“When you’re just starting out and you have this sense of, ‘You know what? I think I could be a leader.’ First of all, don’t ignore that voice.” -Dr. Inga Lennes
In this episode, Coach Jill Farmer talks with Dr. Inga Lennes about physician leadership, the leadership qualities you innately have as a physician, and what skills you need to become an effective leader. Dr. Lennes is the Senior Vice President for Ambulatory Care and Patient Experience at Massachusetts General Hospital and for the Mass General Physicians’ Organization. She is also a practicing thoracic medical oncologist with an MPH and MBA. We are thrilled to have her on the podcast to share her wealth of knowledge on leadership. Whether you are in leadership now or you hope to be in the future, you will gain a lot from this episode!
Books mentioned in the show:
The Corporate Lattice: Achieving High Performance In the Changing World of Work by Cathleen Benko & Molly Anderson
There’s Not Enough Time:…and other lies we tell ourselves by Jill Farmer
Dr. Inga Lennes is the SVP for Ambulatory Care and Patient Experience at Massachusetts General Hospital and for the Mass General Physicians’ Organization. She is a practicing thoracic medical oncologist and quality of care researcher and formerly the Medical Director of Ambulatory Services and the Director of Clinical Quality at the MGH Cancer Center. She went to the University of Massachusetts Medical School and completed internal medicine residency training and chief residency at Beth Israel Deaconess Medical Center. Dr. Lennes completed a fellowship in medical oncology at Dana Farber Cancer Institute and joined the MGH and Harvard Medical School staff in 2009. In 2011, she earned her MPH from Harvard University and completed her MBA at MIT in 2014. Areas of interest include defining quality improvement metrics for oncology care, improving efficiency in oncology care delivery and integrating electronic health record technology into routine oncology visits. Her areas of research interest include outcomes related to supportive care of cancer patients and measuring the quality of oncology care.
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Please enjoy the full transcript below
Inga: When you’re just starting out and you have this sense of, “You know what? I think I could be a leader.” First of all, don’t ignore that voice.
Jill: Hello and welcome to DocWorking: The Whole Physician Podcast. I’m Jill Farmer, one of the lead coaches at DocWorking. Today, we are talking about leadership in physicians and ways that you can help find your inner leader, and also work on some of your vulnerabilities when it comes to developing as a strong leader. We have the absolute perfect person here with us [chuckles] today, in my opinion, to talk about this.
Dr. Inga Lennes is a physician as well as an MPH and MBA. She is the Senior Vice President for Ambulatory Care and Patient Experience at Massachusetts General Hospital, and for the Mass General Physicians Organization. She’s a practicing thoracic medical oncologist and quality of care researcher, also formerly the Medical Director of Ambulatory Service, and the Director of Clinical Quality at the MGH Cancer Center. Not only is she a trained physician, but she is a trained leader with a Master’s in Public Health from Harvard, and an MBA from MIT.
A thing or two about leadership, somebody I’ve known a long time, and I really appreciate you sharing your expertise with us today. I know that you will say that often doctors don’t recognize that they have a little bit more leadership foundational strengths than they know they have. Can you talk a little bit about that for us?
Inga: Sure. First, let me say, Jill, thanks for having me. This is such a pleasure to be here on the DocWorking Podcast. Yeah, I teach leadership in our Physician Leadership Training Program at Mass General. One of the things that I like to talk to doctors about are some of those skills that they don’t even know that they have that are superpowers. I think that goes back to some of our training. Physicians have a long road for training. Part of that training, when we become early doctors or residents, is making decisions rapid fire, very quickly, and then observing an outcome. Someone once told me, “You’re sort of like a mini scientist,” because we’re making decisions for patients, we have to be attentive to the outcomes. And then, we have to be able to leave the prior decisions behind, to be open to what we are hearing, the data that we’re collecting, what we’re finding out, and we have to make new decisions.
It dawned on me that this is something that there’s lots of other people that work very hard to develop that skill set, to be able to make quick decisions, to be not too tied to the outcome, and then to think critically about what they’re learning and to make new decisions. I think that is just really ingrained in how physicians are trained. So, when we join leadership positions, I think it’s something that is underrecognized as a strength of physicians.
Jill: At the same time, I know we’ve had conversations on the podcast about it from different physicians, there’s historically been this idea that sometimes the smartest people get promoted, but they’re not necessarily the best people leaders. How do we adjust those two things with people having some, just by the very nature of training, some foundational skills that are really integral to good leadership? In this case, as you said, being decisive and being able to adjust outcomes as the algorithm changes, so to speak. And how are we changing in medicine, the idea that sometimes people just get promoted based on how smart they are, [chuckles] not on how good they are at leading people?
Inga: It’s such a great point, is that the face of physician leadership is changing as we see more people who are dedicated to honing the craft of leadership and to really developing skills. I said before that I think physicians come with this innate training that makes them very good at some parts of leadership. I also think there’s some parts of our profession that can also hold us back in leadership positions. Part of that is, like you said, the history of the way that physicians have been promoted traditionally, is for academic achievement, or for clinical productivity, or for some other standards that may have some bearing on leadership, may make you a really good individual contributor, but not a great leader of people.
These new skills of leadership, I mean they’re not new, they’re old, but now, I would say newly recognized, being a great communicator, being a fantastic listener, being able to be emotionally intelligent, to be able to hear something that you might disagree with, and to hold your fire for a little while to be able to really think about something, and integrate it into your decision making, these are not always characteristics that physicians are known for, I will say, but I do think that they’re important for the new generation of physician leaders. Oftentimes, again, I do think that we have that superpower of being able to make good decisions and not being too wedded to the outcome. But there are other places where we really have to have dedicated effort to develop those skills like a muscle. Like a great concert pianist, they don’t show up to do their concerts having never practiced. Even people who are very good at something need to take some time to reflect, and to work on those vulnerabilities, those blind spots that we all have.
Jill: In your opinion, are things moving in the right direction? From what I’m hearing, you’re saying, this is me reading between the lines, so you can tell me where I’m wrong. Part of what’s changing is that we kind of had a model of what a physician looked like, what gender they were [chuckles] in many cases, and what leadership looked like, which was my way or the highway thinking around this. Do you think that as healthcare systems, hospitals, practice groups look for more diversity in who is stepping into leadership positions, that is having an effect on what leadership strengths are being recognized and honed as well?
Inga: Absolutely. I see that in the people who are being promoted and hired around me. I see it across the country and in all areas of our business, and in other businesses as well. I think as the table is getting expanded, and we see more diverse voices come to the table, the ability to listen is something that we value more and more. Also, the ability to partner to make change in complex environments, and to distribute credit, I think those are some of the new foundational skills that we see emerging in healthcare leaders, and to do that all in a very multidisciplinary way.
I work for a physician’s organization, and I’m fond of saying I represent the physician voice. But that physician voice has to be partnered with people who come from all parts of the hospital system in order to make effective and lasting change. My highest compliment is when I hear from my colleagues, from our advanced practice providers, or nursing, or other parts of patient care services, or the administrative teams, I hear from a young, emerging leader, in those groups who says, “I’ve learned something from you. I count you as a role model,” those types of complements when they’re cross discipline, I think, are so meaningful, because I do think that as physicians, and especially physician leaders, we’re leading a healthcare team, and that’s the important part of understanding this, is that it’s a team. I think the more that we can position ourselves as leaders of that team, not just of our discipline, I think that the better it is for physicians in general.
I think it’s also, as individual leaders, it’s much more fulfilling. It’s just a nicer way to work. Like, I always say, I was like being part of a team. So, thinking about that, and being very deliberate in the way that we hold ourselves, the way that we communicate who we connect with, I think is so important, and for the future as well.
Jill: Yeah. It’s depressurizing in its own way, because that’s where a lot of times, especially younger physicians, when I’m working in a coaching relationship with them, and they’ll say, “I don’t think I’m ever going to be “good enough to be a leader” or division head or chief,” or whatever those kinds of aspirational goals are. I think what I’m hearing you say, is if we start at that day to day practice of how are you leading yourself, and how are you modeling meaningful behavior, at every interaction, whether it’s the janitor, a colleague, somebody else on support staff, patient. I like what I’ve heard you say before, there’s a stat that the percentage of physicians that don’t mean to, but they tend to interrupt patients before they really hear what patients are telling them and that impacts patient outcomes, I’m thinking that if you start honing your leadership skill by just practicing being a better listener, every day on your patients, that’s going to actually translate into leadership later. Tell me where I’m wrong or if I’m extrapolating too much there.
Inga: No, I love that. I learned that in medical school. The dean, the leader of my medical school at UMass, Dr. Lazare, published a paper, he’s a psychiatrist. This was many years ago, and it was seminal at the time, because it showed that, as healthcare providers, as physicians, we interrupt our patients within 30 seconds of them starting to speak when we see them in the office, and that has downstream effects in the ability for patients to connect with us. It’s just such a great lesson in life in general. But I love what you said about young leaders. I get asked the same question, and there’s lots of people, very forward thinking, thinking about the accomplishments they need to tick off or what they need to do. In playing in bigger and bigger stages, on bigger stages I should say, my best advice, and it’s been foolproof so far, is that one of the best ways forward is to do what you’re doing now really well.
When I hire, I hire for people who are doing their current job very well. If you’re thinking too much ahead of playing chess and a few moves ahead, I think sometimes you can take your eyes off what is right in front of you. Like you said, building connections, that foundational connections with the people that you work with now, showing that you are a collaborator, a great listener, some of these building blocks of leadership, if you start to work on those foundational building blocks, the rest comes. People gravitate towards your energy and want to work with you.
And then, the issue is just saying yes to the things that you’re interested in. So, that’s the other question I get is, I have lots of opportunities that can go this way or that, and really putting your energy into the things that you care about, because I think if you work on those foundational building blocks, the opportunities come to you. And then, it’s just picking the opportunities that aren’t just good on paper, but speak to you in terms of your vocation and what you want to do in life. If you put some energy into those things, I think that it tends to make the rest of your career flow in a way that makes sense. You might zig left and you might zig right, but all of these building blocks are building towards the future that you’re hoping for.
Jill: So much good stuff there. You can rewind that everybody and listen to it one more time. You’re going to have a really good foundation for setting yourself up to be a leader. One of the other things that I hear happening sometimes in that vacuum of, “I think I want to do some type of leadership,” or “I just don’t know how to be a leader,” kind of conversations I’ll have with physicians, and not just young physicians. Sometimes, it’s just people been doing it for a while and saying, “Ah, I think I could be part of leadership, but I don’t even know how to do it.” Is this idea that there’s a step-by-step process, and then you become a leader, and then you are going to be good enough at it, and you won’t make any mistakes. As Glennon Doyle would say, the brutiful aspects of leadership and it’s brutal at times and beautiful at other times is, it is dynamic, and it sometimes is messy, and we do have to have some conflict. We do have to have some courageous conversations. We do have to have really smart people who have sometimes differing ideas of the results that they’re trying to achieve, and we need to compromise and blend and be strong and do all kinds of things.
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What are your thoughts for people that think that there’s a formula or once they figure it out, it’s smooth sailing?
Inga: Well, my life has taken a lot of twists and turns. I was just telling someone this that if I could go back and tell you all the things that I thought I was going to do with my career, and almost none of them have happened. Other really great things have happened. So, I think being open– The other thing is, sometimes when you’re just starting out and you have the sense of, “You know what? I think I could be a leader.” First of all, don’t ignore that voice. Women especially take that voice and they say, “Oh, that’s too much. I shouldn’t say that. I’m being a little bit ahead of myself. I’m being a little bit too forward.” “It’s not becoming for a woman to sort of think, oh, I could be a good leader.” First of all, don’t ignore the voice.
Second of all, it’s hard to just pop right into a leadership role, like you said. You have to demonstrate leadership qualities, and then take advantage of a leadership opportunity. If you think about it in that order, how am I going to demonstrate that I am a fantastic leader, and then you can start to go pull those opportunities towards you, ask about leadership opportunities, look into starting something yourself, maybe there’s a program that needs to be started that never has been started before, start the program, start to look for collaborators. There’s probably a little bit of work, a little bit of elbow grease that might need to be put in before you’re a named leader. Being aware of that, I think, and getting that balance right of demonstrating your leadership qualities and then looking for leadership opportunities is the beginning part.
Once you get a few of these, it’s like, “How am I going to do this job really well, so that it gets me to the next stepping stone, and I’m keeping my eyes on the horizon?” But like you said, you don’t have to be perfect. Part of the biggest lessons that I’ve ever learned, and the things that have propelled me forward are in times where things didn’t go as well as I had hoped. They really caused a change or I had to take step back and say, “What’s working and what isn’t working? What are the things that I need to practice that I need to get better at?” And then, having faith that I’m going to get another chance in the future, to retool, to make myself better, and to be ready for the next opportunity. I think that if you really are foundational, you’re thinking about your skills, demonstrating your leadership, it’s being ready for the opportunities that come your way, and then taking advantage of them when they come.
Jill: Such good stuff. One final thought I want us to play with a little bit is, I think sometimes people have an idea that there’s this linear ladder kind of way, like, “I need to get to this title and this title,” and that’s sort of success in that linear fashion. What I’ve had the experience, again, with some fantastic physician clients is sometimes helping them as a trusted thinking partner to recognize that, even though the next step is to be X leader, a lot of times what they’re really fascinated with, or what they’re really passionate about or interested in, is leading something else that isn’t necessarily in that linear job title. So, broadening the definition of what leadership is, as you talked about it leading in daily life, just in every interaction, thinking about how we can be a meaningful role model, and lead with equity and inclusion and all of those things, but also, that sometimes it’s okay to step off that ladder and think about how you lead change, how you lead improvement, how you lead in those areas can be meaningful as well. Can you talk a little about that?
Inga: One of my favorite books that I read– well, other than yours, Jill. [chuckles] There’s a book, I forget the author’s name, but The Corporate Lattice is what it’s called, and it’s a book that I grabbed when I was in business school that talks about how, like you said, we can really hurt ourselves thinking about the ladder, and the next rung up and the next rung up, and that really successful careers of transformational leaders are not linear. They actually are turned on their side 45 degrees, and you’re moving, gathering skills in one direction, and then gathering skills in another. But over time, overall looking at the lattice, we’re moving up, so to speak, but it’s not straight up.
One of the most important messages I have is that that is a stronger foundation for a successful career than going straight up the ladder. I firmly believe that. Some of the most transformational and important leaders that I’ve seen in healthcare, they have done a variety of different things, and they’ve taken on special projects or been a committee member. This is the other thing, is that in this day and age, being an effective member of a team is also a leadership muscle. There are certain times when I joined committees where I have to say to myself, “You’re not here to lead this, you’re here to support the person who’s leading this and to make it a successful outcome.” To me, I look at that when I hire is people who can move in and out of both roles, because of the matrix nature of healthcare, that is an essential skill.
So, you should not feel bad about the trajectory up the ladder. If you’re moving to the left, moving to the right, gaining skills, creating that foundation of great leadership skills, the ability to move in and out of leadership positions, and to support the project and the outcomes, those are the things that are going to take you so far, and also not just far, but the places that you want to go, and that might be different. We have to be really mindful of those language things, like, going up the ladder and going far. That all doesn’t matter if it’s not in a place that you actually feel fulfilled by and that you want to go. So, listening to those voices and being mindful of those skills are really important things for future leaders.
Jill: Yeah. We talk about it a lot because we have various conversations. For those of you who have listened to the podcast a lot, we talk about the research around burnout, and doing work that matters to you has a more direct result on sustainable work as a physician often than doing the high achievement things, checking off the list that feel extrinsically disconnected. I think that lattice concept is just a powerful way to think about impact for yourself, impact on others in a meaningful way that’s going to be a really healthy way to create sustainable career longevity for yourself as a physician as well.
Dr. Inga Lennes, you gave us so many good things to think about. To recap a couple of keys and takeaways for you guys. Remember that the nature of your medical training probably gave you a good foundation for a key leadership skill, which is decisiveness and the need to be able to come in and make decisions and to pivot on the fly at times based on the best information available. That’s actually a foundational leadership skill that can serve you. So, you’re starting with some keys that maybe other people outside of medicine don’t have as naturally as you do. At the same time, there may be vulnerabilities when it comes to leadership, like sometimes that decisiveness and wanting to move quickly, can be a vulnerability. So, working to be a listener, to be inclusive, to take different perspectives in, is another way that you can constantly be in the dynamic process of building your leadership skills.
And then finally, Dr. Lennes gave us this idea of the lattice. We’re not necessarily supposed to be just climbing up the ladder in a linear way that’s a step-by-step process, but to be open to building skills, collaborating, finding what matters to you, and not just what somebody else says you should be doing in terms of growth, when it comes to leadership can be powerful as well. Dr. Lennes, anything else that you want to leave us with in terms of final thoughts for today?
Inga: Well, thanks, Jill. It’s been so great to be here with you. I would leave your listeners with the thought that I think that being a physician is a noble profession. I am proud every day that I come to work and get to do the work that I do with patients and in the healthcare system. In this past couple of years with the pandemic and also the pressures that we have for healthcare in general, there’s a lot of what I hear from many physicians, especially younger ones, and some older physicians who feel very burned out is that the profession has changed, and that it’s not the same anymore, and they’re feeling negative. I would say that if there’s a way to connect with the pride that you feel in the work that we do, and how important it is, and some of the feelings that you had when you graduated from medical school and when you started on this road, those things still exist. They are in our hearts. Our patients look up to us, and so do many other professionals in the healthcare system. We should all feel very proud of the work that we do.
I take a little time sometimes to just tell my physicians that, that I work with, is that there’s still a tremendous amount of pride in the work that we do. It doesn’t mean that we don’t have work to do to be better leaders and to work on those skills like we are today. But if I could give you a virtual pat on the back and tell you that the whole world is so thankful for the work that we’ve done over the past couple of years, and that we need to take a deep breath, fortify ourselves, and keep going because everyone needs us to do the work that we do.
Jill: Dr. Inga Lennes, Oncologist, Physician Leader at MGH in Boston, thank you so, so much. And thanks all of you for listening to DocWorking: The Whole Physician Podcast. Until next time, I’m Jill Farmer.
Speaker: Stay tuned for more from today’s guest after this important message.
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