Leadership Development in Cancer Care

Podcast Transcript

Dale Shepard, MD, PhD: Cancer Advances, a Cleveland Clinic podcast for medical professionals, exploring the latest innovative research and clinical advances in the field of oncology. Thank you for joining us for another episode of Cancer Advances. I'm your host, Dr. Dale Shepard, a medical oncologist here at Cleveland Clinic overseeing our Taussig Phase I and Sarcoma programs. Today, I'm happy to be joined by Dr. John Suh. John is the chair of the Department of Radiation Oncology here at Cleveland Clinic. He's talking to me today about leadership and cancer care. So welcome, John.

John Suh, MD: Thanks Dale for inviting me to this podcast.

Dale Shepard, MD, PhD: Absolutely. Maybe you could start by just giving us a little background on what your role is here at Cleveland Clinic.

John Suh, MD: Sure. I started here at Cleveland clinic back in 1990 as an intern. I progressed to resident and fellow. I specialize in treatment of brain and spine tumor patients. I have an interest in stereotactic radiosurgery and stereotactic body radiotherapy. I became chair of the department in 2006. My role is to help lead the patient care research, education, and culture within the Department of Radiation Oncology here at the Taussig Cancer Institute. I'm very fortunate to work with some tremendous caregivers who believe in the core missions of the Cleveland Clinic, its values, its priorities, as well as its vision to provide the best care possible for its patients and also to be the best place to work in healthcare.

Dale Shepard, MD, PhD: So we're going to talk a little bit about leadership today, and you mentioned that 2006, you became the chair. But if you sort of think back, what do you think was your first leadership role?

John Suh, MD: I actually reflected on that in terms of my first leadership role. I suspect leadership probably being a bigger older brother, I have a younger brother, Steve, who's an ophthalmologist. And being the older brother, I had to share with him what was the difference between right and wrong, also share with him what the right behaviors and actions would be. So I would say my first role as being a leader was actually being an older brother overall, and obviously learning from my parents as well. But I would say that was really my first role and kind of understanding the impact I could have as being a person I related with closely, which was my younger brother.

Dale Shepard, MD, PhD: That's really an important point because sometimes you think about a role related to your occupation, but I think it brings home the point that leadership has many, many faces and we're leaders in many, many ways. And I guess one thing, maybe for your view on this, leader versus manager. When we think about leadership and what's the difference between the two?

John Suh, MD: So in my mind, I like this quote from Peter Crocker, a leadership guru in terms of the difference between managing and leading and his thoughts are that management is doing things right while leadership is doing the right things. So when I first started as a chair, I was very much going into the weeds and becoming a manager, trying to take care of many things myself, rather than having others around me leveraging the strengths and talents of the coworkers and caregivers to make the change, believing in them. So it's very important that as a leader, you lead, do the right things, have your actions, behaviors emulate what you would like others to do and leave the management to those who are hired in those positions.

Dale Shepard, MD, PhD: So you took on the chair position 14 years ago, and you were thrust into a role as a leader. Where you ready? As you look back now, were you ready? From a leadership standpoint, it's like, "What did I get into?"

John Suh, MD: I also reflected on that question quite a bit as well. And I remember when I was thinking about leadership opportunities back at around 2005, 2006, I really had to look myself into a mirror and to say to myself whether or not leadership was the right thing for me to do. I knew that any leadership opportunity would take extraordinary work, also would take time away from my family, which at the time was a young family. And at the time, I had a four year old daughter and a one year old son. So I had to do a lot of soul searching in terms of whether or not this is something I really wanted to do. I think for me, when the option came up to potentially become the chair of the Department of Radiation Oncology at Cleveland Clinic, it was really something I thought about long and hard, partly because I, as I shared with the listeners, I trained here at the Cleveland Clinic.

I've been here for a very long time, so when the opportunity arose that for someone who trained here to have the opportunity to help lead and influence the department, that I thought to be tremendous honor and privilege. That's why I decided to become the chair and I was fortunate to be selected as chair of the Department of Radiation Ecology at the Taussig Cancer Institute.

I had a lot of ups and downs. I'll be very honest that it was very tough. I would say the first couple of years I was chair, I've never worked as hard in my life, partly because I want to see transformation occur and also to make sure that we continued this upward trajectory of going from, as Jim Collins puts in this book, from good to great, so what we needed. One of the first actions I did was to do a SWOT analysis, a SWOT stands for strengths, weaknesses, opportunities, and threats. I sat down and put together what I thought were the strengths of the department, what the weaknesses of department were, what the opportunities were, as well as the threats. This actually helped me in trying to figure out how to best guide an aligned department to become better in patient care, research, education, and most importantly, culture.

Dale Shepard, MD, PhD: I know on some of the things you've written about leadership, you've suggested that certainly leadership is something that can be taught and can be learned. What's the best way to do that? What do you think is the best way for someone who wants to learn more about leadership or become a better leader? What's the best way for them to tackle that?

John Suh, MD: I think to become a better leader, you need to want to become a better leader. So for me personally, I read a lot of leadership books. I listened to podcasts about leadership. I watched leadership behaviors. And just as an example, I recently watched the show, the documentary The Last Dance which talked about The Bulls' six championship run in basketball. I'm talking about the last year of Michael Jordan and the Chicago Bulls winning their sixth championship. And while watching that documentary, it became very clear that each person had different roles in terms of leadership. So in terms of leadership, it's something that if you really want to become a better leader, it's important that you listen, you learn, you try to mimic those types of behaviors. And ultimately, that becomes reflex, becomes a stronger muscle for you. And as a result, you become a stronger leader.

For me personally, being in the role that I'm in, I have really taken leadership to heart. One of the best things that happened to me as part of my leadership development was I was offered the opportunity in 2011 to go through executive coaching. At the time, upper leadership here at Cleveland Clinic felt that I had opportunities to become a better leader and I embraced that challenge. As a result, I had an executive coach who worked with me for approximately 18 months.

One of the first tasks that he did was he actually asked me to go find individuals who'd be very candid about what my strengths and weaknesses were as a leader. And as a result of that report, he presented me a 17 page report of all the things I was doing wrong as a leader, which was quite humbling. Obviously, I thought that I was doing some things well, but obviously many felt that I was not doing a lot of things well. So as a result, I took that to heart and decided to learn and become a better student of leadership, and as a result, was able to help improve a lot of different domains that are important and competencies of becoming a better leader, one of which is emotional intelligence.

Dale Shepard, MD, PhD: So tell me a little bit more about emotional intelligence and how that ties into leadership.

John Suh, MD: Emotional Intelligence is one of the most influential books for me in terms of my leadership journey. It's a terrific book by Daniel Goleman, and really talks about how emotional intelligence is a much better predictor of success rather than IQ. According to the book, it's about a four times better predictor of success. So if you think about an emotional intelligence, there are domains that you can control and there are domains that are outside your influence, but you can certainly influence. So you can think of emotional intelligence that if you're presented with a situation which is very stressful, very uncomfortable, how do you deal with that situation? If you think about the domains of emotional intelligence, in my mind, it starts with self-management. So what can I do as a person to control my emotions, adapt to changes, be positive in face of negative circumstances, try to continue to achieve and do more? Another domain is self-awareness, how do my emotions deal with my surroundings, my interactions, my phone calls, the emails that I may receive?

Those are two domains that can clearly control into this self-awareness and self-management skills. And then it leads to social awareness. Social awareness is your empathy. How do you deal with someone who is hurting, someone who is having pain. And obviously being cancer physicians, we both know that that's very important in terms of providing best care possible. Sometimes, the outcome is not what we want or what the patient wants, but showing that empathetic manner, the behavior to the patients and families can make a big, an important difference. And also, the social awareness is what does the organization, what does the people around you want in terms of making them better overall?

And finally, it deals with relationships. Relationships I would argue is the toughest part of emotional intelligence because it deals with influencing, coaching, mentoring individuals, trying to deal with conflict, which as a leader, you will come up with conflict. So those are very important terms in of how do you drive those ideal relationships? So those four components of self-management, self-awareness, social awareness, and relationship management is really important in terms of trying to drive the best behaviors, the best actions of not only yourself, but the people around you.

Dale Shepard, MD, PhD: You just mentioned mentorship and coaching, and you mentioned the executive coaching that you received. When should people who are interested in learning more about leadership, when should they be thinking about reaching out to look for resources, for coaching or mentoring, and how should they approach that as a resource?

John Suh, MD: I believe that everyone, even if you don't want to become a leader, can benefit from coaching and mentorship. It doesn't need to be a formal process. It could be your friend. It could be your wife. It could be your brother. It could be one of your coworkers. Just asking them, what could I be doing differently? Do you have some candid thoughts about what is going well, what is not going well? So I think in terms of the coaching and mentorship part, that can start at a very early age. And if I think back at when I was involved with sports or involved with music, that I had a music teacher, I had a sports coach that would tell me what I was doing correctly, what I could be doing better. So I think there are plenty of opportunities in dealing with coaching and mentorship.

I personally believe that coaching and mentorship is really important if you want to embrace continuous improvement, which is also another core belief of mine, that there's always a chance to become better and stronger at anything that you do in life, in particular leadership. A recent book that I read that was very influential is a book by James Clear, it's a book called the Atomic Habit. The premise of this book is that each of us can become better at a particular task if we really want to be better at that task. He talks about this 1% better role, so if you can become 1% better each day at a particular task, you compound that over a period of a year, you're actually 34 times better at the task.

Obviously for many tasks, if you asked me, for instance I play tennis. If I practice 1% more tennis each day, will I become a 34 times better tennis player? Obviously not, but it is actually a really good thing to think about in terms of trying to become better in terms of your various aspects. And for me, leadership is something that I think about a lot and how can I tweak my leadership to become a better, stronger, and more capable leader.

Dale Shepard, MD, PhD: In terms of the importance of mentorship, I like how you pointed out that a mentor doesn't necessarily have to be a colleague or peer or someone in your specialty. Oftentimes, we think of our colleagues as peers or someone that we've trained with or something, so I like the fact that you pointed out that it can be anyone.

John Suh, MD: Oh, no, no, absolutely. The mentorship and coaching piece, sometimes I will watch a movie or a TV coach and say, "Wow, that's was a really good line," or, "The way they handle that situation was really ideal." Let me put that in my reserve, maybe when I'm faced with a similar type of situation. So with coaching, mentorship is always around us. We just have to seek it and look at it, observe it. The nice thing about leadership is that if leadership is done really well, it's something that you can witness, you can feel. There's a very visceral feeling that that was true leadership that I'm witnessing or I'm hearing or I'm seeing.

Dale Shepard, MD, PhD: So anyone that's sort of setting out to work on their leadership style if you will or method has to start somewhere and they have to pick a way to approach things as a leader. What guidance could you give to people in terms of where do you start, how their different approaches to leadership, how does someone best start at least with what works for them?

John Suh, MD: My suggestion is that one way of starting is actually trying to figure out what your strengths are. Another influential book that I have used is a book by Tom Rath is called StrengthsFinder 2.0. This is a survey. This is a small book. You actually start out with doing a survey. I believe it's around 160 questions and it asks a question such as when you play a game, do you want to win or do you want to do your best? And depending on how you answer these particular questions, you're categorizing the 34 different strengths overall. And these strengths, just as an example for myself, my strengths are achiever, focus, responsibility, learner, and competitiveness. So my styles are very much an execution type of style. I'd like to get things done and realizing that learning my strengths, I can build on those strengths. So what I would suggest for those who are interested in starting the leadership journey, I would maybe first start out by getting that book, seeing what your strengths are, and then trying to figure out how you can best leverage those strengths.

The nice thing about the book is for each category, here's an example of what does an achiever look like and what are the downfalls of being an achiever? For instance, being more of an execution mindset, I have to be very careful that I don't continue to have that mindset for everybody because that could lead to burnout with my colleagues for instance. I think that's very important. I think number one is figuring out what your strengths are.

And number two is just taking inventory of what ultimately will make you happy overall. And I'm a big believer that if you are able to find a job, a position that makes you happy, makes you fulfilled, it gives you a sense of purpose, that alarm clock wakes up early in the morning, you're up and ready for the challenge. I think that also helps in trying to figure out what you'd like to do. But leadership is really important and obviously for all of us having a good leader that we can look up to, someone that we work with each day is really important in making the day go really well. Obviously, all of us face challenges in life and whatever we can do, whether a leader or not, can make a true difference. I would say that that's really important for me personally.

Dale Shepard, MD, PhD: So as the chair of a department, when you have people that you've pulled into leadership roles, do you have something in place where clearly this is something that you're very passionate about. Do you sit them down and talk to them about it and provide some structure for them to flourish in that role as a leader?

John Suh, MD: One of the first things I do when having a conversation about if they're interested in leadership is to ask them candidly, is this something that you want? Like many things in life, if this is not a role that they want, it's something I certainly would not want to push them into. Although there are certain circumstances where you can sense someone has the abilities, the competency to become a good leader. And sometimes, you have to coach them to see the opportunities of being a leader. But becoming a leader and coaching someone to become a leader, I think it has to start with individual. If the individual wants to become a leader is certainly something I am happy to sit down with them and provide whatever coaching mentorship is available to make them become a stronger and more capable leader.

Dale Shepard, MD, PhD: Well, you've certainly provided some insights and I'd like to remind people that you actually tweet about this on a regular basis. So I encourage them to follow you and read along here @DrJohnSuh on Twitter, get some insights. So any additional comments about leadership?

John Suh, MD: Well, first Dale, I just want to thank you again for giving me the opportunity to do this podcast. This is actually my very first podcast, so I will definitely put this in my memory book and my achievements book that I have in my desk in terms of a first for me but I'll just leave the listeners with one thought. This is a thought by John Quincy Adams, the sixth president of the United States. Some of you may not remember who he is. He's not the Washington, the Lincoln president a lot of us think about, but there's a quote that I really like that that really encapsulates how I think about leadership. His quote goes something like this, "If your actions inspire others to dream more, learn more, do more, and become more, you are a leader."

Dale Shepard, MD, PhD: Very good. Well, thank you very much for joining us.

John Suh, MD: All right. Thanks, Dale.

Dale Shepard, MD, PhD: This concludes this episode of Cancer Advances. You will find additional podcast episodes on our website, clevelandclinic.org/canceradvancespodcast. Subscribe to the podcast on iTunes, Google Play, Spotify, SoundCloud, or wherever you listen to podcasts. And don't forget you can access real-time updates from Cleveland Clinic's Cancer Center experts on our Consult QD website at consultqd.clevelandclinic.org/cancer. Thank you for listening. Please join us again soon.