Then she says those fateful words:
“Maybe the problem isn't getting better committee members. Maybe the committee needs a better leader.”
Ouch!!
“I don't have time to read a lot of books or listen to podcasts. I don't have time to do a five‐day leadership conference! I am a very busy doctor, for heaven's sakes! My patients need me! Besides, I'm smart enough to figure out anything. In fact, that is what I do all day, every day!”
You begin to wonder if maybe that mentor is not quite so kind as you thought, when she says…
“You've tried leading three times already, so it would appear that if you could have figured it out, you would have done so by now.”
Double ouch!
Hence, this little book. This doctor is me. Unfortunately, I didn't go to a kind and wise mentor to get this good advice after just three tries at leadership. I've been a leader all my life. My three younger sisters still call me “bossy.” After one “instruction” session in the backyard, one of my sisters said, “You are not the boss of me!”
But I always assumed that I was! The evidence started early. In the Christmas pageant, I was one of the group of 4‐year‐olds who had been taught to sing a song as we marched around the entire 15‐feet oval area down front in the church where the pulpit was positioned. However, as each succeeding child followed the one ahead, they effectively cut off the end of the oval, in order to follow more closely the one ahead. By the time I was the next in line to walk around
