Do The Right Thing

Podcast Transcript

Brian Bolwell, MD: Beyond Leadership, a Cleveland Clinic podcast at the intersection of leadership and everything else. In this podcast, we will commingle with extraordinary thinkers and explore the impact of their ideas and experiences on leadership and management.

Hello everyone, I'm your host, Dr. Brian Bolwell. And today I'm thrilled to be speaking with Dr. Steven Corwin, President and CEO of NewYork-Presbyterian Healthcare System. Welcome to Beyond Leadership, Steven.

Steven Corwin, MD: Well, thanks Brian for having me, really appreciate it.

Brian Bolwell, MD: Steve, can you tell our listeners a little bit about your journey to CEO? You're a cardiologist by trade, are you not?

Steven Corwin, MD: I am.  I trained in…I…after graduating Northwestern medical school, trained in internal medicine at Columbia, did a chief residency there, then cardiology fellowship, and then became a cardiology attending. And my first administrative job actually was leading the coronary care unit at the then Columbia Presbyterian. Ended up leading all of the intensive care units, became the medical director there. And then upon the merger of New York Hospital and Presbyterian Hospital became the chief medical officer of the enterprise and that was 1999. And then chief operating officer in 2005 and CEO as of 2011. So, it was not a designed pathway, let's put it that way. I really thought that I would practice cardiology for my career, really never thought that I would get on the administrative side and by serendipity, this all developed.

Brian Bolwell, MD: So, you must have done a lot of things very well. Go back to your days as the head of the coronary care unit, you must have been pretty young when you were in charge of that. Are there any take home lessons that you learned from that?

Steven Corwin, MD: I think that between that and my chief residency, I think there are a couple of things that I learned. First, teamwork really in any setting is really essential and valuing nursing, respiratory therapy, critical care anesthesia that became really important because cardiologists certainly didn't know everything about CCU care at the time. But also, really understanding, I think, the guts of what happens in a clinical enterprise, knowing what it's like to be up at two o'clock in the morning with a hypotensive patient who you're worried is going to arrest, and translating that into how you deal with physicians and caregivers in general. I think that's the biggest take home that I would have.

Brian Bolwell, MD: Yeah, I really agree with that. I think having that insight and that experience is invaluable. So, then you were a chief medical officer and then not too long after were a chief operating officer. As you continue to evolve in your administrative career and became responsible for a larger constituency, what additional learnings did you need to learn, or how did you even start to learn about leadership? Did you study it? How did that all happen?

Steven Corwin, MD: You know, I didn't study leadership per se. What I would say to people asked me is that as we talked about before, I had a very firm understanding of what good clinical care was, what not so good clinical care was what quality was, what lack of quality precipitates. So, I think I had a very good understanding of the clinical realm. And I tell that to all clinicians who want to go into the administrative realm. I tell the administrative people who want to understand clinical medicine you really have to spend time doing that. So, starting with what I did in the CCU and then beyond that, I really was tutored informally by many people in terms of how do you conduct a meeting? How do you read a balance sheet? How do you do accounting? I mean, I didn't take accounting in medical school, I don't know who does. And so, I had to learn accounting.

I took some short courses at Wharton in a variety of different topics, mainly the finance topics, because I think if you're running a substantial operation, you have to understand the finances of it, you have to understand the business planning process, you have to understand what works and what doesn't work, but then put it through the filter of does this program make sense? So, when I became the chief medical officer, I was in charge of all the service lines and therefore all the service line business plans, you had to understand all of that. This is the margin mission deal that we talk about all the time. You want to embrace the mission, but you can't embrace the mission without a margin, and you have to understand not only what programmatic excellence is, but how do you develop programs in a fiscally sane manner?

Brian Bolwell, MD: In 2011 you became CEO. A lot has changed between now and then. And certainly, in the spring of 2020, New York was the epicenter of COVID and I think you have the largest healthcare system in New York City. A massive crisis, and a huge leadership test. Tell us about that because I think it affected your metropolitan area more acutely than any other place in the United States.

Steven Corwin, MD: Well, let me take a step back for a sec. And I think that one of the things that is axiomatic but worth mentioning when one becomes a CEO is how do you deal with your board, your board of trustees? We have a large one, the governance is exceptional. I've always believed in complete transparency with the board and using the board as a means to develop and achieve strategy. And I think that in many instances, not utilizing the skillset of board members who are of course trying to serve a public mission, these are not paid positions, but have expertise in various areas of business is really helpful. So, as we got into 2020, having had that relationship with the board, I think was really critical.

Secondly, I really think that our notion around an academic medical center is it should be physician led and physician driven. And so, the chairs of departments, the chiefs of service lines become critical in terms of how do you achieve an objective? So, we get into 2020, and we had made a decision, perhaps belatedly as a system that we were going to go completely Epic as an information substrate, all of our hospitals on the same instance of Epic, all of the physicians on the same instance of Epic. We had spent the better part of 18 to 20 months preparing for it. And at the end of January, we had our first go live at our Columbia campus, which was one of our largest campuses.

So, most of what I was thinking about in January had to do with the Epic go live because of some of the horror stories associated with those go lives, making sure that we were ready, making sure that all the physicians were trained. I took the training. I wanted to see what people of my generation felt about getting into Epic, as opposed to the residents who took to it like ducks to water. And we were following what was happening in Wuhan, and then got very concerned as we started seeing what was happening in Italy.

But I would say that we were probably distracted by the Epic go live at the end of January. Thankfully, in retrospect, we did it, we had it ready to go. And I think we did an excellent job of that during the month of February. We were somewhat taken aback when it became very clear with the first index case in New York that was from Westchester that actually came to our hospital, it was pretty clear he had done no travel and it was very clear that we had community spread. We knew the R value of the coronavirus and we knew we were in for a rude awakening and trouble.

We all do tabletop exercises all the time and we all do preparedness, whether it's for pandemics or for power outage, et cetera, but we didn't have something specific around pandemic. We had disaster preparedness of which this was a subset. When we did that exercise, that tabletop exercise, we thought that we had an adequate number of ICU beds across the system, 450. We thought we had an adequate supply chain of masks. We thought that we would generally use a certain number of masks per day, and we thought that might go up fourfold. So, what did we find? That this was calamitous. We had to suddenly construct an additional 450 ICU beds. And we were using 25 times the number of masks that we had anticipated with the pandemic. And we all know now the supply chain issues were horrendous, the CDC was late to the plate in terms of testing, so we had a limited number of tests, limited that the test had to go to the public health lab in New York and then get to the CDC, so we were a day late and a dollar short on the testing.

And we were confronted with a disease in the spring of 2020 where there was a 20 plus percent in-hospital mortality rate. So, it was just really horrific. Part of the issues associated with that really were the fact that, again, we get back to this issue of understanding clinical medicine. It was very clear to all of our chairs, to myself, that this was going to be an ICU crisis, emergency room and ICU crisis. You could create all the comfort ships and all of the post-acute care things like the JATA center, but you needed to have ICU beds and you needed to have ICU capability. And it's academic centers like Cleveland Clinic, like New York Presbyterian, like Hopkins, et cetera, that not only has the wherewithal to build the ICU beds, but actually has the medical talent to run the ICUs for very, very critically ill patients. And I think that should be a take home to the country at large. The major academic centers in this country are absolutely essential for the healthcare infrastructure of the US.

Brian Bolwell, MD: I remember I was running the cancer center, we weren't within the ICU COVID environment, but the thing that I remember the most vividly was the fear that was within the community and also within our caregivers, because we didn't understand the virus, we just knew it was lethal. And yet there became a esprit de corps because we showed up every day, we continued to take care of people and it was almost a bonding experience for those of us who were still practicing medicine. And I found that the key for me was to be authentic and to be transparent and to constantly communicate, sometimes multiple times a day. How did you approach that?

Steven Corwin, MD: I think the same way. First of all, I think that…we redeployed 3000 physicians. If you were a dermatologist, you might be working in the emergency department. And we were asking people to do a lot, people who would not necessarily…our chief of orthopedics was in the emergency department. So, the first thing basically is we had to convey a couple of things. If New York Presbyterian falters, the city is in trouble. So, we've got to lead the way through this, and we can't afford to fail.

The second thing was basically, how do we organize ourselves so that we can maximize the number of patients that we can take care of and how we can take care of them? So, we developed a parametal staffing mechanism for the ICU. So, our most capable intensivist nurses, respiratory therapists, physicians were at the top of the pyramid and then we had a lot of people working below them who did not necessarily have a lot of ICU experience but could be instructed. Otherwise, we could not have gotten through it with a traditional intensive care model. We were probably…for nursing, we were at one to three or one to four in ICU care. And ordinarily you'd be one to one or one to two with somebody that is basically leaving the unit. So that was really problematic.

And I think that the key was basically, look, we're in this alone, we're not getting helped. We have to do this. And that esprit de corps, that sense of who we were, NewYork-Presbyterian, Columbia, Cornell, that we were going to do it. And if we couldn't do it, we'd be the last man standing. And I think that to your point, everyone was afraid, but I think everybody stepped up to the plate. And I'm not just talking about the doctors, I'm talking environmental service workers and nurses. And we decided that we had to support them. We spent 300 million in support. We gave four meals a day, and I'll get back to that in a second, four meals a day to staff, we domiciled 3000 staff members who were afraid to go back home for fear that they would give their families the virus. We had a 50 bus service to make sure that people could get to work amongst other things. We gave out two bonuses to help people through this, et cetera.

And the board basically getting back to that level said, "Steve, whatever you have to spend, spend. Don't worry about it." So, we ended up in 2020, I think even with federal grant monies, the PRF monies, we lost 650 million and the board said, "We don't care. You just have to do what the right thing is." And I think that gets to the relationship of the CEO and the board. And also, the CEO with the leaders of the institution, physician leaders, the nursing leaders, and you really perform, I think, a convening role. This was very humbling for me. It was very humbling to see the level of dedication that people really had and really inspiring. I know that it became perhaps a little trite, healthcare heroes, but they were, there's no question about it in my mind.

Brian Bolwell, MD: Yeah. I mean, we talked previously about the importance of kind of understanding clinical medicine. I don't think that people fully appreciate the pandemic unless they were working within a healthcare organization. Obviously, families do because there was so much tragedy and that's continuing, unfortunately, but the heroism that so many organizations across the world really, and you're a hundred percent correct, physicians and nurses and environmental people and just everybody associated was stunning and it was humbling and it was something that made you incredibly proud.

But what you just said is I think kind of the essence of leadership and that's doing the right thing. When I coach people, that's always one of my themes is do the right thing, because doing the right thing isn't always easy. So, in your case, one of the consequences was to do all this stuff, had major financial impact. But at the end of the day, if you've got that sort of north star, usually things are going to be okay.

Steven Corwin, MD: I think that's right, and I think also people want you to be authentic…

Brian Bolwell, MD: Yep.

Steven Corwin, MD: …In this world, you got to show empathy. You have to be empathic; you have to understand what somebody else is going through and culture trumps strategy every day of the week. If the culture of the place is a culture of respect and belonging and people feel valued across the board, good things happen. Listen, we made mistakes along the way. I mean, I just told you that we probably were distracted by Epic. We clearly underestimated the magnitude of what could happen in terms of masks and ICU care. But geez, I mean the federal stockpile was a joke as you well know, we got ventilators that were old, didn't have tubes established with them. I had one supply chain director drive out to New Jersey to speak to a small manufacturer female-owned firm that made tubing. And she constructed tubing for the ventilators that we got from the federal government that did not have tubing. She had never manufactured those before.

So, these stories that come out, it's one after another. But then of course you have the tragedies associated with this. We had an ER medical director commit suicide after having COVID. We had employees die. We had employees that quit work because they just couldn't come back to work after having been through this, FaceTiming with the family of a dying family member, things of that nature. We had finance people that had to work in our morgues because we didn't have enough morgue technicians and you get forever scarred by that. But I think that everyone feels that we got through it and that we made a major contribution and that it was a significant accomplishment, but there was a lot of pain along the way and a lot of people who are still pained by it.

Brian Bolwell, MD: Yeah. I agree with that. So having that sort of culture to allow you to do all the things you did, for you to lead that group of that the entire organization, I mean, you have to generate, you mentioned authenticity, which I'm a massive believer in, and obviously trust. So, when you think about trust from your role as CEO, how do you generate trust? What do you think's important and if you have it, what does it get you?

Steven Corwin, MD: Well, my father used to tell me if you're sitting around a table and you think you're the smartest guy in the room, think again. [Brian laughs.] So, I always took that to heart. And I think that leads you to, you're not going to out finesse somebody. I don't believe you can play angles. I don't think that there is a Machiavellian approach to this where somehow, you're going to finesse somebody or pull the wool over somebody's eyes or maneuver somebody. So, I've always taken the position of just tell it straight up. And I always tell my senior managers, "When the board asks you a question, answer the question, just answer the question and don't try to spin it, don't try to fluff it, just answer the question because however many angles you've seen these board members have seen a similar number, if not more."

So, I think that's helpful, I really do. And I think that it gets beyond authenticity, the fact that you're going to be a straight shooter you tell people what's actually going on. So, at the beginning of this we modeled it out. And I said, "We're in for a rough ride. We're anticipating that we could get close to 3000 patients in the hospital." At the peak of this, we had 2,600 patients in the hospital. We had 80% of them in one form of ICU or another, we went from 450 to 1000 ICU beds. We had our facilities guys just constructing ICU beds at every op area, you name it. And we were basically three ventilators shy of basically not being able to provide ventilatory support. And then it peaked, thank God.

But we were questioned all the time, "Is there an algorithm for determining who gets a ventilator, who doesn't give a ventilator?" And I take the position of any physician that has to make a critical decision, we'll back the physician, we'll take the liability for the decision, but I'm not going to use a color by the numbers algorithm to determine should patient A or patient B get a ventilator. If you think somebody is going to die and you want to remove support, remove support. If you don't think somebody should be intubated to begin with, don't intubate them. And that was hard. It was hard for the clinicians. They really felt like, "Gee, you know, I'm not sure I'm up for this," but I felt that if we did it any other way, it was going to be the wrong decision ethically. And that was not a slam dunk, I think that 70% of the physicians probably agreed with it, 30% of the physicians were concerned about it. And that was probably one of my toughest decisions.

Brian Bolwell, MD: So now partly as a result of COVID, we are in the midst of the Great Resignation and staffing is a big issue. And I think almost every academic healthcare system is having a challenging 2022 financially, how are you coping? How are you managing? How are you planning? How are you strategizing? What's going on?

Steven Corwin, MD: Fortunately for us, I think we're coming out of the back end of this. Our vacancy rates have gone down substantially, but at the peak of this, our nursing vacancy rate was about 15%, and traditionally our vacancy rate is, I don't know, 3, 4%, right around there. It's trending down now, it's probably around 6 or 7%, which is much better. A couple of things.

First, the Great Resignation, the staffing issues hit it the worst time for us because it was right as Omicron surged. Now Omicron wasn't as severe in terms of people were requiring ICUs or people dying, but they still were in the hospital, still a lot of sick patients. And the basic problem we had in this past winter was the staffing problem. So, we had started ramping up staffing in the September, October timeframe, thank God. But we had a devil of the time in January, February timeframe, our patients experience numbers if you want to look at that as any sort of proxy went down to the lowest it's been in 20 years. Our staff were burnt out, they were really on edge. And we committed to them that we're hiring as many people as we can. At one point, I think we were hiring close to 300 nurses a month and that type of thing. I'm sure other academic centers have gone through a similar experience.

I think it raises a couple of issues. The first is we've hired 4,000 new people. So, what's the culture? How do you reinforce who we are, what we stand for, what the mission is? And that gets back down to the, what are the foundations of what we believe? What's the respect foundation, what's the belonging foundation? What does it mean to be at NewYork-Presbyterian? What does it mean to be at the Cleveland Clinic? And what is our mission? And so, you've got 4,000 new people that you're inculcating into an environment, and you want them to have that same feeling.

Second thing is in terms of turnover, most people will leave an organization within the first 12 to 18 months of being hired. So how do you have a retention program for all these new hires? And a lot of our program is predicate on the nature we recruited you because you're excellent. The adjustment period, especially for a new grad nurse or a young physician, can be very tough. Your workload is higher than what it was pre-hiring. We hired you for your excellence. We know it can be tough, we're here to support you and you're going to make it through this, we're going to make sure you make it through this. So, developing the programs associated with that verbiage I think is really an important thing.

For the remaining employees, I think a lot of it was, "Hey, look, as we have come out of the backside of this thing, it's a sense of together we will, but also remember together we did." So, it's not just looking forward and saying, "Okay, there's a renewed sense of optimism. We've gotten through it. We're supporting you. We want to reaffirm the culture, but let's remember what you went through. Let's remember what you did." And so, I think those things are really important. Financially we're coming out of it, but long term financially, if you don't put those things in place, you won't make it because you won't have the workforce that delivers the results that you want in whatever dimension you're talking about.

Brian Bolwell, MD: Steve, you've talked a lot about culture, and I read an article about you and at one point you talked about the mother test and that, I guess, is would you want your mother to be taken care for in this hospital bed, whether that's at the main campus or at one of your affiliated hospitals. And that's really important to you. How do you transmit that to your whole organization?

Steven Corwin, MD: What I found, Brian, in my years, in my administrative years is whatever the rank or the disagreements are amongst various, whether it's amongst physicians or between physicians and nurses, or amongst the general staff at large, if you say what's the right thing for the patient, everyone generally gets in line. And I think that's got to be the motivator. As not for profit institutions, we exist for the public good. And what is the public good? The public good is a single standard of care for every patient who walks through our doors. And if it was your mother, what would you do?

And I think that's the conveyance that you have to have, which is yes, the suits have to be in count, and you have to be aware of what the capital plan is, and the facilities plans are, and the programmatic needs are. But at the end of the day, can you look at yourself in the mirror and say, "Look, we're doing the right thing by our patients. We may not hit the mark all the time, we may not save everybody, but we're doing the right thing for the patients." And I think that people resonate to that, and they'll rally around that even if they disagree with a specific policy decision or a specific way of doing things.

The other thing that people will accept is basically if you're telling them, "I can't do this today, but I'll try to do it six months from now," they'll accept that. If you BS them and you say, "Well we're going to do this," and then you don't do it, you don't gain any traction with people.

Brian Bolwell, MD: Well, that's an essential element of trust, right? I mean, just doing what you say you're going to do. It's something that actually has been thematic in this podcast is as adult human beings, how frequently people will say they're going to do X and wind up not doing X. And if you simply do what you say you're going to do, that's a great way to generate trust and respect and a lot of other positive things. You're a very authentic, straight shooter and I think that's essential for good leadership, but how do you make sure that people do the same towards you? How do you get feedback? How do you create psychological safety and how do you ensure that people can say, "Gosh, Steve, maybe you're not thinking about this right"?

Steven Corwin, MD: Well, I think that gets to a couple of things. First of all, you have to be reasonably comfortable with the fact that you don't have all the answers, and you have to accept the fact that you're not going to be right all the time. And as CEOs, you can exist in a bubble where, A, you either think you have to be right all the time or unfortunately you can tell yourself, "Gee, I'm the greatest thing since sliced white bread." And you really have to avoid that. My wife is pretty good at telling me that I don't have all the answers, so that's helpful.

But I'll tell you an anecdote. When we've recruited our CIO, Dan Barchi from Yale, he had had experience in epic implementation. And the prior CIO, this is 2015/16-ish, the prior CIO had a clear strategy that ultimately there was going to be interoperability of systems that you could have overlay on top of this and that everything talked to everything else. And I bought into that. So, I said to him, during the interviewing process and said, "Daniel, I said, you're a terrific candidate, but I'll tell you the one thing I'm not going to do is implement Epic." A year later, he convinced me I had to implement epic. And then we implemented Epic, and it's been a good decision.

I like to tell people that story, because you have to show your vulnerability and you have to show that you're not always right. And I try to show people if I've made a mistake, "Hey, I made this mistake," or, "This is on me. This decision that didn't go well is on me. It's not on the senior manager who implemented it, it's on me." And I think that's part of what you have to do as a CEO. And then I think people will feel more comfortable, not entirely comfortable, more comfortable giving you the straight scoop. And if you say to somebody, "Just give it to me straight," they'll do that. Ivan Seidenberg who's on our board, former chair of Verizon Communications said to me early on in my tenure, he says, "Steve, you don't have to just hear the bad news, a good CEO finds the bad news."

So if that's part of your charge, then people have to be comfortable telling you the bad news and you can't react to the bad news, whether it's a bad case that's going to result in a malpractice or a joint commission survey or anything, bad financial decision, a mistake, financial supply chain, a contract mistake, you have to hear the bad news because otherwise you're blithely ignorant of what's going on in the organization. You just have to accept that. And at times I have trouble with this, you can't overreact to a particular piece of it, you just have to take a deep breath.

Brian Bolwell, MD: Do you utilize 360s for ways for feedback and to utilize executive coaching in your organization?

Steven Corwin, MD: That's a good question. What I would say is that in the early 2000s, everybody had wanted to adopt the Jack Welch GE approach, rack them and stack them and fire the lowest 10%. And all of the healthcare organizations started going to Fairfield, Connecticut to take the GE leadership thing and everything else. I was never a big fan of that and I'm not a big fan of 360s. I'm not sure it gives you the insight that you really need and I think it can be terribly corrosive for people. My father, again, used to tell me success breeds success, confidence breeds confidence. If you can instill confidence in people that'll perform at their best, yes, you have to make tough decisions. You have to make tough decisions in terms of letting somebody go, et cetera, but I'm not a big believer in 360s.

I am a big believer in executive coaching. I do think that people can gain insights into public speaking, they can gain insights into style, they can gain insights from somebody in terms of here's what you do that can irritate somebody, here's the ways to sort of avoid that, here's the way to be affirmative without being aggressive. I was once told by a senior manager that the executive coach said to her, "Look, everyone knows that you can play this serious note, that you're very talented, competent, and serious, but sometimes you have to play a different note, whether that's a whimsical note or a casual note, because otherwise people will slot you into a sort of two-dimensional figure." And I think that's really important feedback to give to people in terms of how to play things.

So executive coaching, yes, 360s I'm not a big fan of and rack them and stack them, I think was a terrible idea and doesn't create great culture as GE found out over a period of time.

Brian Bolwell, MD: So, you've mentioned teamwork as being incredibly important. And obviously I would agree with that. When you recruit and you're looking for new members to join your team, what are you looking for? How do you recruit?

Steven Corwin, MD: First of all, I think that chemistry is really important. So competence has got to be there, no question about it, but the chemistry. Will this person fit with the culture that we have, the people that we have? And how does that... Look, when you're recruiting, especially when you're recruiting from outside, you never get it entirely right, you just can't, it's just no way. The rule of thumb that I've always had was you're probably 50 to 60% successful from outside, you're probably 80 plus percent successful from inside, but it's never universal.

The second thing is I believe very strongly in diversity, diversity of thought, diversity of gender, diversity of age, diversity of race, not because I want to take a class picture of my senior management team, but because I really believe that when you have that degree of diversity, you do better, teams do better, business results are better, clinical results are better. So I think I look for, is this a cultural fit? How's my diversity? And how does the team function as a whole? You watch certain things, you watch certain behaviors, you watch people interact with each other.

I'll give you an example, we're putting together a major gift proposal for a significant donor, and there are probably seven or eight senior managers involved with getting this gift proposal together. It's a complicated gift proposal. I watch to see how they interact with each other. I watch them and I get the reports of where are we with this gift proposal, when can I give it to the donor? I think that you have to, as a CEO, be observant of that.

And you also have to basically accept the fact that we're all flawed. We all have idiosyncrasies, we all have things that we don't do as well as other things. And you have to accept somebody's flaws in addition to what they're bringing to the table. And if you can't do that, you just can't be in a position like this because everybody's got weakness including me. So you have to accept the flaws that human brings bring to the table and the fact that they'll make mistakes sometimes, that they'll lose their temper sometimes. But as long as you have the confidence that they're the right person, then you can move forward.

Brian Bolwell, MD: I think that's really profound. Thank you for that. You've been CEO for about a decade now, a little more than that. Are there any leadership philosophies that have evolved in that period of time that you stick to, or that you believe in?

Steven Corwin, MD: Listen, if you don't think you're getting better, if you don't think you're climbing uphill all the time, you'll soon find yourself going downhill. I think these jobs have shelf lives. I think you've got to know when that time is. Hopefully I will, I don't think you die in these jobs, God willing. I think you make a determination because I think ultimately these jobs are jobs of stewardship. You're stewarding the organization towards the next leader. You try to make the best decisions for the next generation, you try to develop the next generation. So I think that's really the important thing. I think that you've got to feel that you're constantly growing in the job, you're constantly learning in the job, you're constantly finding out new things, because if it doesn't have that challenge, if you think you've got it down, you just don't. And I think that would be the biggest lesson that I've taken in my decade as a leader.

Brian Bolwell, MD: And if you were going to give advice to somebody who wanted to aspire to an administrative role in academic medicine, what would you tell them?

Steven Corwin, MD:  I think you need to move from individual attribution to collective attribution. But I think that people who have clinical backgrounds, who understand the care of the patient should be well positioned and should lead these types of institutions because of the care that we deliver. I think that's critically important. So I would urge people who are thinking about these roles, who are clinically oriented, that the non-clinical side of the equation is not as daunting as you think, that understanding clinical medicine is a great part of what you need to bring to the table and that it's very rewarding. It's a rewarding life, but it's not of individual attribution. I still miss the joy of taking care of an individual patient and making it better, make no mistake about it. That was something that I thought I did well and that I really enjoyed the personal relationships. This is a different type of gratification.

Brian Bolwell, MD: Steve, thank you so much for joining us. To our listeners, I would say this about today's episode. This is going to require more than one listen, because Dr. Corwin has shared many, many pearls of leadership on many levels that I think will be very worthwhile to absorb, a lot of cool stuff here. So, Steve, thank you so much.

Steven Corwin, MD: Well, thank you.

I hope everybody enjoyed today's episode. Thank you for tuning in and we look forward to sharing another episode of Beyond Leadership. Have a great day.

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