• Rob Orman

29. How To Be An Effective Leader

Effective (and ineffective) leadership comes in many flavors, but there is an underlying quality to any good leadership that you know when you see it. In this episode, Colonel Jim Czarnik, MD and Josh Bucher, MD break down the lessons they’ve learned leading in both the military and civilian worlds of medicine and crisis situations.

Cover Photo by Matteo Vistocco on Unsplash

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Guest Bios:

Colonel Jim Czarnik, MD is the Deputy Chief Of Staff, Surgeon United States Army Special Operations Command. He has previously served as Command Surgeon for US Army Africa and was instrumental in coordinating the multinational response to the recent western Africa Ebola outbreak.

Josh Bucher, MD is an assistant professor of emergency medicine at Rutgers- RWJMS. He is EMS-fellowship trained and currently holds the position of associate EMS Medical Director for RWJ-Barnabas MHS. An expert in tactical emergency medicine, he is medical director of the Middlesex and Somerset County SWAT team.

This episode is sponsored by Wild Health. More below.

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We discuss:

What it means to be a leader and why leadership is a state of mind [03:15];

  • Leadership is a philosophy and mindset on how you approach daily interactions.

  • It is about other people, not yourself, and about developing other people’s talents and skills.

“Leaders use their skills when in a professional or personal situation to help others achieve their goals.”

The culture that you want to create in your professional environment [04:10];

  • You want a culture where everyone feels empowered to make their own decisions, and they’ve been given the opportunity to improve and to get better.

  • You want a culture where people want to work with you to do things.

  • A big part of leadership is self-reflection and being able to recognize and accept when you’ve made a mistake or you’ve done something wrong.

“Oftentimes people blame somebody else, the situation, or the environment for their mistakes; all blaming does is deflect the true cause of something.”

The ERO relationship (Event + Response= Outcome) [06:20];

  • You can only control your response to a situation; you cannot control the event itself or the outcome

  • Failure can be your best teacher. It is an opportunity to contemplate what you could do better next time to improve the outcome.

"If you fail at something, you can only blame your response or reaction to the event. You can’t blame the event or the outcome."

Why self-motivation is so important for success in the ED [09:00];

  • Self-motivation is not something that’s easy to teach, nor is it something that’s easy to find within yourself.

  • Those who want to be able to perform at an elite level have to prepare at an elite level. You have to be disciplined to get better and desire to challenge yourself.

  • In the ED, those who choose to do the minimum and have little desire to get better will choose to care for the simplest patients.

How teamwork is directly related to your mission: a good patient outcome [10:40];

  • In the ED, the mission is a good outcome for the patient. This requires trust, confidence in each other, and communication. Not only do these things improve our outcomes, but they also improve our working environment and our basic steps of humanity.

  • Getting to know your team and their personal lives leads to more cohesion and a happier, more positive work environment. Unit cohesion is tremendously motivating.

  • The goal is to create an environment where team members feel comfortable bringing up questions and concerns.

“A leader challenges the people below them. They listen when someone speaks. They encourage people to speak their mind, and they don’t reward ‘yes people’. They reward honesty, clarity, hard work, and self-reflection.”

Keys to success when you make a transition to a position of leadership [13:40];

  • Never malign the person whose role you’re taking over. Avoid the behavior of blaming your predecessor for things that happened in the past. Rather, thank the person who led the place before you, acknowledging that everyone did the best job that they could.

  • Outreach and transparency from the top down are important for an organization. Critical to this are listening to others and understanding their point of view. When you take the time to listen, you can actually learn something or your mind can be changed.

Mistakes young leaders or people newly in leadership positions commonly make [20:15];

  • Young leaders often put their ego at the forefront of what they do and fail to realize that what’s most important is the mission or the common goal.

  • Leaders need to learn how to say, “I need your help”. Rather than saying, “Why the ...did you do that?”, they should say, “Would you please help me understand why you chose to do X? I’m sure there’s a reason and I just need to understand it.”

“The job of the leader is not to execute tasks to get the mission accomplished. Instead, it is to ensure that the people who are actually going to execute the tasks are taken care of. If they understand this, then they’ll take care of your joint mission.”

The right mix of being respected and being liked [22:30];

  • When you’re leading people, there’s a balance between being approachable but also being able to give honest feedback.

  • As a leader, the first step is to be clear regarding your organization’s vision and mission. Included in this is a description of how you’re going to engage with each other.

  • Lay out for people upfront what characteristics are important, such as integrity, service, personal courage, dignity, respect. The next step is to be a good role model and live it.

  • A job of the leader is to generate a shared sense of purpose and passion in the organization. This, ideally, is what gets people out of bed in the morning to come to work.

“The leader can be friendly and look after everyone’s well-being, but doesn’t need to be everyone’s friend. The leader is responsible for the organization, but is not responsible for everyone’s actions.”

Czarnik’s special skill for being able to start conversations with anybody, no matter who they are [27:25];

  • When in a tense situation or one where he senses nervousness, he uses laughter as a remedy. He looks to do or say something that causes people to laugh, often at himself or at a part of the environment. His goal is to generate some kind of joy for people.

  • When starting conversations, he avoids irrelevant or filler topics. Instead, he tries to get people to talk honestly about what motivates them. He asks about their frustrations in life and tries to decipher how he can help them.

  • Czarnik tries to get people to tell him their stories, so he can better understand where they’re coming from.

“Joy in people’s life doesn’t just happen. It’s an active process. We make joy happen. I try to generate some type of joy, whether it’s laughter, buying drinks, or picking up the tab for meals. My goal is to die with no money.”

How Czarnik manages email [31:15];

  • He makes it clear that there’s no such thing as an emergent email or text. If somebody needs him to respond urgently, they should call him.

  • When he gets email, he color codes them so he can prioritize his need to respond.

Czarnik’s personal philosophy and approach to life [33:00];

  • What gets him out of bed is what he has chosen. It’s an active choice to engage in the world and of providing an embrace and love in his interactions with other people.

“Purpose is embraced, not imposed.”

Czarnik’s ask for the world of medicine and something he’d like to see change [34:10];

  • Accept and embrace any opportunity to work with medics from the Department of Defense. These young men and women are tasked with practicing medicine in an austere environment and the closest thing they can get to prepare for this is working in an ED or ICU.

  • Mentor them. Help them understand how to make clinical decisions.

And more.

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Shownotes by Melissa Orman, MD

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