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While this entire definition is important, there are two keywords that not only run to
the heart of leadership, but can be the measure of one’s effectiveness as a leader, i.e.,
the words “want to.” People can be trained to do things, afraid not to do things,
prepared to do things, and paid to do things, but do they want to do them? When
they want to, they will not only take on the task, they will work very hard and persist
in the face of difficulty.
Leaders turn people resisting change into “willing followers.” The tools they use
include action plans with clear goals, priorities, timeframes, and targets. They mobi-
lize people to be willing to cut budgets, outsource labs, retreat from some service
lines, and consolidate suppliers, because they understand the rationale for making
difficult decisions to fix the organization. They persuade key people that the current
situation requires difficult and painful changes in order to get to a future situation
that fulfills the mission or accomplishes a goal everyone aspires to achieve. Later in
the chapter, I will discuss how this happens. Next, I turn my attention to understand-
ing whether surgeons are prepared to be leaders and what it means for a surgeon to
lead. I will draw on the sports metaphor of the player-coach.
The Surgeon as Leader^13
Surgeons are uniquely positioned to be leaders, but are they prepared? Robert
Goffee and Gareth Jones once posed the most troubling, look-in-the-mirror, ques-
tion posed to professionals—“why should anybody be led by you?”^14 They argued
that not everyone can be an inspirational leader, and yet authentic leaders are found
at every level in an organization. Every surgeon should ask themselves this ques-
tion, because if you cannot manage yourself, you cannot manage others [ 22 ].
Next, to further explore the surgeon as leader, I will raise the following questions:—
Is it possible to be both a player and a coach? Is it possible for leaders to continue to
practice medicine? I will give an example of one leader trying to play both roles.
A New Imperative: Every Surgeon a Player-Coach?
What does it mean to be a clinical leader? One of the best examples of a clinical
leader is Dr. Tomy Mihaljevic, MD, a practicing thoracic surgeon and the former
CEO in Cleveland Clinic Abu Dhabi (CCAD).^15
Being an MD-CEO required being both a team player and a coach, taking on
multiple roles—clinical leader, cardiothoracic surgeon, chief strategist, visionary,
and figurehead. While being CEO and a physician is daunting, he would not have it
any other way. Dr. Mihaljevic explained:
(^13) When we try to answer the question, “what is leadership,” it is as difficult as answering the ques-
tion “what is surgical quality?” Like quality, leadership is multidimensional (see [ 11 ]).
(^14) Goffee and Jones [ 27 ].
(^15) This section is based on my interviews with Dr. Mihaljevic between 2014 and 2017 and my case
study of CCAD.
J.A. Chilingerian