Listening is the Key

Podcast Transcript

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

Hello, everyone. I am your host, Dr. Brian Bolwell, and today I'm joined by Dr. Raed Dweik, Chief of the Integrated Hospital Care Institute at the Cleveland Clinic. Raed is one of our most accomplished leaders and it's my pleasure to introduce him to all of you. Raed, welcome.

Raed Dweik, MD, MBA: Thank you, Brian. Happy to be here.

Brian Bolwell, MD: So Raed, you're a pulmonary doctor by training and now you've got a very large and complex leadership role. Can you tell us a little bit about the beginnings of your career?

Raed Dweik, MD, MBA: Yes, so thank you. I've been at the Cleveland Clinic for 30 years, Brian, so actually I got my 30-year certificate just in July and I actually, this really an accomplishment. When my wife and I came to Cleveland here now 30 years ago, obviously, our decision was three years and here we are 30 years and three kids later, we're still in Cleveland. And that really, a lot of it is due to the Cleveland Clinic, but also Cleveland. Cleveland's a great place to live, but the Cleveland Clinic is definitely an outstanding place to work. And I came here to do my fellowship, so I did my pulmonary and critical care fellowship here after residency in southern Ohio in Dayton. Went to medical school in Jordan before that, but really fellowship here is what got me started in the Cleveland Clinic and I stayed on staff since then.

And the amazing thing, I think, as I reflected on this is how I spent here 30 years, but really had at least five or six careers here as you kindly alluded to. And I almost left without leaving because I kept growing here from being on staff the first few years to doing research, to doing education, to having leadership roles, having multiple leadership roles, and now leading an institute. So really almost every five to six years I had a different career and a different leadership role, which is I think what kept me here pretty much.

Brian Bolwell, MD: You became a very accomplished researcher in the Pulmonary Institute, and I believe you've had significant federal funding. Was that your initial focus?

Raed Dweik, MD, MBA: No, that's a very interesting story in its own right. So, when I was a fellow here, I wanted to do research, so I tried to go spend some time in the lab, but I had to work with Dr. Erzurum who is now the Chief Academic Officer and she had her own lab and she said, you have to spend a year in the lab. But our fellowship was really designed to be a clinical fellowship. At the time I was the first one to try to do any basic research and I was told, no, you knew you were coming to a clinical fellowship. You can't do research. It really took vision from Dr. Wiedemann, who was my chairman at the time, to really redesign my schedule after the fact, after being here as a fellow to spend a year in the lab. I ended up spending an extra year after fellowship as a clinical associate to do research. But that was not even my initial plan, and then as they say, the rest is history.

I've been NIH funded for the past 20 plus years. And really once you start that and you start discovering things and learning things, it really becomes part of your career. It's something that I tell people all the time, it probably does not happen too many other places that somebody comes to an entirely clinical fellowship and has an entirely clinical career and midway switches focus to become really a researcher. Since then, several in the Respiratory Institute have done that, but I was the first I remember.

Brian Bolwell, MD: That's quite an accomplishment. So how do you continue to renew your RO1s? It must be difficult.

Raed Dweik, MD, MBA: Yes. Now I just sent one in in September, so last month. Maybe this will be my last one. My goal is to help the next generation, people who I have trained here. There's several faculty and staff members here who are just about to get their R01s, so I'm really trying to hold onto that until they get their own R01s. Many of them had K awards, which as you know, I'm passionate about physician scientist training, and I lead the KL2 program here, which is a citywide program in Cleveland to encourage young staff to get NIH funding and to have careers in research. And I have two staff right now who are themselves applying for R01s. So hopefully they will carry the legacy and the torch moving on from my lab, which is focused on the pulmonary circulation.

Brian Bolwell, MD: What was your first significant leadership role?

Raed Dweik, MD, MBA: Running the pulmonary hypertension program. So that was more than almost 20 years ago. My chairman at the time came to me out of the blue. Actually, literally, if you asked me then, in the early 2000, if I ever do anything related with leadership, I would say you're crazy. And people asked me that question at the time and I said, no, it's not going to happen. I love research, I love my patients and education. That's all I'm going to do for the rest of my life. Then my chairman walked into my office one day and said, what do you think about running the pulmonary hypertension program? I said, why? It apparently turned out to be has been dysfunctional. There was a leader there who was really not doing well. Several physicians were not even talking to each other, they were not even aligning practices. And the reason I took it on is because my research was in pulmonary hypertension. So, I figured, okay, if I fix the program, I can help my research. So, I took it on and it's amazing to me how I started building the educational aspects of it, the research aspects, really the clinical practice just getting, all I did was just get people together to meet every week and just share best practices. And I remember still the nurse practitioner at the time looking at me, what do you think you're going to do? This has been dysfunctional forever. You're not going to be able to fix it. I said, if I take something on, it has to be the best that it can be. I don't accept anything less than excellence.

And I can tell you within a few months the group transformed. They became highly functional, working together, just by getting them together and listening to each other and realizing what the other person does and what does it do, what they don't do. And recruitment, of course, I was supported to recruit more people. So young blood came into it and it became an example actually, nationally and internationally, how to build a pulmonary vascular disease program that has all aspects. Clinical, we get referral from 40 states. Education, we built a summit that attracts attendees from more than 40 states and internationally, and research, we built a research program that was, the nucleus was my work, but then we built on it. So, we really built a very well-rounded program and I realized at the end of that, wow, we can do a lot by building programs and leading people more than you can ever do just on your own, seeing patients and do your own research, and that's where really my entry into leadership.

Brian Bolwell, MD: So just very briefly for the non-physicians listening to this podcast, pulmonary hypertension is what?

Raed Dweik, MD, MBA: So, this is high blood pressure in the lungs. If you know of high blood pressure, everybody recognizes that, but this really is specifically in the lung. It usually affects young females of child-rearing age, but it happens now with older people as well. So, see, what happens is the pulmonary circulation, the vessels in the lung start constricting to a point where the blood pressure rises and results in the right side of the heart failing. Usually systemic hypertension, which is the more common type of hypertension, is where the left side of the heart is dealing with it. Now we're dealing with the right side of the heart and it's a very devastating disease. When I first started taking care of these patients, they would live no longer than two to three years. That's what the average lifespan. And now there are so many medications, at least a dozen medications that they live 12, 15, 20 years. Initially the only viable treatment for them was lung transplant. Now we rarely send them for lung transplant, which is great.

Brian Bolwell, MD: Thank you for that. So, you had your first exposure to leadership, and it sounds like it went well and primarily because you just got everybody engaged and talking and listening to each other. So, then what? What was your next big leadership role?

Raed Dweik, MD, MBA: Absolutely. So, the next leadership role was when you and I worked together on the Board of Governors. So that led to, probably people recognized maybe so around the institute, it became really pulmonary hypertension program became the flagship program within the Respiratory Institute. And I was soon after that elected by my peers here in the Respiratory Institute to serve on the board of Governors, and this is where you and I got to meet, and I got to learn from you about all the leadership lessons that I have now. And we spent five years together on the board.

That, I can tell you, probably the most transformative experience in my leadership journey because of course the board of governors is a group of physicians that really are responsible for the physician practice, the hiring, the firing, the disciplinary action, the search committees, review committees, and just to get that 30,000 foot view of an organization like ours that at the time was a 10 billion dollar organization, just was an amazing view.

And an extra perk for it other than working with you, Brian, of course, was that the last two years we serve on the board of trustees at the Cleveland Clinic and the last year we spent on the board of directors. And that was transformative in its own right because you get to see how true business leaders who know what they're doing day in and day out, how they make decisions. And one thing I learned that I would never have thought of before from that group is how a wrong decision is better than no decision, because by itself, no decision is a decision. But at least if you make a wrong decision, you can get the troops moving and you can adjust course, but if you don't make a decision, you'll leave people wallowing, which is probably the worst possible thing for leadership. And that's one of the things that I learned there.

Brian Bolwell, MD: The board of Governors is one of the, I'm not sure it's unique to the Clinic, but we elect members of the professional staff, the docs to have a five-year term to, it's a combination of a medical executive committee and as you said, we're kind of the governance for the whole physician practice. And you wind up having an exposure to the entire organization, which these days expands to Florida and London and Abu Dhabi and Canada, and that's really fascinating. You also wind up getting to know the CEO and the Chief of Staff, both of which tend to be invaluable. And I think at that time it was Dr. Cosgrove if I'm not mistaken.

Raed Dweik, MD, MBA: Yes, was Dr. Cosgrove and then Dr. Hahn, and then Dr. Donley after. Yeah. One of the things I actually also, as you said, you get to see the organization from a very high level, the 30,000-foot view, but also from the ground level because of the annual professional review that we do here. And you get to interact with staff one-on-one and learn from them really firsthand all the great things that they're doing in the organization. And that's another valuable lesson I learned there is the importance of leadership. That's where really it came very clear to me because as you know, we've done APRs for institutes and departments where they had great leadership and we've done it for institutes and departments where there's bad leadership. And this one realized, whoa, that has a huge impact. And I have to say I probably learned more from those who were not doing a good job than the ones who were doing a good job, because it's obvious. I'm not going to do this, okay? I'm not going to do this when I become a leader of my own group, and those were invaluable lessons.

Brian Bolwell, MD: Well, give me a couple examples. So, what did you learn back then about the people who were doing well from a leadership perspective and those who weren't?

Raed Dweik, MD, MBA: Yeah, the ones who did well, I feel one of the important things they did is communicate well, and you and I have talked about this all the time about communication and the importance of communication, and I think it's really misunderstood. I've been in leadership meetings where the leader speaks the whole time, and they really think they communicated, and nobody felt that they communicated because it was just a one-way lecture. And I've been in meetings where the leader really just started the conversation and maybe wrapped it up at the end. They really spoke very little, but then everybody felt engaged and communicated to because they were heard.

I think communication, as you and I know and talked about in the past, is more about listening than talking, and I see that many leaders miss that. I've been guilty of it, of course, myself, but sometimes we get wrapped up. Do we want to give so many things? You want to give the message, you want to make sure people heard the message, but people hear the message. What they want is to be heard and that's really a big contrast between good and bad leaders.

The other one is something I learned from one of our early days when I did department reviews is the walking around. Actually, one of my leaders here told me this is the, what do you call it? MBWA, management by walking around. It's really how to see people in their place. They appreciate that you see them in their office, in their clinic, in the hospital setting, and we just learn about them more and I think they appreciate it more. And that's something I learned from good leaders, that their teams will be a lot more engaged when they see them interact with them in their environment, and I thought that to be very helpful.

Brian Bolwell, MD: Well, I really agree with that. In fact, when I give leadership talks these days, this is something that I emphasize because in today's really whole society, we don't really meet that often in person. And one of the ramifications of that is it's pretty frequent for people to hear information second, third, fourth hand. So-and-so said this about that, or so-and-so said that about that. And as a leader, I think it's important to go to the source, get out of your office. If there's an issue someplace, go talk to the people who are involved, who are in fact right in the middle of it. And odds are you're going to get more of a nuance, more of a clarity about what the real issue is than if you just rely on other people giving you second or third hand information. So, I think that I certainly agree with that in a very big way.

Raed Dweik, MD, MBA: One time that that really helped me quite a bit is during COVID when there was a lot of uncertainty and people were hungry for information, and I wanted to make sure that they all knew what I knew in as much real time as possible. I started actually during COVID to have meetings twice a day, the beginning of the day and end of the day, and people attended. I mean, they're virtual meetings, but they were attended by hundreds of people because they just want to know what's going on. And that's something I maintained of course. Now I do it once a week, but even that compared to other institutes, I think that some people think that's too much, having once a week town hall with the entire institute, but I feel they hear directly from me. And I said, when people stop attending, I'll stop having it, but people still show up. [Laughs.] If people vote with their feet, in this case, vote with their mouths, they come and they attend the meeting. So, the attendance has been steady, and I feel that is meaningful to people, and that to me how I make decisions about meetings. It's just if nobody comes, we'll stop having them.

Brian Bolwell, MD: So you became the Chairman of the Respiratory Institute, and how long was it between getting that role and COVID in 2020? How long were you chair?

Raed Dweik, MD, MBA: Yeah, so I started as chair of the Respiratory Institute in 2018, so really officially maybe almost a year later. So, at the end of 2018, because I was interim for about 10 months. So maybe a little bit over a year later, COVID hit us and that was of course very frightening and times of uncertainty for all of us at the time. Now we look back and we say, yeah, we went through it. But I remember the first days of it where nobody knew what's going on, nobody knew what to do. And leading through times of uncertainty is probably going to, because as leaders we always lead through uncertainty, right? Because not everything is clear, and that's why we are leaders because if everything is known, you don't need leaders. But that was uncertainty on steroids, right? Because it's not only, we didn't know, nobody knew what was going on.

So, this is why I think communication was key and to me try to get information from as many sources and communicated to as many people as possible, but really just responding to that. And I am proud of how as a system, the Cleveland Clinic, how we prepared for it, but also as an institute, because my institute at the time still had pulmonary critical care and infectious disease, which really are the center of all these COVID things. And later on, allergy, which nobody thought had anything to do with COVID, when the vaccine hesitancy and the vaccine immune response and reactions came up, then even allergy got pulled into the mix.

So being able to manage all of that was really a transformative experience for me and for the entire team because if you recall, many of the providers went home because the elective surgeries were canceled, a lot of elective procedures were canceled. But we are here, we are pulmonary, we’re infectious disease, we're the ICUs, and that was very difficult times, but also difficult and challenging, but I'm proud that we really went through them. And I remember having the meetings with the teams and what I used to tell them is that this is really our calling, right? We have been preparing all our lives for the skill, trained for it. It's not just a job at that point. It has become a calling. If it's a job, people would quit that kind of job, but I think taking it as a calling, and I'm proud of our team who took the challenge head on, really ran into the storm instead of away from it and to the benefit of the organization.

Brian Bolwell, MD: So for our listeners, Dr. Dweik was pretty amazing during the first year of COVID. You brought up communication, but it's also a lot of leadership because you basically did stuff on three levels. For our listeners, we have around 12 to 15 regional hospitals and many of which are ICUs, and we had to make sure that the care was the same in all of the ICUs because there were so many COVID patients. And Raed very, very quickly got all of his ICUs aligned and the care in fact was stellar.

Secondly, I mean you can tell me much more about this than I know, Raed, but you formed a national consortium of pulmonary chairman to talk about the latest updates or the latest way to treat people much more quickly than could have been done via just publishing. And then, of course, Raed had kept all of us informed within the Cleveland Clinic who were not part of the Pulmonary institute or Respiratory Institute. And as I was running the cancer center at the time, and certainly we were very much open as well, but those updates from Dr. Dweik were incredibly insightful. So, pick any one of those topics, Raed, and why don't you embellish them a little bit. I was always fascinated by what you're able to do on the national level.

Raed Dweik, MD, MBA: Yes, and actually the nice thing about that is we had a national group already that we were meeting together, and actually that's how I learned the very first thing when we interacted with the individuals, the physicians in Seattle and New York, you remember they were hit early on in the pandemic, and this was the origin of my first presentation to the executive team. I remember when Tom reached out to me, Dr. Mihaljevic our CEO, and he wanted to hear about our plan for the ICU, what we're going to do for the ICUs, as he pointed out. So, it was helpful to be part of these national groups.

And then I presented this talk which focused on three things at the time. I called them space, staffing and I called it stuff, which turned out to be supplies later on. Basically, if you boil it down to these three things, that's what we needed to do in the response of the pandemic. And I think then you go into each one and you know what you're going to do in a space. Do you cohort? You do not cohort. Staffing. How many people can you see? How can you make intensivists see a lot more people? And then of course stuff, remember, the supplies for masks and ventilators and all these things. So, we had groups working on each one of these and that allowed us to coordinate all this.

The Cleveland Clinic had a leg up during this because we already functioned as a system. As you pointed out, Brian, we oversee the ICUs in all our hospitals and that allowed us really to have visibility. I have this dashboard that would show me every bed in the entire system, whether it's full and empty. And if it's full, is it a COVID patient or not? If it's a COVID patient, are they intubated or not? So just with one screenshot you can see what's happening and be able to move resources. That was radical, and I almost remembered when I presented this to the executive team at the time. You could sense the sigh of relief. It looks like somebody knows what they're doing kind of thing, because it's just a huge undertaking. But of course, the leadership was very supportive and the teams that we have, our critical care chair and pulmonary and ID chairs were just amazing in their own ways in helping us navigate and the staff. The individual staff stepped up in ways that really surprised me and impressed me in more than I can imagine.

Brian Bolwell, MD: Again, for our listeners who may not have been on the front lines back in 2020, one of the challenges in the first few weeks was we didn't know what the volume of COVID patients requiring our help was going to be in the next week or next month, and the projections were very scary that we would be overwhelmed by just a massive influx of patients with COVID. And so, we were putting together all sorts of contingency plans about what to do about that. And obviously, Raed, you were front and center, but that was part of the whole challenge.

Raed Dweik, MD, MBA: Correct, yeah. The uncertainty at every level, national, local, medical, social, because people have different attitudes about it. So really uncertainty at every level is what really, I think what characterized the beginning of the COVID pandemic.

Brian Bolwell, MD: So from a leadership perspective, I mean obviously you were very good at communicating, but I think another thing that I found to be very, very important during COVID was not just being present, which clearly you were, but also being authentic and real. Somehow, if you were authentic and real in a crisis, that really resonated with the team. And I think it was a glue that kept the team connected, and you're always a very authentic person and I think, I'm sure, it served you well.

Raed Dweik, MD, MBA: Yeah, that's a great point. And I felt that exactly one thing is sharing what you know with people, but also be honest with them about how you feel and what's going on and be there with them. I agree with you 100 percent that we cannot fake authenticity. I think it's something that people can smell a mile away if you're not authentic and they know you, and that really leads to something you and I have talked about over time, which is trust, right? People will trust people that they feel are authentic and honest. You and I talk about how you can do things much more efficiently and much faster if your teams trust you, and that's something you cannot take for granted. You can never take for granted. You cannot take it lightly. I don't know who it is who said that trust is gained in drops and lost in buckets, because really, it's just one misstep, you can lose a lot of trust with people and that's something you have to build and hold on to because it helps everyone. It helps you; it helps the team, it helps everybody who's involved. Yeah, I agree.

Brian Bolwell, MD: Well, that's certainly true and trust is thematic of I think good leadership and I agree with you about how it's won and how it's lost. Another thing you just said that's interesting, you said that one of the keys was managing stuff and the higher I personally became in leadership roles, it seemed like the more stuff I had to deal with.

Raed Dweik, MD, MBA: Yeah. Stuff, for the lack of a better term, yeah.

Brian Bolwell, MD: I love the term actually. I remember back in 2016 when then Vice President Joe Biden was in charge of a project called the Cancer Moonshot, and the goal was to accelerate cancer research across the country. And I would go to forums where he was talking and he said he didn't know much about cancer research, but he's really good at stuff, especially removing obstacles and stuff like that.

Raed Dweik, MD, MBA: Yeah, yeah.

Brian Bolwell, MD: Those are the words he used.

Raed Dweik, MD, MBA: Yeah.

Brian Bolwell, MD: And as I have taught and thought about leadership over the years, one of our roles is in fact to deal with stuff because stuff can be things that get in the way and they can make it hard for your team to succeed, and sometimes you have to get in there and figure out what the stuff is and deal with it.

Raed Dweik, MD, MBA: Yeah, absolutely. I think that, too, we have many roles as leaders, but there are a couple that I feel are very important. One, before I get to the stuff, is dealing with uncertainty and ambiguity. Sometimes people just want to know that you know about it and then they move on. So, we can absorb that people's anxieties and uncertainties. We just take them in, and it allows them to do their job better, and that's something I find myself doing regularly. And the other one is really removing obstacles in front of people. Just because of who we know, our connections, our roles, also as leaders, we are able to remove obstacles from people who really want to do the right thing and want to run with their projects, but they run into obstacles that may be easier for us. They are much easier for us to help them with than for them to navigate.

And I tell people that all the time. I delegate a lot. That's one of my things that I like to do is empower people, and you can't only empower people by delegating to them. But once you delegate it to them, the thing I tell them is keep me informed and let me know if something, if it stops because the worst thing that could happen is you get stuck at something and I don't know about it, and you come to me a month later with something I could have probably either easily done or give you an idea of how to get around it. And that's what I really tell people is just keep me informed and let me know if there's anything in the way that I can help with. Yeah.

Brian Bolwell, MD: Yeah, exactly. I really agree with that. So the Clinic right now is undergoing a reorganization and your role has expanded to a new institute, the Institute of Integrated Hospital Care, in which you've added a variety of service lines, including the emergency room, ICUs, some other things which you can tell me about, but this is all kind of an example of change management. So why don't you tell us about your new role and how you approach change management?

Raed Dweik, MD, MBA: Yeah, this is probably one of the most exciting things we have done at the Clinic in a while. I remember, you and I remember when the first wave of the institutes happened in the early 2000, 2005, 2006, that's when we formed the 18 clinical institutes that we have now. This is as Dr. Mihaljevic described it as Institutes 2.0, so what we did is we combined some and split others. So, the institute that I'm leading is the Integrated Hospital Care Institute, as you've mentioned, has the same things that were in the Respiratory Institute other than allergy. We have pulmonary critical care and infectious disease. We also have anesthesiology, emergency medicine, hospital medicine, urgent and expressed care and perioperative medicine. And there's nothing like it anywhere else in the world, and that's what makes it so exciting.

So, the idea is how to smooth the patient journey out. But before we get there, as you pointed out, I have big visions for that obviously how to make this work. But as you said, to get there, you have to get the people on board. As they say, as a leader, you have to get the people on the bus because otherwise you are not going to go anywhere.

So, and it's fascinating as I go through this, how I'm learning about leadership styles of other people, those who hold people accountable, those who don't hold people accountable. And the one thing that really became very clear to me, the importance for us as leaders is to do these two things simultaneously, which is advocate for our people and teams and hold them accountable at the same time. This seems counterintuitive, but I think to me it perfectly makes sense. You have to do both. One without the other is just not going to work. If you just support, support, support, there's no accountability. Too much accountability and no support, people just burn out. So, I think how to find that right balance, and I think that is key to change management. People again can trust you. You're fair, you're trustworthy, and you're going to advocate for people while you're holding them accountable.

The other area to deal with the change management is conflict, right? There are conflicts because people have different incentives, they have different agendas. And then how do you reconcile that? And I think one thing I would, is not negotiable to me is civilized discourse, right? I'm willing to hear everyone, but everybody has to be civilized, everybody has to be respectful. And I've been fortunate that I've built a transition team that has been meeting the last several months, which I call it the IHI transition team, and its leaders from the existing institutes that joined the new institute. And we have been really having amazing conversations that are respectful and everybody contributes and they're moving forward. Some are moving forward faster than others, but that's I guess the role of a leader, to keep the people moving fast, not holding them back, but also pull the people who are behind to get them on board. Because if we don't do that, we will not succeed, and that's my current focus.

Brian Bolwell, MD: So conflict managements not easy. Any tips?

Raed Dweik, MD, MBA: So, I have years of experience in that. As you know, I chaired the Conflict Interest Committee at the Cleveland Clinic for about 10 years. Oh, my God, the stories there. We could have another podcast, Brian, about conflict management. But I think the key that I learned from that and from another committee I served on, which is the Capital Committee, the key is communication. I mean, I come back to that again because, and finding I am learning more and more that it's not really compromise that we're looking for. It is really looking for a win-win situation when people are, and initially I said, well, we can't find a win-win. These people are so different when they come in and they start. But the more you talk and the more you hear people and listen what they have to say, it's actually easier than I thought is finding win-win situations in times of conflict.

But the key to that is what we really started this podcast with, it's listening. So many people, I can tell you, come in into a conflict resolution knowing the answer. If you come in knowing the answer, you are going to fail. You need to come in with an open mind, listening to both sides or more if there are more than two sides, and then really coming up with a solution that works for them, not for you. And that's one thing I've noticed that we as leaders sometimes we miss is how we have our own personal agendas with anything, whether it's a meeting, whether it's a budget, whether it's a hire. I think for these kinds of things, the conflicts, the best possible way is to come with no preconceived agenda, just come in with an open mind and listen and just have a good outcome. And that helped me quite a bit over the years.

Brian Bolwell, MD: I think that's really good advice. I like that a lot. The only other thing I might add is I remember a few years ago, one of my, I've had several executive coaches and one of them told me if I was in a conflict situation, to view it as an educational opportunity, and that tends to reduce stress and anxiety. And anyway, it's worked for me as well, but I certainly share your fundamental thought about listening and not having preconceived notions. And the fact is, I'm with you, Raed. I think a lot of the time, if not most of the time, you can actually come up with a win-win.

One of the things I think I was able to do when I was leading the cancer center, if there was something that made sense to do and it was an issue of how to pay for it, that was a silly thing in my mind to draw a line in the sand about. I mean, there's plenty of ways, whether it was the cancer center paying for all of it or 80 percent of it or whatever, but you can get creative with solutions. And I think that sometimes we're just not creative enough, because there's usually ways to get things done.

Raed Dweik, MD, MBA: Yeah, 100 percent agree, and if you just listen to people, they'll give you the solutions. They may not be even aware of them themselves, but if you listen to them, they'll just bubble up and you can just grab onto them.

Brian Bolwell, MD: I think that's a great point. Gosh, we could talk about a lot of things with your career because you've had a truly stellar one, but any things you'd like to leave our listeners with from a theme perspective? Any other pearls that you have that have been important to you in your various leadership roles?

Raed Dweik, MD, MBA: My own career, the one thing that maybe I add that we didn't get to address is being adaptable. I feel that change is inevitable. You mentioned change a few times and change management. I think as individuals, I think the more adaptable we are, the more likely we are to succeed. And as teams, I encourage my teams to be adaptable. Don't get set in your ways. The world is changing. We have to adapt to it. And I keep that in mind whenever change comes at me or from me or either way, it's just adaptability helps quite a bit.

Brian Bolwell, MD: Another thing, Raed, though, you've always said yes. I tell this to people a lot. If you have a new opportunity, usually you should say yes. And I mean as you mentioned, you were head of the Capital Committee, you still are, I think, and head of the Physician Misconduct Committee, I'm not sure what we call it now, and had a variety of other roles as well. And usually if you're exposed to something new, you learn a lot and you gain perspective and saying yes usually is a good idea in my opinion.

Raed Dweik, MD, MBA: Yeah, thank you for that. One of my mentors a while back gave me good advice. He said, you should always keep 10 to 20 percent of your bandwidth available. You never know what comes up, if something good comes up, because if you are too busy, you can give up. You can pass important opportunities because you're busy with things that may not be as meaningful. So, I think always have a little bit of bandwidth will help.

Brian Bolwell, MD: Raed, thank you. This has been fabulous. And to our listeners, thank you so much for your continued interest in Beyond Leadership, and I hope everybody has a lovely day. Take care.

This concludes this episode of Beyond Leadership. You can find additional podcast episodes on our website, clevelandclinic.org/beyond leadership, or subscribe to the podcast on iTunes, Google Play, Spotify, or wherever you get your podcasts. We welcome any topic ideas you may have for future episodes, comments and questions about this or any past episode. You can let us know by emailing us at executiveeducation@ccf.org.