Intro to Managing Career Transitions with Gina Cronin and Brian Bolwell, MD

Podcast Transcript

Introduction: Welcome to Beyond Leadership at the Intersection of Leadership and Everything Else. In this Cleveland Clinic Podcast, we will commingle with extraordinary thinkers and explore the impact of their ideas and experiences on leadership and management.

Brian Bolwell, MD: Today I am joined by Gina Cronin, Chief Talent Officer at Cleveland Clinic, to help us kick off our next mini-series on career transitions. Gina, thank you for joining us today.

Gina Cronin, FACHE: Thank you, Brian. It's truly a pleasure to join you and I'm eager to hear from the folks that you're going to be having conversations with. But I would love to start with a question for you as we kick off this mini-series, if that's okay with you.

Brian Bolwell, MD: You bet.

Gina Cronin, FACHE: So I know a little bit about your leader journey here at Cleveland Clinic and know that you were tapped really early in your tenure, and pretty fresh out of your medical training for your first leadership role. Can you share with us what that transition was like for you?

Brian Bolwell, MD: Yes, I can. It was a surprise. So I came here many, many years ago now to be a leukemia doc and specialize in leukemia and hematologic malignancies. Included in that is bone marrow transplantation, which for our listeners is a pretty intensive and specialized way to try to treat leukemias and lymphomas and some other disorders. At the time we had a small transplant program and it consisted of a couple of seasoned physicians. And I joined the group, even though it wasn't my primary area of interest at the time.

And within the first 18 months, both of the other two physicians left the organization. And so I was told that I was now in charge of this program. And I actually knew absolutely nothing about leadership. I was a pretty good clinician and so that's what I focused on. I focused on trying to make sure that we took care of our patients well and that we did well clinically and we got good clinical results. From there I realized the importance of having good people around me because we needed good nursing. It kind of started with there because nursing is essential to clinical care, I think, especially for people who are quite sick as transplant survivors are.

And the other part of that which was important was developing a database and some research support because especially back then everything we did to do with bone marrow transplants was relatively new. It really hadn't been around that long. And so it was important that we kept track of our data. But in terms of fundamental principles, Gina, I really was winging it. And I knew I cared about patients and I knew that it was important to try to do the best we could from a clinical perspective. But beyond that, there was a lot of learning on the job.

Gina Cronin, FACHE: I bet. What advice do you wish you could give your younger self at that pivotal moment when you were handed the helm of bone marrow transplant?

Brian Bolwell, MD: Oh, I wish I'd be able to tell myself that I was an incredible novice when it came to leadership, that there was a lot of resources out there that I could tap into and that I should have tapped into. But I was actually unaware that people talked about leadership, that people would do what we're doing right now. That there are many, many authors who have written some wonderful, wonderful books about leadership that are available to everybody.

Gina Cronin, FACHE: So the research on leader transitions by Corporate Executive Board is kind of dismal. And they estimate that 50 to 70% of executives fail within 18 months of the role. And that's really agnostic whether they're internal hires or external hires. How have you seen leaders go off the rails when they're new into the role? What are the root causes of that?

Brian Bolwell, MD: I think that's a wonderful question so thanks for that. I think that it's rarely because a new leader does not understand the technical parts of the job. It's usually because they don't exhibit humility. They don't listen enough. They don't get enough input. They think they have all the answers and they're level one leaders. So again to remind our audience, a level one leader is a leader who basically orders people around because they're the boss as opposed to developing relationships and building teams, and being transparent and humble.

And so I think that step one whenever you get a new leadership job is to listen. That's just absolutely essential. You've got to go on a listening tour and I'm trying to do that now. I mean, I've taken on the role of director of physician leadership at the clinic full time. And my goal for the next several months is simply to listen and to hear what people are thinking, what they think our opportunities are, where they think we can do better. But I think that's what derails people, Gina, is they don't act humble and they don't listen and they think they've got all the answers and they don't engage the team very effectively.

Gina Cronin, FACHE: Mm-hmm (affirmative). One of the transition points that we obsess about here at Cleveland Clinic and in partnership now with you Brian is new leaders when they're new in role. So we really work intensely with them for about six months with a whole variety of very personalized support from stakeholder interviews to coaching, team assessment and team formation. If you had to pick a tool that you think really is a must-have for a new leader for them to hit the ground running, which one would you recommend?

Brian Bolwell, MD: Well, I think all of the things you mentioned are important and I think that under your leadership, Gina, we have a best practice when it comes to new leader onboarding, but I think we're very proud of and I think a lot of people can learn a lot from. And I think that's pretty cool. I'm proud of that. I think that there's a lot of ways to try to get to know culture. I think culture is different in every organization. I've always been a huge fan of executive coaching. And so I think if you've got a good executive coach that can help tremendously. And it can certainly help you recover if you've made some errors.

It's interesting. One of the things I'm doing right now is rereading a bunch of leadership books that I've read in the past two decades and I was just reading one earlier today actually. I'm not reading it its entirely, but going over it. And one of the things it talked about was how important it is to develop trust and then if you've lost trust, you can rebuild it. You can admit your mistakes. You can be transparent and open and honest and vulnerable. And you can repair the errors that, that inevitably we all make.

As you know, I like to say I have a PhD in making mistakes. But I think for new leaders in transitions inevitably they will do things that appear to be odd or different. But I think it's okay. It's okay as long as you're open and honest about that and receive some guidance. That's why having onboarding and having coaching I think is a wonderful way to try to make sure that that transition is successful.

Gina Cronin, FACHE: Mm-hmm (affirmative). One bit of insight I heard from our CEO, Dr. Mihaljevic is that as your leader responsibilities expand when you really grow in the organization, you have to pick what you're going to let go of which often is really, really hard especially when we love our teams and love the work that we're leading. Have you had that experience in your career where it just risen up and have led the Taussig Cancer Institute? What have you had to let go of?

Brian Bolwell, MD: Yes, I have. The hardest thing to let go of was the bone marrow transplant program. So that was my first leadership job and we built the program into something that was very, very good. And we had a lot of great people and, we still do. And I like to say how important relationships are to work and how important relationships are to getting things done and to achieving results and to having an enjoyable workplace. And so I had some very, very close relationships with members of the bone marrow transplant program for many, many years. But as I became chair of the cancer center, I had so many additional responsibilities that it just wasn't feasible for me to continue to lead it.

And so I stepped away from leadership and then I gradually stepped away from any sort of major role within the program, because I was doing a lot of other things within the cancer center. That was hard. And the second one just happened, Gina, is when I left the cancer center. 30-plus years of my life have been devoted to the Taussig Cancer Institute at the clinic. And we're very, very proud of everything that we've accomplished. And you accomplish it with the people, you accomplish it with great people and with great teams, and with a great culture. And it was nice to have as many going away parties as I did, but it was pretty emotionally drenching.

Gina Cronin, FACHE: Mm-hmm (affirmative). I think one of the things where we feel very fortunate, Brian, is to have you in this new role and in leading physician development, is that you've experienced it, right? So you can walk the walk and talk the talk. When you're mentoring new leaders, how do you talk to them about the emotional effect of transitions? It could be fear or lots of different things I'm sure bubble up.

Brian Bolwell, MD: Yes, you're absolutely right. Everybody has anxiety when they take on something new and everybody wants to be successful and everybody wants to please the boss and all that's normal, all that's natural. I think that it's important to, to remind people that there's a reason why they were selected to do whatever they were selected to do. And it's usually because they have a lot of talent, they have a lot of knowledge, they have a lot of expertise. And hopefully it's because they have a lot of leadership capabilities.

I think it's okay to tell people that missteps happen. It's okay to make mistakes. I mean, Gina, I think so much of this journey of leadership is about self-insight and self-awareness. And I think that if you're willing to be open to feedback, which is why executive coaching is so important. If you're willing to listen and have a true desire to improve and improvement means that you have to change. I mean, if you want to be different than what you are today it means by definition you have to change. And that means you have to change your behaviors and your actions. And that's not easy. In fact, it's quite challenging.

But I think that step one with a career transition is just to reaffirm that somebody got a given position because a lot of people thought that they were quite qualified for that. They need to be kind to themselves because it's going to take time to figure it all out. And they shouldn't assume they've got to fix everything today.

Gina Cronin, FACHE: Mm-hmm (affirmative). And often when people are placed into these roles we know they have the skills and experiences to do the job. You alluded to that before. How do you think of culture, right? So when you're talking to leaders who are brand new to an organization, how do you help them think through how do they determine the culture, understand it, how important is that for them?

Brian Bolwell, MD: I think it's very important. I think that, as I said earlier, every organization has its own culture. I mean, my personal belief is that the way to absorb whatever culture you're in is to be true to your own values and to stick with core values, being honest, being transparent, having the courage to do the right thing even when people aren't listening or watching. If you stick to your values and again, if you're willing to listen and willing to improve, I think that the learning culture gets easier.

I think if you're willing to be transparent and willing to be vulnerable and authentic. And say what you don't understand or what's confusing you, I think people are generally very willing to help up and down an organization. And so that's another part of course is don't just stay in a cloistered environment at a very high level. I think to truly understand culture you've got to talk to people at all levels and go out and mingle and go out and make a lot of meetings with people. And ask about their lives. Ask about their families, ask about what they like to do. Some people like to hike. Some people like to fish, whatever. I mean, all these things are ways to connect. And I think the more you make connections, the more it's easy to digest and to understand culture.

Gina Cronin, FACHE: Yep. So you talked a lot about honesty and courage and values, but the word that stood out for me, Brian, was when you talked about vulnerability. And for a new leader, who's trying to be super competent, how can they show vulnerability in a way? What do you suggest?

Brian Bolwell, MD: Well, it's one of the hardest things to do, Gina. I like to quote Brene Brown who has a wonderful book called Daring Greatly in which her main thesis is that it takes tremendous courage to be vulnerable because the antithesis to vulnerability is the feeling of shame, the feeling that you're a failure and you're unworthy. And therefore it does take courage to be vulnerable to admit that you don't understand or that you don't know the answer to a given question.

Brian Bolwell, MD: But I think if you're willing to have that sort of courage, it leads to very authentic relationships and authentic relationship building and connections. And I really think it's worth it. It's hard for people to do and not everybody seems to be able to do it, but boy it's a skill that I think is pretty cool if you can develop it.

Gina Cronin, FACHE: That's great. Well, Brian, I am really looking forward to listening to the episodes you're going to be releasing in the series. Can you give us a preview of some of the leaders are going to be interviewing?

Brian Bolwell, MD: Yeah. So one of the things that I want to focus on is not just transitions, but also kind of overcoming times when things didn't go so well. I'm not sure it applies to our next upcoming people because they tend to be pretty big success stories. But one is our president of our hospitals, Don Malone. One is the CEO of the Allegheny Health System, Cynthia Hundorfean. And one is Mark Harrison who's the president and CEO of Intermountain Healthcare.

But I've been appointed to a variety of positions here in our organization and sometimes I've been asked to lead those positions. And that's where resilience comes in. And that's also where I think that being clear about your values and being clear about what your core is and number one and number two to learn from these sort of setbacks. And to try to understand why they happen and what you can do to improve. Some people say that to change you actually need some sort of stimulus that's painful. And I'm not sure if that's always true, but I think it certainly can be very motivating and it historically has been for me.

When I have a career setback it hurts. I don't like it at all. I'm very, very driven and motivated to succeed. But I think that, that the opportunity when that happens is to try to learn and to try to learn more about yourself, to try to learn about what sort of challenges you have personally, and to face them with honesty and courage and to try to get better. And if you can do that it's incredibly rewarding. I think it also makes for pretty good storytelling.

So I'm very hopeful that we can get into a little of that with, with the trio that we've got coming up, which is a very special group of people. They're all very good friends of mine and they're all wildly talented and extraordinarily successful. And I think our listeners will love to meet them. Speaking of transitions, you've had a few, Gina. Would you like to comment on transitioning from being a leader in our clinical area to what you are now, which is our chief talent officer?

Gina Cronin, FACHE: Oh, yeah. That was a really dramatic change for me, Brian, and a big learning curve for sure. So I had spent my career here at Cleveland Clinic working with our physician leadership and nursing leadership really around clinical operations and very much daily management, as well as strategic management. And I was tapped on the shoulder by Dr. Brian Donley who was chief of staff at the time and asked to do something completely different and out of my comfort zone, which was really around leadership development.

And it was jumping to a whole other S-curve. So I started at the very bottom of knowledge and learning terminology and human capital trends and made a lot of early mistakes. Someone with my trying to bring in my operational acumen top strong and made some people mistakes, but it has been a great journey really with the team that we have built. I have learned more with this smaller scope of responsibility at least around revenue and budgets than any point in my career. So it's been a real honor to serve the team.

Brian Bolwell, MD: So we talked earlier about what do you do in the beginning? So what did you do in the beginning? How did you learn something that you didn't know much about?

Gina Cronin, FACHE: Yeah, I went out into the outside of Cleveland Clinic and really wanted to learn outside of healthcare. There have been a couple of decades of organizations who've done this very well whether in consumer or financial services or banking, and I was an eager learner. So I hopped on a plane and got in a car and ended up with the folks from Procter and Gamble and GE and Pepsi. And really sought out what they did as best practices and didn't adopt them because we have a very unique culture, not only here in healthcare, but Cleveland Clinic. But try to assess what would work here, what we were ready for and bring back some of those recommendations to our executive team for consideration.

So that really I think helped us. And then from there it's about, as you said, Brian, it's about the team. And so we really built a fabulous team and probably my most humblest learning has been rather than leading from the front that once we allowed the team to work together across boundaries and across silos, we just saw all kinds of incredible ideas and genius bubble up. So that was a tremendous opportunity and learning for us to really move things forward.

Brian Bolwell, MD: So we have a wonderful team here. Thanks again thanks to you. How do you keep growing and learning? How do you keep all of this continuing to thrive? Is it strictly using your team? Do you continually try to learn new stuff about leadership? Do you ever use a coach yourself? Do you get feedback? Do you have 360s? Do you use some of the tools that we think are important for other leaders? What are your thoughts about all that?

Gina Cronin, FACHE: Mm-hmm (affirmative). Yeah, I can tell you we've had some nice successes, but we always feel that we have to continue to stretch and push and we don't rest on our laurels. So I think for us our purpose, our 70,000 caregivers, our leaders and how do we serve them well? So we continue to get insights from within the organization. We do a lot of listening too from our leaders and our caregivers. What's working well? What do you need to grow in your job? How do you want to develop? And so that's a lot of kind of the listening and after action review tools that we do in all of our work.

We're a bit obsessed about metrics. So it can't just be building something and feeling that someone went through a leadership program and they enjoyed it. Ultimately the holy grail for us is to find outcome metrics just as we do in medicine. So how can we know that we've designed a program that's leading to an outcome that's going to help us serve the organization well? So that's I think really what we're continuing to push and never love your ideas too much. You've got to embrace that you have done something wrong and to regroup.

Personally just like you, Brian, I am a work in progress. And so I very much have liked using especially the insight tools that our team has had. It's given us the opportunity to not only determine what would work well in our organization, but you get insight and debriefing and coaching. So I have an accountability partner on our team. So I asked my accountability partner on the team to call me out whenever I'm not living up to what I hope to do for the team. So I think that's an incredibly important to have that embedded. Someone right in the moment who can say, "Hey, you said you want to show up like this, but when you talking to that person that actually was not what happened."

So again, having that trust to have colleagues as well as direct reports call call you out on that is tremendously helpful for ongoing growth.

Brian Bolwell, MD: That's fabulous. How do you create leadership metrics?

Gina Cronin, FACHE: Ultimately, what we'll do is we'll go to our organizational strategy. So we'll go right to our CEO scorecard and look at our objectives and key results for that year. And so we'll tie our learning metrics right to that. So a great example is we're looking at caregiver development and we know how important it is for our 70,000 caregivers to feel that they're learning and growing in their job. And not just around promotions, but just gaining skills and capabilities.

And so the metric we have, we tied it right to our annual experience survey. And we built a learning metric, not just a single metric, but a whole kind of compendium of metrics around development. So now we have a development index for our caregivers that can show us how we're doing baseline and year-over-year. So continue kind of benchmarking to ourselves within that. But it's not always easy. It's not trying to show that someone has developed as a leader is going to lead to greater operational success is a little bit tricky to do so. Hopefully we can partner with you, Brian, to continue to push the envelope there to really get to that place.

Brian Bolwell, MD: Yeah. So you touched on a lot of very important things right there. I think that tying development to an annual engagement survey is brilliant. I think that makes a ton of sense. And then it's a great way to get feedback and to see how we're doing. So huge applause for that. And yes, I mean I think that one of the things about leadership. Development and teaching and curriculum is that at the end of the day we have to deliver results. Any leader of any organization has to deliver results. We have to have wonderful quality and safety in healthcare. We have to have great patient experience. We have to grow our business. We have to have great access.

These are all fundamental to a high functioning healthcare organization and the leaders are responsible for that. And as well as many other things and aligning with the CEOs' OKRs I think are an obvious way to ensure alignment. But all of the things that we talk about on this podcast and all of the things that both Gina and I talk about when we talk about leadership development, one end result has to be that it makes it better that we make the organization better. And that we lead to improvement within our organization as well as for our caregivers. And we can't forget that because I think that's always got to be front and center.

Gina Cronin, FACHE: 100% and how do we connect it all, right? So that's selection, and development and results and pipelines that that is all interconnected so we can serve the organization at whatever stage people are in.

Brian Bolwell, MD: Yeah. That kind of leads to something that Gina and I are partnering on with respect to search committees. Academic medicine is used to having a national search committees. We're adding some structure to the way we do that here at the clinic, which we can talk about in a future episode. But I think which is quite an opportunity for us and I think will be a differentiating for how we select our leaders to very high level of clinical roles.

Gina Cronin, FACHE: Mm-hmm (affirmative). Absolutely. It's a huge opportunity and how do we bring best practice and structure to really mitigate bias within that process? And to ensure that it's a fair, transparent process. And I look forward to partnering with you on that, Brian. That's really important work.

Brian Bolwell, MD: Yeah, I think it's vital. One of the things that we've done this year, which I would suggest for all of our listeners to do is when any sort of leadership position is open to make sure that it's broadly posted and that it's widely available for everybody to see. Because you never know who's going to wind up applying for a given job unless you give them an opportunity.

And the second thing that Gina raised, which I think is incredibly important is with the whole issue of bias. And I think it's an opportunity for every organization especially in healthcare to address it with a little more rigor than we've historically done.

Conclusion: Thank you for joining us for this episode of Beyond Leadership. We welcome any topic ideas, comments or questions about this, or any past episodes. Email us at executiveeducation@ccf.org or by clicking on the link in the show notes.