Latest / Flourishing in Medicine: From Surviving to Thriving / Flourishing in Medicine: From Surviving to Thriving Episode 23 Executive Coaching Insights for Healthcare Leaders with Charles Pfeffer

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Flourishing in Medicine: From Surviving to Thriving Episode 23 Executive Coaching Insights for Healthcare Leaders with Charles Pfeffer · Flourishing in Medicine: From Surviving to Thriving

0:00
I love that word that you used, oath. I think
0:04
that's such a powerful word. And there's something
0:07
about that word, oath, that to me connects with
0:11
something else you said earlier, which is authenticity.
0:15
And the bridge between authenticity and oath
0:18
for me would be purpose. So I think if I am the
0:22
kind of person who is prepared to take an oath,
0:26
I am the kind of person who has some clarity
0:30
about the connection between my own purpose and
0:33
what I'm applying that to. And I think if I am
0:37
someone who is seen by others as authentic, I've
0:41
found a way to align who I am with this purpose
0:45
and towards this oath. If I do that long enough,
0:50
it becomes my identity. It is who I am. Now,
0:56
if My ability to fulfill my purpose, words and
1:02
oath I've taken is disrupted. It's a bigger disruption
1:06
than if I just lost my job, but I can go get
1:10
another job. Welcome back to Flourishing in Medicine
1:15
from Surviving to Thriving. I'm your host, Dr.
1:19
Mick Krasner, and this podcast is produced by
1:22
EmPRO, a medical professional liability insurance
1:25
carrier. headquartered in New York State. EmPRO
1:29
is committed through their peer support programs
1:33
to help the physicians that they protect. This
1:37
podcast, Flourishing in Medicine, is really focused
1:39
on having conversations with thought leaders
1:42
from a variety of backgrounds who can help us
1:46
think about ways in which we can flourish within
1:48
the complex and challenging world of healthcare.
1:53
Today's podcast, I'm really excited because it
1:55
is a little bit different. The title of this
1:58
podcast today is called Executive Coaching Insights
2:01
for Healthcare Leaders with Charles Pfeffer.
2:05
So our guest today is Charles Pfeffer, an organizational
2:08
consultant and executive coach with over 30 years
2:12
of experience helping leaders harness through
2:15
their own and their organization's inherent abilities
2:17
to create change through learning and adaptation.
2:21
He has a lifelong engagement and interest in
2:24
self -awareness approaches and group dynamics
2:26
training, and he guides his clients with deep
2:29
listening and reflection skills to clarify what
2:32
they want for their enterprise, for their teams,
2:35
for themselves, and for the world. He's worked
2:38
with many companies, including FedEx, Xerox,
2:41
DuPont, Medifast, NASA, Starbucks, Save the Children,
2:47
The New York Times, Express Scripts, The State
2:49
of Maine, Merck, United Airlines, and Ecolab,
2:53
and he is deeply committed to helping executives
2:56
cultivate principled, creative, and responsive
3:01
leadership. In this podcast, Charles recounts
3:05
his accidental journey into personal growth and
3:08
development work after experiencing a very powerful
3:10
and transformative personal program himself.
3:14
He highlights autonomy, responsibility, and balancing
3:19
discipline with creativity in his work with senior
3:22
leaders at pivotal learning junctures. Charles
3:26
stresses understanding one's true desires and
3:29
adapting to organizational complexities, drawing
3:32
parallels between executive leadership and healthcare
3:37
professionals' challenges, focusing on the need
3:40
for communication and integration within the
3:43
fragmented healthcare system. and advocates for
3:47
a calm and competent environment through better
3:50
resource management. One of the reasons for bringing
3:53
this conversation to this podcast is to help
3:55
bridge the gap between the worldview of leaders
3:58
and clinicians to foster alignment and positive
4:02
change toward flourishing in medicine. And now,
4:06
my conversation with my good friend and colleague,
4:08
Charles Pfeffer. Welcome, Charles, to Flourishing
4:12
in Medicine, From Surviving to Thriving. I'm
4:15
really excited to have you and your point of
4:17
view on this podcast, in this conversation, and
4:22
looking forward to what unfolds. Right. Mick,
4:26
thanks for having me. I really appreciate it.
4:28
Wonderful. So I'd like to begin the way I begin
4:31
with all of our guests, and you're a unique guest
4:33
in the type of experiences you have and what
4:36
we'd love to hear about. But I ask... the guests
4:39
about their origin story. And what I mean by
4:42
that is for whatever field they're in, most of
4:45
them are coming in the medical field. What was
4:48
it in their early experiences, later experiences,
4:52
whatever experiences they had that really motivated
4:55
them and moved them to want to do this? So however
5:00
you conceptualize your profession, what was it
5:04
about your experiences that you had? They could
5:07
have been in your childhood. It could have been
5:09
among family members, friends. It could have
5:11
been more after you were educated or during your
5:14
education. Whatever that story was, we'd really
5:17
love to hear kind of how you got to be the professional
5:21
which you are now. Wow, that's a great question.
5:25
The way I would say how I got to be doing what
5:29
I do today and have been doing for over 30 years
5:32
now is kind of almost accidental. I was a student
5:39
at the University of Rochester, and I had a group
5:42
of friends who were teammates of mine who had
5:45
participated in a personal growth program that
5:49
they were really excited about. And they enrolled
5:52
me in that program. And I went and did a two
5:56
weekend course. And coming out of that course,
6:00
I would say I had some breakthroughs, particularly
6:03
in my understanding of my own autonomy and agency
6:09
and responsibility. And that had a big effect
6:13
on my My sense of my relationship with my family,
6:17
I wound up having some conversations with my
6:20
parents that were along the lines of, you know,
6:23
I've been blaming you for a lot of things and
6:25
I'm done with that. And so it was a very transformational
6:29
experience. And as a result of that, I had been
6:33
on a path to go into banking and finance, which
6:37
I then did after I graduated. But at the same
6:40
time at Parallel, I was very involved in this
6:44
kind of personal growth work. And over a few
6:48
years, I started to realize that I was more interested
6:51
in that than I was in what I'd gone to university
6:54
for. And I looked for the chance to make working
6:58
on my own personal growth, other people's personal
7:02
growth, and the growth and development of organizations
7:04
as a profession. And was very fortunate to get
7:08
an opportunity in my 20s to join a small boutique
7:11
consulting firm that was doing that. And 30 -something
7:15
years later, I'm still doing that work in larger
7:18
organizations. So in a lot of ways, it sounds
7:21
like you've taken that vocation, we could call
7:24
it, of personal growth or helping others grow
7:28
and transform that into a viable career in which
7:32
you could not only support yourself, but also
7:35
give. to the people that you interact with i
7:39
am going to ask you charles just to perhaps maybe
7:43
dig a little deeper as you learned about these
7:47
breakthroughs as you described them these understandings
7:50
of autonomy responsibility what you described
7:52
as transformation and then you mentioned going
7:54
back to the family and kind of taking responsibility
7:57
for some of the things that were yours solely
8:00
and trying to understand those dynamics was there
8:03
anything else about how you were raised that
8:06
sort of created the fertile ground, we could
8:11
say, for wanting to move into that personal growth
8:16
domain? Well, what comes to mind, you know, there's
8:20
a lot that I could probably say, but what comes
8:22
to mind is that when I think about my parents,
8:25
I think they both grew up in households that
8:30
had high standards, lots of rules. And kind of
8:35
a disciplinary environment that was tough. And
8:39
I would say that they carried that forward into
8:42
our household as well. So there was a lot about
8:46
what are the limitations? What's allowed? What's
8:49
not allowed? And, you know, as any teenager would
8:54
probably tell you, you know, constraints are
8:56
not really what you're looking for as a teenager.
8:58
You're looking for, you know, freedom. I kind
9:03
of rebelled against that and left as early as
9:06
I could possibly get out to go kind of explore
9:10
things on my own. And I think the story I came
9:13
out of that with was my family isn't letting
9:16
me do what I want to do or my family is trying
9:19
to put the brakes on me and I want to do something
9:22
else. So I think what the breakthrough was for
9:26
me was that I could have the freedom and autonomy
9:29
and agency that I wanted without blaming my parents.
9:32
And that was really what I wanted to let them
9:35
know is I'm taking responsibility. I'm not saying
9:39
that the limits you put on me are going to define
9:43
my life, nor am I rejecting them. I'm just saying
9:46
I'm responsible. Yeah, I like that frame. And
9:50
I think it's a healthier frame and probably a
9:52
more honest frame, authentic frame, if you will.
9:55
I also am thinking about the description of some
9:58
of these, the limitations of the discipline being
10:01
kind of a dark. side to it. But there are positive
10:05
aspects, of course, of discipline. You were an
10:08
athlete in college. You mentioned being on a
10:10
team. And you carried this discipline into this
10:13
new vocation, I'd imagine, and poured yourself
10:17
into it, wouldn't you say? It's interesting because
10:22
in my work, there is this concept of polarities.
10:28
And polarity is kind of like two phenomenon that
10:31
are linked to each other. And I think freedom
10:35
and responsibility are a polarity. If all you
10:40
have is freedom without responsibility, you're
10:44
kind of unlikely to produce anything necessarily,
10:47
I would say. But if all you have is responsibility,
10:50
or as you put it, like discipline, and you're
10:53
like completely on the end of discipline, the
10:56
sense I would have is you might miss the opportunity
11:00
to create and innovate and develop yourself as
11:03
a human being. So it's not that one's right and
11:06
the other's wrong. It's more like they live in
11:09
tension with each other. And the challenge is
11:12
to find ways to integrate the values of both.
11:15
So I think it's an interesting question you pose
11:19
is, yeah, I do bring a certain... amount of discipline
11:22
into my work. And I'm always looking for where's
11:26
the edge? What else can I learn that would alter
11:30
the way I do my work with my clients? I think
11:34
this is a really relevant, it may seem like a
11:36
sidetrack, but it's really relevant to the podcast
11:39
itself, which is about flourishing. And I'm thinking
11:41
that when we live in these binaries that say
11:45
in the experience as a health professional, as
11:47
a physician in today's the healthcare industry,
11:50
the way it's set up is just a mess and terrible,
11:54
in some ways precludes the possibility that I
11:56
could flourish. And so flourishing requires us
11:59
to be able to hold, kind of hold these intention,
12:02
the polarities, as you described, the paradox,
12:05
if you will, and being able to work through them
12:07
and find a middle way, we could call it, that
12:10
is one of flourishing. And so I would love to
12:13
hear now a little bit about what is it that you
12:16
actually do? How does it work? What approaches
12:19
and what's the explicit and the tacit agreements
12:23
that you enter into one of your coaching relationships?
12:27
The listeners will know by the introduction to
12:31
the podcast that you are an executive coach and
12:33
this is the kind of work you do. But tell us
12:35
a little bit about that and how that works. I
12:39
work with very senior executives in large corporations,
12:44
global corporations. If they've asked to work
12:49
with me, it's typically because they are finding
12:54
themselves at some edge, which is a learning
12:58
edge, it may be a strategy edge. It's at a point
13:01
where what it is that they want and the capacities
13:07
that they've been able to bring or their teams
13:10
have been able to bring are in question. not
13:15
necessarily in question in a negative way, but
13:17
maybe, you know, I've gotten this new position,
13:20
I've gotten this new role, and the challenges
13:23
that are out in front of me are challenges I
13:25
haven't had to meet before. And I want to learn
13:27
my way into, you know, fulfilling the responsibilities
13:31
that I have. So it is very much a learning and
13:36
development kind of a frame that I bring to my
13:40
coaching work. And the coaching work always starts
13:43
with a question that I'll ask in a variety of
13:47
different ways, but the essence of it is, what
13:49
do you want? And when I ask a senior executive
13:54
what they want, it can go in a number of directions.
13:58
But I know, because I've worked with so many
14:01
people, that there's going to be their technical
14:04
responsibilities within their job. There's going
14:09
to be their career aspirations. If this isn't
14:14
the last job they're ever planning to have, they're
14:16
thinking about how does this get me to what I
14:18
want to do next? And then almost always in the
14:23
background, there's and I have a life. You know,
14:26
I've got a family and I've got responsibilities
14:29
outside of work. And these jobs are big and they
14:33
take a lot of energy. They take a lot of brain
14:37
power. So there can be a question of. What am
14:42
I sacrificing? Am I sacrificing my family? Am
14:46
I sacrificing my health? How do I manage across
14:50
these different domains of life? So let me stop
14:54
and see if I'm answering the question you asked,
14:57
Nick. Yes, you are definitely answering it. And
15:01
there's, I'm hearing and feeling and sensing
15:04
into a lot of parallels here with physicians,
15:07
big jobs. a learning and development phrase on
15:11
in reflecting on who we are unfortunately i think
15:14
many of my colleagues don't have the prompts
15:18
or the opportunities or the environment beyond
15:21
their training to really ask some of those fundamental
15:24
questions that you're asking your leaders what
15:27
do you want i think that's really a fundamental
15:30
question for all of us so i think i'm with you
15:33
if you want to go on that would be great well
15:36
what i like about the question What do you want?
15:39
And it's one that I got from a friend and teacher
15:43
of mine named Dave Ellis, is that you can ask
15:48
you at a lot of different levels. You know, you
15:50
could be in a restaurant and the waiter would
15:51
say, you know, well, what would you want? And
15:54
you order your meal. But then there's the bigger
15:57
picture question, which is, you know, what do
15:59
you want from life? What's your purpose? Your
16:02
purpose is a desire. Your purpose is an intention
16:06
or a goal, if you will. Your values are an answer
16:11
to the question, what do you want? I want to
16:14
be a certain way. I want to contribute in a certain
16:18
way. So the question, what do you want, can go
16:22
in a lot of different directions. Whenever someone
16:25
is kind of off track or stuck and I ask, what
16:28
do you want? It's a pathway into an inquiry.
16:32
that they may or may not have had with themselves
16:34
about what's fundamentally important. Perfect.
16:39
Yes. So let me say something and state something
16:43
that you already know. Healthcare is complex,
16:47
especially for physicians and other clinical
16:51
health professionals that are involved in it.
16:53
And I know you've had some experience in this
16:55
industry, but part of why I wanted to... have
16:58
this conversation with you had less to do with
17:00
those experiences although i do want you to draw
17:02
from your experiences it had more to do with
17:05
how myself and the listeners of this podcast
17:08
mostly physicians and other health professionals
17:11
can better understand leadership organizational
17:14
leadership in general through some of the experiences
17:17
you've had i'm hoping that after listening to
17:20
this we will have a better lexicon so that we
17:23
can communicate our perspectives and some of
17:26
the dire needs that we find ourselves having
17:29
right now to leadership really for mutual benefit
17:32
so if you can help us start with that what would
17:36
be most helpful for us to know about through
17:40
your experiences how leadership and how organizations
17:42
really operate i think it's really interesting
17:46
that you started with sometimes the leaders have
17:49
multiple that they're holding. It's something
17:52
that I don't think about much when I'm engaged
17:56
with a problem in the setting of healthcare organization
17:59
and trying to work it out with our leaders. There's
18:04
a number of ways I can go with this. So let me
18:06
just dive in and share what comes to mind for
18:09
me. And maybe what I'll do is I'll answer by
18:12
speaking first about a different client experience
18:16
that I've had. which is companies that are coming
18:22
to the end of the viability of their business
18:25
models. So in the late 90s, early 2000s, I had
18:30
the opportunity to do work with two companies
18:33
that were, their business models were very much
18:36
in question. One is well -known, the Eastman
18:39
Kodak Company, through a shift in technology,
18:43
which they actually launched. it was no longer
18:47
going to be viable for them to make most of their
18:50
profits from the sale of film and photographic
18:53
paper. And they knew that was coming. They could
18:56
see it coming. And there was kind of a curve.
18:59
And what they tried to do was come up with a
19:02
lot of different ways to make money. So ultimately,
19:07
they were not successful. They still exist, but
19:10
they're a shadow of their former selves. The
19:13
other company was Xerox. And in a somewhat similar
19:17
way, technology, particularly computer technology,
19:20
digital technology, was changing the nature of
19:24
their popular printer business. And they still
19:28
exist. They still have a viable business. But
19:32
they went through substantial disruption, nearly
19:36
went bankrupt. I'm speaking now about one of
19:40
the concerns that leaders, in particular executive
19:42
leaders, face, which is their underlying economics
19:47
of their business. So now let me talk about what
19:51
I know and understand about the healthcare world,
19:54
which is limited. But my observation is that
19:59
healthcare has become a business. I don't think
20:03
we would have said that about healthcare. in
20:06
the 1960s. I think the invention of the health
20:11
management organizations sometime late 60s, early
20:15
70s, I think that changed things. The other thing
20:20
that changed in my understanding is that the
20:23
role of technology in healthcare made it necessary
20:27
to be able to attract a lot of capital, a lot
20:30
of money. old ways in which hospitals were structured
20:35
and even you know hospital systems were structured
20:38
didn't allow for raising the kind of capital
20:40
that's necessary for you know the advanced technology
20:44
that's used now so from the standpoint of someone
20:49
who's a practicing physician inside of a healthcare
20:52
system knowing and understanding that the economics
20:57
of the system are driving a lot of the policies
21:00
driving a lot of the systems within the system
21:05
and that the leaders of the top, whether they're
21:09
physicians or not, are in some ways trying to
21:14
adapt their system to the way I'll call it the
21:18
industry works, which could be very unclear and
21:23
opaque if you're working deep down in a physician
21:26
practice or even as a physician in a hospital,
21:29
you might. not have a lot of sense of what it
21:34
is that people in the upper echelons of the administration
21:38
are having to deal with. So let me stop there
21:42
and see if any of that made any sense. Oh, very
21:45
much, very much. I mean, the corollary, which
21:47
I hope you'll get to, because this is helpful.
21:50
I think many of us in the clinical side of things
21:54
are aware of the economic dynamics somewhat.
21:58
We may not be. as acutely aware of what kind
22:01
of margins that people are operating on, these
22:03
organizations run on, and how many different
22:07
stakeholders there are that are involved in that
22:11
enterprise itself, not just the health professionals.
22:15
I'd also at some point like you to turn things
22:18
and what is it that you, from what you understand,
22:21
just being a consumer of healthcare, that the
22:24
healthcare leaders need to know about? what you
22:28
understand from the clinician's point of view
22:30
and their experience in the trenches, so to speak.
22:33
So both, yeah. This is what I would say. In any
22:37
complex organization, there will be specialties.
22:41
There'll be specialists. And that's true. It's
22:45
true in the technology -oriented manufacturing
22:47
companies that I worked with over the years.
22:50
There's the people who are in the R &D world.
22:52
There's the people who are in the marketing world.
22:55
There's the people who are in manufacturing.
22:57
And they, in some ways, speak different languages.
23:00
So they have different vocabularies that are
23:05
tuned to their expertise, but also tuned to their
23:10
interests. And I would say that the practice
23:14
of medicine has its own vocabularies and it has
23:18
its own intents and purposes. And then even within
23:21
medicine, of course, there's all the different
23:23
specialties that are based on. Whether we're
23:27
talking about somebody's heart or whether we're
23:28
talking about their brain, there's all the different
23:30
specialties. I would say that the management
23:34
of the business of healthcare has its own vocabularies
23:39
and its own expertise. For leaders of a large,
23:46
complex organization, getting these different
23:48
vocabularies to interact and talk with each other
23:52
is a skill set. And it requires a set of disciplines
23:56
and processes in order to make that work. And
24:00
the better you are at getting these different
24:03
vocabularies and let's say communities connected
24:07
to each other, the more likely it is that people
24:10
will understand your purposes and why you're
24:13
doing things. In the consulting work I do, in
24:17
addition to the executive coaching work I do,
24:19
often what we're trying to do is connect different
24:22
elements of a large complex system with each
24:27
other so that people actually have a conversation
24:30
where they're informing and learning and coming
24:34
to understand. So, you know, why is that policy
24:37
the one we're using? What else could we be doing
24:41
that would maybe work better? There's something
24:45
about, so now I'll speak from kind of the consumer
24:48
of healthcare standpoint. I have this sense when
24:53
I am meeting with a physician that's trying to
24:57
help me manage my health, that they are working
25:01
within the constraints of a system that they
25:03
don't feel they have a lot of agency towards.
25:08
They would say, well, we can do this, but we
25:10
can't do that, that sort of thing. The insurers
25:15
have a fairly big voice in determining what will
25:20
be paid for, what won't be paid for. And the
25:23
physicians that I deal with recognize that they
25:26
are constrained as to what it is that they're
25:29
able to provide based on that. Or it will be
25:33
something that then the patient winds up paying
25:36
for out of pocket, which, of course, depending
25:38
on what your economic situation is, you may or
25:41
may not be able to. So what I would say is my
25:45
sense when I'm in first contact with a care provider
25:51
is I feel the fragmentation of the system. I
25:56
don't feel the integration of the system and
25:59
the sense in which everybody is pulling together,
26:02
working together to make it work for the patient.
26:06
And that's not unique to healthcare. It's often
26:11
the challenge in business is how do we get the
26:16
customer and the voice of the customer to be
26:18
heard across all these vocabularies, across all
26:22
these specialties in such a way that we provide
26:25
a more integrated and higher value service solution
26:29
product to the customer. That's really helpful.
26:34
You know, if it's a challenge, it's not unique
26:37
to healthcare industry, even though healthcare
26:40
industry is unique and as are many other industries.
26:44
that means that there are probably successes
26:46
out there there's cases in which it's been managed
26:51
more or less in a positive direction and so i
26:54
like this idea of integration of this kind of
26:56
what the way i was thinking about it was a bi
26:59
-directional connecting of these two vastly different
27:02
worlds these two different vastly different in
27:05
some ways world views in a some kind of a common
27:09
language or at least a common mission using the
27:13
variety of languages we have. And then there
27:15
are skill sets that can be developed to help
27:18
that. So I think that's actually really exactly
27:21
what I was hoping for you to describe that. As
27:25
I was reading about some of your work and also
27:29
the writing you have done, which is really quite
27:31
lovely, and I was thinking about the theme of
27:34
the podcast, there was a number of words which
27:36
I saw. Things like authentic leadership, disruption,
27:41
emerging technologies, complexity, self -expression,
27:44
creating space, stillness, meaning. And I thought
27:49
almost like a Rorschach test, you know, what
27:51
arises upon hearing these words in the context
27:54
of this conversation and also our awareness of
27:58
listeners. I'd just be interested knowing who
28:01
is out in the listening space here, the physicians
28:03
and other health professionals. Those kind of
28:06
words, what arises for you as you begin to kind
28:10
of take in the words and think about what is
28:13
it you want to express by using that language?
28:17
I would start with the word complexity. And I
28:21
think why I would start there is that we live
28:26
in a sense of more complexity than certainly
28:29
our distant ancestors would have experienced.
28:33
And that's driven by a lot of things, but I would
28:37
say fundamentally by technology. So I was thinking
28:40
about this notion of change. I think the question
28:43
that you put to me when we were first talking
28:46
about doing this was how do organizations change?
28:50
So I've got three different quotes that I'll
28:54
use. One is from this woman named Peggy Holman.
28:58
edited this book called The Change Handbook.
29:01
So she could be seen as one of the experts on
29:04
change. And she said, all change begins with
29:07
disruption. And I think that that feels accurate
29:11
to me. Organizations don't typically feel a need
29:15
to change until they're being disrupted. And
29:18
when you're being disrupted, you're nose to nose
29:22
with complexity. You're right up against. The
29:25
gap between what we have demonstrated we can
29:28
do and what it seems like the world is now asking
29:31
for. So now, if you're responsible for a big,
29:37
complex organization and you're facing that,
29:39
it brings up all sorts of fear. It probably brings
29:43
up all sorts of kind of bargaining, like, well,
29:46
maybe this will pass. So being present to what
29:53
is actually happening. is a critical faculty
29:56
for any leader who's facing that kind of situation.
30:01
Then my friend Bob Marcus, who you've met, Nick,
30:06
he likes to say, organizations change when people
30:10
change. People change when leaders change. So
30:16
partly that's saying that it's the leaders who
30:20
are getting themselves ready to change who wind
30:24
up being the leaders. If they're not going to
30:27
change in the face of something that's happening
30:30
in the environment, they're not going to be the
30:32
leaders for long. And I think it is true to an
30:36
extent that when leaders change, it does create
30:40
a kind of a wave of change in the organization
30:42
for those people who are prepared to stick around
30:46
long enough. And there will be people who decide,
30:51
This isn't for me. I'm going to go find someplace
30:54
else to give my value. Then I think that really
30:58
does come down to the question I posed earlier,
31:01
which is, what do you want? Do you want to be
31:04
part of something that is of this time? We're
31:09
moving from one set of circumstances to a new
31:13
set of circumstances. Do you want to be part
31:15
of creating that? Or would you rather have a...
31:18
quieter life. And I think that's a choice that
31:21
some people do make. So let me stop because I
31:25
have a sense I might have drifted off of your
31:27
original question. No, I think it's very relevant,
31:32
salient to what my original question was. And
31:35
the thing that comes up from the very last thing
31:39
you just said is that One thing about healthcare
31:43
professionals, especially physicians that I know
31:46
from personal experience and, you know, the literature
31:48
that there's a deep commitment because it takes
31:52
that to actually go through the long, arduous,
31:56
beautiful, but challenging training. So many
32:00
of us have a really deep commitment to the work
32:02
that we do. And hence, we have something called
32:05
the Hippocratic Oath, one of the, probably the
32:08
oldest professional statement of what We commit
32:11
to ideals as a profession that exists among professions
32:16
in the world, several thousand years old. So
32:19
I think to actually consider that, well, maybe
32:23
I shouldn't be doing this is a very difficult
32:26
thing for my colleagues to consider and actually
32:32
leads to a dynamic what's described as moral
32:35
injury or moral distress. You know, it really
32:37
is a... a very difficult thing to come to terms
32:40
with if if it's not working out so we we kind
32:44
of say we're just going to show up for whatever
32:46
the change is so i think in a certain way we
32:49
live the change because we're constantly working
32:51
with new technologies and new this new drugs
32:55
bringing this in and out so i think that in some
33:00
ways is a somewhat unique feature for my colleagues
33:04
in this profession and then the other thing is
33:08
As you speak, I'm thinking about what would it
33:11
mean for the people that you consult with and
33:14
that you coach to flourish? What does it mean
33:17
for your clients? What does it mean for the organizations
33:19
they lead? I'd imagine something along the lines
33:22
of actually being the change itself and actually
33:26
leaning into it, however uncomfortable that may
33:29
be. What does it mean for regular folks who have
33:32
some relational connection in organizations to
33:35
flourish? flourishing itself as sort of a dynamic
33:41
and as a motivator. And then finally, I would
33:44
really like to know personally what allows you
33:47
to flourish. I love that word that you used,
33:51
oath. I think that's such a powerful word. And
33:56
there's something about that word, oath, that
33:59
to me connects with something else you said earlier,
34:03
which is authenticity. And the bridge between
34:06
authenticity and oath for me would be purpose.
34:09
So I think if I am the kind of person who is
34:13
prepared to take an oath, I am the kind of person
34:17
who has some clarity about the connection between
34:21
my own purpose and what I'm applying that to.
34:25
And I think if I am someone who is seen by others
34:29
as authentic, I found a way to align who I am
34:34
with this purpose and towards this oath if i
34:38
do that long enough it becomes my identity it
34:43
is who i am now if my ability to fulfill my purpose
34:50
towards an oath i've taken is disrupted it's
34:54
a bigger disruption than if i just lost my job
34:58
but i can go get another job and i think That
35:02
while for physicians that probably feels like
35:06
a major, major threat to identity is particular
35:11
and special, I do think that there are other
35:14
professions and other vocations where that's
35:18
also the case. When I was doing some work at
35:22
Kodak 20 -something years ago, there were people
35:26
there who were electricians or who were plumbers
35:29
or who were carpenters. And, you know, it's not
35:33
like that was their job. That's who they were,
35:36
you know, and they were proud, deeply, deeply
35:39
proud of the quality of work that they did. And
35:42
many of them were not going to have the chance
35:44
to do that anymore because of the nature of the
35:47
change that was happening there. But that's I
35:49
would make that connection because I think it's
35:51
I think it's key to this notion of flourishing.
35:54
If you can align what you're good at, what you
35:59
love to do. what the world will pay you for with
36:02
a higher order sense of contribution, wow, that's
36:08
a pretty high quality life, I would say, and
36:13
provides the opportunity to flourish if you get
36:17
the compensation that will allow you to do the
36:19
other things in your life that you want to do.
36:21
So there's something about that linkage that
36:26
I think is important. whether you're practicing
36:30
as a physician or whether you're running a marketing
36:34
operation in a global consumer products company.
36:39
Yeah. Thank you very much for very kindly sort
36:44
of reframing that for me. I think you sort of
36:46
helped me a little bit with, I must admit, maybe
36:49
a little bit of professional arrogance that is
36:52
not unique to my profession, but we seem to have
36:54
a good dose of it sometimes. So I appreciate
36:57
that. I agree. And I like the way you also described
37:01
it. Once purpose and authenticity become aligned
37:05
and one commits to something, then that identity
37:08
develops, whether you're an electrician or a
37:11
carpenter or a police officer or a physician
37:15
or an executive of a large organization. Absolutely.
37:19
So that's really, really helpful for you. What
37:22
does flourishing mean for you and how do you
37:25
work toward that? Well, for me, my work is to
37:34
enable leaders to fulfill their sense of purpose
37:38
within the roles that they've agreed to take
37:42
on. Well, and beyond, because what I find is
37:46
I become very close to my clients and I know
37:51
their children and I know their spouses and I
37:55
know something about. how they came up and what
37:59
gave them the opportunity to do what they do.
38:01
And they've got a job to do. So there's kind
38:03
of a frame inside of which they're investing
38:06
their talent and their energy. So my task is
38:10
to help them grow into the challenge of that
38:14
in such a way that they're succeeding while also
38:18
having a life that's worth living. And more and
38:21
more, what I find is that's the challenge, is
38:23
that can they fulfill? the responsibilities that
38:27
they've got within the job and not kill themselves
38:29
doing it. Some of them are better than others.
38:33
Some of them listen to me better than others
38:35
when I talk with them about that aspect. But
38:39
what lets me flourish is a few things. One is
38:42
it is fascinating to be working with people who
38:47
are dealing with huge, complex challenges. It's
38:51
just amazingly fascinating for me. The other
38:56
thing is I find it really gratifying that they
39:03
put so much trust and confidence in me when really
39:08
what I'm doing is I'm listening and I'm asking
39:11
some questions and I'm engaging in an intimate
39:15
dialogue with them about where they are and where
39:19
their edge is and what they can come up with
39:22
in terms of their own ideas. for dealing with
39:25
the challenges that they're facing. Once in a
39:28
while, I might give them a tip or a technique
39:31
or a process or a framework, but largely, I feel
39:35
as though I'm walking alongside somebody who
39:38
is trying to figure out their next big challenge.
39:42
And that's really gratifying to me. And then
39:47
I guess, in terms of the other dimensions of
39:49
flourishing, it's really important for me to
39:52
have some time that I take to get away, to try
39:57
to listen to myself and overhear myself because
40:00
I can get stuck. And I'm really lucky to have
40:03
a life partner who loves me and puts up with
40:07
my tendency to work too hard and make sure that
40:12
we have the space to do the things that we need
40:14
to do to maintain our relationship. Thank you
40:18
for sharing that. And also, I really thank you.
40:21
gave a very wonderful personal description that
40:24
now i understand from that description why professional
40:28
coaching is now becoming one of a cafeteria of
40:32
things that are being brought into healthcare
40:34
for clinicians to flourish that even to get some
40:37
coaching for ourselves can be very very helpful
40:40
and i think it's right it's like being able to
40:44
have people ask the right questions so you can
40:46
reflect and discover the answers as you described
40:49
yourself. We're coming down to sort of the last
40:53
couple of questions. One has a couple parts to
40:56
it and you don't have to answer all of them,
40:58
but I'd like you to imagine it's two years from
41:02
now and health professionals, in particular physicians
41:05
and other clinicians, have been able to get through
41:08
the current difficulties in health care and dysfunction
41:11
in such a way. that they are two years from now
41:15
energetic feeling robust resourced excited truly
41:19
flourishing we could say in their lives and so
41:22
you are in your role just as you are as a non
41:25
-medical professional as a executive coach as
41:30
a consumer of healthcare Just a couple of things
41:34
you can comment on any or all of them and let
41:36
me just enumerate them. What would you notice
41:38
as, say, a consumer about the health professional
41:41
who's in this imaginary world two years from
41:44
now doing so well? What effect would it have
41:46
on your own sense of flourishing, your interactions
41:49
with that person? What would you think about
41:52
the organizations within which they're working
41:55
about that culture of that organization that
41:58
they must work in? What do you think they...
42:01
the health professionals and the organizations
42:03
have had to learn in the last two years to get
42:07
there. I think that's really a curiosity I have.
42:09
Like, what will it take to get there? And how
42:13
did they learn that? So any of those kind of
42:16
questions about this imaginary world two years
42:19
from now where my colleagues and I are just doing
42:22
just well and fine even with the dysfunction
42:25
and we've been able to work through it? Well,
42:28
we're... We're going to create an imaginary world
42:31
together, so I'll imagine with you. This is what
42:35
comes to mind, that the experience of being a
42:38
patient, going to a medical provider, what I
42:43
would experience is a sense of calm, that I'd
42:47
experience a sense of what my colleague Frank
42:51
Staropoli used to say, non -anxious presence.
42:56
When I go into a medical office as a patient,
42:58
if what I experience from the front desk back
43:02
to the time I actually get to meet the provider
43:04
is a sense of high intensity, speed, et cetera,
43:10
it doesn't make me feel better prepared to work
43:14
on my own health, whatever it is. So I think
43:18
from the moment I walked into a provider's office
43:20
to the moment I walked out, what I had a sense
43:23
of was calm. competent, caring service delivery
43:29
to me, that would be a clear indication that
43:33
a shift had been made. Now, there's all kinds
43:36
of elements that I can imagine going into that.
43:40
But one of the elements would be an accurate
43:44
assessment of the gap between the capacity to
43:48
deliver and the demand. So if the demand is too
43:53
high and the capacity isn't enough, it's going
43:55
to feel like frenzy. And I think that's probably
43:59
what many practitioners have been experiencing.
44:03
And in order to be able to match the capacity
44:07
delivered to the demand, now you're getting into
44:10
systems. And if you're getting into systems,
44:12
you're getting into capital, money. Are there
44:15
enough resources to provide the capacity needed
44:18
to meet the demand? For all that to get well
44:22
integrated and well connected, I suspect we go
44:25
back to the conversation we were having earlier
44:27
about vocabularies, that the people who are at
44:29
the front line delivering healthcare have to
44:32
be in the rooms having the conversations with
44:35
the people who do the planning about capacity
44:37
building and capital formation. So what I would
44:42
expect, and I don't know if it's going to happen
44:44
in two years or if it's going to take more, is
44:47
that there's more people who speak the different
44:49
languages talking with each other about the whole
44:51
and figuring out a way to provide a viable, integrated
44:56
solution. So finally, Charles, what do you do
45:02
for your own wellness, for your own fun, for
45:04
your own enjoyment that you would be willing
45:06
to share with listeners? I walk in the woods.
45:11
When I have the sense that I've gone over the
45:15
edge, I get up and walk out of this office and
45:18
walk into the woods. And I will go for three,
45:21
five miles. That's one thing I do. My wife and
45:25
I both have kayaks, and there's lots of places
45:27
around where we live to go paddling. So that's
45:30
another thing. And if it's wintertime, I like
45:33
to get my skis on and go downhill. activity,
45:38
lots of physical activity gets me restored. Wonderful.
45:44
Well, thank you so much. This has been a great
45:46
conversation. I knew it would be great and it's
45:49
exceeded my expectations. So it's really wonderful
45:52
having you, Charles. It is always my pleasure
45:55
to talk with you. Thank you very much for listening
46:00
to today's podcast. We will include a summary
46:04
of the podcast and links about Charles Pfeffer
46:07
in the show notes. I'd like to conclude by sharing
46:10
another exercise that you can do to help you
46:14
flourish. In our conversation today, we were
46:17
talking about leadership. Each of us in whatever
46:21
small or larger ways are leaders. You may not
46:25
see yourself that way, but many other people
46:28
with whom you interact may. This practice very
46:32
brief and something that can be practiced regularly,
46:34
such as the beginning of your day, goes as follows.
46:40
Sitting quietly, wherever you are, at your desk,
46:44
in your car after parking, in the break room,
46:47
wherever, bringing attention to your physical
46:52
being, your body, making contact with the seat,
46:55
noticing the breath, noticing the arms and legs,
46:59
how the body is positioned, Noticing the emotional
47:03
state, anxious, calm, excited, however it is
47:09
for you, simply noticing it. And now bringing
47:13
attention to the thoughts, perhaps the to -do
47:17
list that's in your head, whatever thoughts may
47:21
be swirling around. And now consider the fact,
47:25
however explicit or implicit, however large or
47:28
small, of your leadership. Now that your attention
47:34
has been honed, thinking now about your intention,
47:38
asking yourself, what kind of leader do I want
47:43
to be today, right now? How do I want to lead
47:48
others right now in my interactions, in my way
47:52
of being? How can I best be creative, attentive,
47:57
and responsive in this role as a leader right
48:01
now? today as I step into my workday. And that's
48:06
the practice. Consider repeating this daily,
48:10
weekly, a couple times a day, however you'd like.
48:15
I hope you found this podcast and the simple
48:18
exercise useful to you and look forward to having
48:21
you join us for the next episode of Flourishing
48:23
in Medicine, From Surviving to Thriving. To learn
48:27
more about EmPRO, please visit www .myEmPRO.com
48:33
or their peer support programs at www .myEmPRO
48:39
.com forward slash peer dash support. If you're
48:45
a physician or student in need of urgent support,
48:48
consider calling the physician support line at
48:50
1 -888 -409 -0141. This support line... provides
48:57
a safe space to discuss immediate life stressors
49:01
with colleagues. For information about me and
49:05
my work, please visit www.MickKrasnermd.com
49:10
or www.mindfulpracticeinmedicine.com. Until
49:17
next time.