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Doctors at Work Podcast.

Episode #91

How to be a great team leader. With Declan Woods

Mat Daniel

27/05/2024

As doctors our training focuses on clinical skills, yet sooner or later we all find ourselves in a position of being a team leader. In this episode, David tells me that leadership is a different set of skills, and one that can be learnt and developed. A mindset of listening, asking questions, and being open to try things is important, and modelling psychological safety through acknowledging uncertainties is key to creating an environment where others feel safe to belong and speak up. I love his idea that leadership is something that can move around the team depending on what is needed and what expertise team members have. Perhaps a key insight is noticing what’s going on in the team, what it is that the team needs, and asking how things could be better.

If you enjoyed this episode, you might also like 87 how to become a senior medical leader, 86 how to become head of school of General Practice, and 59 how to create great teams.

Dr. Declan Woods is a ‘top team’ Psychologist and Professor of Leadership Practice at King’s College London (KCL) who specialises in working with boards and leadership teams in international blue-chip corporations and public sector bodies. He has significant experience in the healthcare and pharmaceutical sectors and with the NHS. He is the founding CEO of teamGenie, an international venture specialising in designing, coaching, and developing teams with the mission of transforming organisations through teams (see teamgenie.com). Declan used his expertise and research on teams to create the award-winning diagnostic tool, teamSalient, to help teams radically improve their impact (see teamsalient.com). Declan is the world’s first team Master Coach accredited with the Association for Coaching (AC), and a Chartered and HCPC-registered Psychologist. Declan created the global industry standard for team coaching (see associationforcoaching.com/page/TCADetails) and previously co-authored and launched coaching’s global code of ethics (globalcodeofethics.org) signed by the world’s leading coaching and mentoring bodies and companies. He was made a lifetime Fellow of the Association for Coaching (AC) for this work raising standards of coaching in organisations globally.

Listen at https://matdaniel.net/podcast/https://open.spotify.com/show/1j8uLaUU1g5bYTRVuwUX7j?si=672ec26a73164d7fhttps://podcasts.apple.com/gb/podcast/doctors-at-work/id1701284564; or watch on www.youtube.com/@dr-coach/videos.
Production: Shot by Polachek

Podcast Transcript

Mat: [00:00:00] Welcome to Doctors at Work. My name is Matt Daniel and this podcast is about doctors careers. It’s part of my mission to help doctors create successful and meaningful careers. Today, we’re talking about teams and team leadership, and I’m having a conversation with Declan Woods. Now as doctors, our focus is all about developing our clinical skills as we’re training, but sooner or later we find ourselves in a position of leading a team.

Declan tells me that leadership is a different set of skills, one that can be learned and developed. It’s a mindset of listening, asking questions, and being open to try new things. It’s important to model psychological safety by acknowledging uncertainties, as that is the key to creating an environment where others feel safe to belong and to speak up.

And I love his idea that leadership is something that can move around the team, depending on what is needed and what expertise the team members have. Perhaps a key insight is noticing what’s going on in the team. What is it that the team needs and asking how things can be better?[00:01:00]

Welcome Declan, tell me a little bit about yourself. Thank you, Matt, and for the invitation to join you and listeners today. So, so I have a varied career starting as a, as an army officer and then moving into the foreign office before then moving into a corporate leadership role. And it was really mid career that I then trained as a psychologist.

Um, I think the thing that connects all of those different roles is Um, is change and a desire for change for the better in in organizations. And so it was, it was partly that that led me to retrain as a psychologist. But then increasingly I was doing a lot of one to one work and was looking for some other tools and ways to, to inform that, that work.

And so that led me at the same time to, to start to train and practice as a coach. And so I started working with individuals and then over, over a number of years, that work, uh, increasingly. move to coaching teams. [00:02:00] So I now, I now run a company called Team Genie, and we specialize in coaching teams in large organizations.

I guess the coaching is a real area of passion for me. I’ve, um, particularly the area of coaching teams. So I have a voluntary role for a number of years with one of the main professional coaching bodies, the Association for Coaching and design their global standard for coaching teams. So high quality work and work that really makes a difference.

That sort of means something to me. So I’ve been very, very involved in that. And then alongside all this is. As you know, um, I have a part time professorship at King’s in London. So that’s, that’s a little bit about, uh, about, about me. Thank you very much, Declan. And I’m glad to have you here. And the topic for us today is how to be a great team leader.

And clearly you have a huge amount of practical expertise in that, you know, both from your own roles, but then also in terms of helping develop others. So, I mean, what does make a good team leader? [00:03:00] Yeah, I think the first thing is use the experience that you’ve got. I think the, I mentioned earlier that I, I’ve got quite a varied career.

It probably made more sense looking back on it than it did looking forward. But the, but that variety of experiences in sectors, in organizations, in roles, has actually proved to be really sort of valuable. So, so often what I find is when we When we move into a new organization or take on the leadership of a team, often we forget what we’ve done before.

And so we’ve got this wealth of experience that sometimes we ignore or downplay. So what I would say is use what you’ve got, think about the experience that you’ve got, and then think about how that May or may not apply to the team that you’re working with currently and and think about how you might, um, how you might find an outlet for that and use that.

So that’s the that’s the first thing I think maybe another thing is that, uh, although we’re here to talk about being a team leader, it would be easy to think a team is all about the team leader on. Ironically, it is. [00:04:00] And this isn’t so. So to me, the what makes a great team leader is if the is if the team does the work.

So I think a key part of this team leadership role is for the team leader to create the conditions for the team to do the work. So this is very much about managing the managing the team as a whole, creating the conditions and the contribution of the team as part of a system in an organization. So I think those are.

Those are some of the things for me about, um, yes, teams need leadership, but the way in which leadership is exercises is through the team so that the team then delivers the work and delivers more than it could do through a collection of individuals. I’m interested then in this idea of team then. So what makes a great team?

Yeah, well, I think there’s, there’s, there’s many things. And so, um, I think, uh, uh, typically teams are sort of thrown together, um, often with, uh, with high promise and high [00:05:00] expectations. Um, but, But often without a great deal of thought. And so, um, teams that are really effective are designed and set up well.

So I think that’s the place to start for me is thinking about what do you want this team to do? What is it there to do and to deliver? And then setting it up well to achieve that. So thinking about who’s on the team, but also who isn’t on the team? Why is the Why is the team there? Why has it been created?

And what’s the work for it to do? And then how do you bring those things together and align, um, individuals in roles with, with the sort of with the aspiration for the team. So I think that’s a I think that’s probably a key messages is to really think about the what are the fundamentals of a team and to really put those those foundational elements in place.

One of the things that for me is interesting is that as doctors, we work within teams all the time. And, um, but often it’s, it is, it’s like, if I think of a theater [00:06:00] team, you know, there’s people occupy roles. Yeah. You know, there’s the, there’s the runner or there’s the ODP, the scrub nurse, the anesthetist, et cetera.

So, you know, people come in and everybody occupies a role. Um, and that’s what forms a team, but those people may or may not know themselves But they may or may not know each other as individuals. Yeah, you know, there’s a role that people occupy. I mean, how how how important is that knowing each other as human beings in a team versus coming in and occupying the role?

Yeah, I think there’s two things in what you said there Matt. One is that um, uh, you know, we’re human beings and so we have a Uh, there’s a we have a sense of belonging and need to belong to a team. So there’s a sense of being part of something. And I think the, I think by just focusing on the roles, we forget or often downplay the, the individual within the role.

So I think that’s the first thing. And the fact that, uh, you know, we bring ourselves to roles, um, as, as individuals. And, and at the same time, um, [00:07:00] being really clear on not only the role that you’re playing, but the role that others are playing is absolutely. And to make an effective team. Um, so what are you here to do?

And, and, uh, are you clear on that? And equally, am I, am I as clear on your role and your contribution and part in this team and vice versa, so that we, we can align those roles and sort of interlink in how we work together, rather than play tug of war. Um, or, or overlap with each other and sort of often trip over each other.

So I think role clarity is, is, is really important. And I guess in, in a sort of medical context, that might be assumed by, by virtue of the, uh, the label or title that, uh, a healthcare practitioner may come with. But what that means for this, for this team right now, and this, and the work that this team is doing with a particular patient, um, May not be that obvious.

And so that may need to be, um, unpicked. It may need to be clarified, um, and [00:08:00] reinforced. Yeah. So I think there’s, I think that’s a really important point about the roles that we play and how those roles come together. Because one of the, one of the core components of a team and what makes a team a team is, is the interdependence that members of that team have on each other.

Um, so are we reliant on each other? To do the job and the work that we’re there to do. Um, and can we, can we do more together than we can, um, individually? So, uh, understanding who’s there to do what, um, and how we, how we need to rely on each other is, is really important. Um, part of this. Yeah. And I think the, the team leader.

Plays an important orchestrating role and in that so there’s both a functional role but also there’s the the role beyond the sort of function beyond the sort of technical expertise. So it may be for example that you might be a brilliant surgeon, but it may be that you have a Um, uh, uh, a [00:09:00] theater nurse, for example, that he’s a brilliant communicator.

Well, it may be in a particular scenario that actually the team needs to dial that up. Um, well, that goes beyond the sort of technical role and brings it, brings to play the sort of individual in the role. And so these things, um, if they’re known about, can be sort of more actively sort of drawn upon. A challenge for us as doctors is that all our training is focused on our clinical skills, our technical skills.

And you know, that, that is a massive part. And of course, that kind of makes sense because you know, if you’re a patient, you want a doctor who knows how to be a really good doctor, whatever their particular area is. Um, the problem then arises is that one day you find yourself being a fully qualified GP or a fully qualified hospital consultant.

And, you know, one of the things that maybe I discovered is whether I want to or not. Then all of a sudden, everybody else thinks that I’m a leader. It’s nothing to do with the fact whether I want to be or whether I believe that I should be there. So it’s just by [00:10:00] virtue of the fact that I’m a consultant, everybody else sees me and treats me as a leader.

Um, and why is it, why is it so difficult to kind of make that transition? between being a clinician with a clinical skill and then there’s a whole other set of, excuse me, there’s a whole other set of skills that are needed. And as you said, they’re not, they’re not necessarily the same thing. So why is there this tension between our technical, technical clinical skills and our leadership team management skills?

Yeah, I think that’s, um, I think there’s really something in this map because of course when we’re at school, when we’re sort of setting out thinking about the work we want to do and the career we want to have, um, we don’t start by saying I want to be a team leader. We might start with I want to be a medic and I’m interested in surgery or.

orthopedics, uh, or whatever. Um, and so there’s, there’s an identity [00:11:00] question for this as well. And typically what we see, and this is not just true of medics, but more generally, um, anyone in a sort of specialist role typically gets promoted, uh, because of their success as a technical specialist, and then suddenly finds themselves in a sort of managerial or leadership role.

Um, which is often quite, quite different. And we, you know, certainly we see that, uh, with, uh, with, uh, team coaching work that we do with very senior academics. They’re trained to be researchers, but not necessarily, uh, not necessarily leaders of big, complex organizations. And the same is true for, for sort of medics as well.

So I think there’s, um, that can often come as a surprise that, um, the role that we, you Um, suddenly find ourselves in his is very different from the role that, uh, that has led us to where we are now. And often we’re not we’re not trained in in how to lead teams. So I think that would be a that would be, um, that would be a great place to start is seek some training or some mentorship or some guidance on, um, how to [00:12:00] lead a team.

Typically, how people go about that is they, they look left and right. They look at teams they’ve worked with in the past and they and they imitate they copy. Well, Um, it helps if you’re copying somebody that’s a great team leader, but often, um, as I say, we’re not trained and and may not do that particularly well.

So I think that’s that’s the first thing leading a team is a is a skill we can we can improve and get better at it through both training, but also through practice. Your original question was why, why do people find it difficult to make that transition? Well, um, I think the, you know, um, uh, as you, as you mentioned, you know, we know that there’s, you know, a long and demanding training to become a medical doctor.

Um, and some, uh, so not surprisingly, some real sort of professional pride in, in, in that. And in some respects, the, um, becoming a team leader, um, an emphasis on a different, uh, on a different set of skills. And one that requires you sometimes to sort of let go [00:13:00] of, uh, of your sort of technical abilities and sort of prowess, um, to, to inhabit and take on a new role and so that, that letting go is often is often not easy because of the, you know, the years of sort of training.

Um, and the, uh, the rewards, um, and the promotions that we’ve got from, from our medical sort of knowledge and prowess. So I think letting go and, and, um, um, putting on a different coat, trying that out, um, um, and inhabiting that is, is a, uh, is as much as a sort of mindset, uh, mindset and identity shift as, uh, as one of, uh, sort of skills and ability.

So I think the, um, I think let it, letting go is, is, uh, um, is an important part of this. So it’s interesting because as you say, if I think for me when I become a consultant, you know, I’m, I’m, I’m an expert, you know, this is the operation I do. I’m an expert in this operation in managing these conditions. Um, but then you’ve said when it comes to being a team leader, you know, I might not be the [00:14:00] expert.

Because there might be somebody else who’s a better communicator or there might be somebody else who’s a better completer finisher, you know, yes, I might be the best surgeon in the room, you know, or the only surgeon in the room, and therefore the best surgeon in the room. But, but I might not be the best communicator or the best, the best, you know, resource investigator, whatever else it might be.

So it is that letting go of my identity as me who is the expert and recognizing that actually. When it comes to other tasks, other people are the experts. I’m not the experts in everything. Yeah. So, yeah. And that requires a certain amount of humility. Um, is, of course, the other part of this is the, is the way that, um, um, other, other healthcare professionals might project their own sort of hopes and fears onto, uh, onto you as the team leader, um, and, uh, and being the sort of, uh, all knowing specialist.

And so there’s, there’s some humility in this. There’s, um, [00:15:00] I think making that transition from, um, a technical medical expert to a leader of a complex team, particularly one in, in a sort of very multidisciplinary setting, um, can often necessitate, um, the team leader working outside their comfort zone, maybe with, um, uh, areas and, and, uh, perhaps patient groups that are, that they’re less familiar with.

And so becoming uncomfortable, uh, becoming more comfortable, being uncomfortable and not knowing, uh, is all part of that. Um, I think there’s some, some other sort of, uh, so called sort of softer skills in this around, um, listening, for example, to other healthcare professionals, their opinion, um, their attitudes, um, being curious about, uh, what’s going on, what you’re noticing, um, being able to ask some, some great questions to sort of draw out that, uh, expertise and perspectives as, of others.

Um, And critically, I think, [00:16:00] uh, trusting, trusting more, you know, whereas previously you may have trusted yourself, but sort of, um, trusting others, um, and that their, that their, that their intention is a positive one, um, to, to really sort of leverage and, and draw on the strengths and, and, uh, capabilities that they bring to this team.

You’ve mentioned, um, training. So, I mean, what, what kind of training, what is there out there and what kind of things did you have in mind for training? Yeah. Yeah. I think the, you know, it’s, um, let’s, let’s not turn this into rocket science because it doesn’t need to be. I think this is about, this is about doing the basics well and consistently.

And so, um, You know, I think a short program of sort of two or three days that really, um, bring into awareness aspects of, um, the team leader’s role and, um, how a team leader can create the conditions for the team to be successful, um, is often enough. [00:17:00] Team leadership is a, is a contact sport. So I think the, what really makes a difference is, is taking what you’ve learned on maybe a short, very skills based program and putting it into practice and then getting some feedback on, on that.

Um, so I think there’s, yes, there’s some, some, uh, some training to give you some skills, but I think what really makes the difference is, is, Putting that is putting that into into practices application and then getting some feedback on on that. And then testing it out. You know, Matt, I’m going to try something today.

Can I have your feedback on on that and how that landed? What was the effect of that? Did it lead to a better outcome both for us as a team, but also crucially for the for the patient and the patient outcome? You know, did that lead to, um, yeah, a better end result? Yeah. So I think that’s, um, yeah, I think that’s all part of it.

So that’s, that strike me as a real mindset shift. Yeah. You know, if you go from that identity or of a doctor is an expert, [00:18:00] whereas, you know, what we’re now discussing is a doctor that goes out there and asks for feedback and tries different things and different ways of working, different thoughts and behaviors and, and wants to know how that lands and what everybody thinks.

So, I mean, what, what, what did you need to make that change? Mindset shift from I’m the expert. I know everything into I’m going to ask for feedback and i’m going to experiment and try some different things Yeah, well, I think it, um, I think it depends on your sort of theory of change. But, uh, you know, one, one way of looking at this could be the, you know, to change behavior, we need to change mindsets.

Equally, you might say, well, actually, I’m just going to try some things out. And then that, and then the results of those experiments may lead me to thinking, actually, this team leadership thing does work. It does make a difference. It does lead to better outcomes. And therefore, okay, I’m, I’m. I’m going to stick with it.

I’ll give it a go. So I think in some ways, it doesn’t matter whether you start with sort of behavior and acting differently or whether [00:19:00] you start with, um, changing, changing some beliefs about the role of contribution that you’re playing. Um, I think the, you know, my encouragement would be to Give it a go, you know, to experiment, to try some things out, start small, um, um, uh, gather some feedback, um, often it can be helpful sort of, um, cueing people, teeing people to, to the fact that you’re trying something differently, so they’re not confused about what you’re, about what you’re doing, um, and, um, And then adjusting it from, from there.

And this is all part of the, I mean, what we’re talking about here is, uh, is an imperfect science. So it’s about, uh, it’s about adapting to, um, based on, um, your experiments and having tried things out, um, and, and learning not only what works for you and the team, but also, um, leads to the outcomes that, uh, that you want.

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Thank you. Now on with the show.

Um, so there’ll be people listening who are going to think this is great. I can apply or even I already do some of that. And there’s going to be people listening who are going to say, you know, well, I have colleagues that are just terrible team leaders. You know, they don’t listen to anybody else’s point of view.

They talk all over everybody else. They just push and drive their own agenda. Um, and sometimes that’s probably me as well, Declan. So, but, so when the people are going to think, okay, you know, this, there’s these people that just drive their own agenda. They don’t listen. Um, and like, there’s no having discussion.

with this kind of person. I mean, how do, how, how can, how can maybe I, as a colleague, help those kind of people change or influence. If I have leaders that are like that, or if I have [00:21:00] colleagues that like that, or let’s sort of say, you know, other, other staff come to me and say, do you know what, you know, so, so, and so it is just, you know, rude and they don’t listen, how, what, what can I do in those circumstances?

Yeah, I mentioned earlier that that I’m a psychologist. I’m in the business of changing people’s behavior and people only change if they want to, you know, if they can see the benefits of changing and doing things differently. Um, and so, uh, often the, the catalyst for that is some, is some feedback. So that may come from you directly, but either it may come, it may come indirectly, possibly from a patient in a particular outcome, or maybe from a professional peer who’s, you know, Who’s opinion that they, they respect.

But I, you know, there’s a number of sort of different entry points, but I guess the, um, I guess part of the answer here is, how do we, how do we create an agenda for change so that people are open minded about, about this and at least willing to, um, consider and try some things out, not necessarily make a [00:22:00] wholesale shift or, or change, but, but be willing to sort of entertain and try and try to do things differently.

Sometimes a sort of useful question, uh, to help with that might be something along the lines of, um, um, Are we, are we satisfied that the outcomes were as good as they could have been here? And it creates a, an opening for new possibilities. I think that leads me on to a second point here, Matt, which is, um, less about the team leader themselves, but, but, but about how the team, the team leader’s role in, in, Uh, setting, um, setting that culture for the team where the team is, is willing and able to try different things.

And so the sort of technical term that I’m talking about here is sort of psychological safety. Um, I mean, this was not created, but popularized by Amy Edmondson at, at Harvard. And in effect, it’s, at its heart, it, it, what it talks about is, um, can I be included and accepted as part of this team? And, um, is it [00:23:00] safe for me to speak up and speak out?

Uh, including if I, if I, if I have or think I might have a sort of minority view, can I do that in a way that I know I’m not going to be, um, censured or subject to, uh, uh, criticism or, or ridicule kind of go, actually, I’m not sure about this or, um, um, I think we might be heading towards a mistake here, something like that, or the team leader plays a vital role in this because they set the tone for this.

So the team leader saying. I’m not sure, or I think we may have some different options here, or particularly I made a mistake. Um, it legitimizes others doing that. So I think the, the team leader has a role in, in setting the tone and role modeling the sort of behaviors for the, for the rest of the team to follow.

If the team leader, the most senior person in the room is willing to do that, it sends a very clear signal to everybody else that, That’s okay. And it’s okay for them to do that. Um, and that, that takes some real, some real [00:24:00] humility, some real courage, uh, a willingness to take some, some risks. So I recognize that that, um, you know, that may be alien, but this is really important.

So, so Google did some work trying to work out what, what makes a great team, what makes an effective team in, in a project called Project Aristotle. And what they found was not what they expected. What they found is that psychological safety was the. The single biggest determinant of what made a team effective, and the team leader, as I said, has a has a really critical role in in in that.

Yeah, so I think that’s, you know, so there’s both a personal aspect of that about, um, uh, a medic’s practice. But also, um, as that medic transitions into a more leadership role, how they then, um, set the tone and create the conditions for others to do that as well. I think this is going to come as a shock to a lot of people, the idea that, you know, you find the consultant or the team leader in whatever context that I would say, I don’t know, [00:25:00] because, you know, people come to me for answers, you know, people say, you know, Matt, what do we do?

And there’s an expectation. That I, or a consultant, GP, team leader, will know what to do. Um, and, um, yeah, sort of the kind of the acknowledging, um, when mistakes were made. I think, you know, that, that, that can be tough also. Um, but actually for me, you know, that, that, that idea of, of, of, you know, apologizing when you’ve done something wrong.

That’s, I think that’s probably relatively simple for, for most of us that are normal human being. But, uh, but acknowledging that, that we don’t know the answers. I think that’s, that I think is really tough. Yes. Yes. I agree. I agree. So a place to start with this might be some selective disclosure. Um, so it may not be appropriate or, or, and that it may not be willing to make that full step to say, I don’t know.

So there’s, there’s some steps or some scaffolding that they might take along the way. And it might be that, um, say in a particularly complicated piece of surgery that there are. Uh, [00:26:00] there are two surgeons in the room, so it might be that you have an agreement between you two. You might say, well, actually, I’m, um, can you look out for this in my, in my practice, for example, and I’ll do the same for you.

So there might be a sort of reciprocity in that. So these things often start small, um, and then we sort of see if there’s, if it leads to a difference, um, and then if it does, we might continue doing with that and then sort of, um, widen that out. So I think the. Um, um, then that would be a, that would be a way of sort of working with this and making, making a start.

And the key thing then also is going back to do people want to change? Because again, you know, I’m thinking if there are people around me or somebody listening, then if that person doesn’t want to change, then, you know, I’m never going to change. managed to change them, no matter, no matter how much I see a problem in the matter, how much I try, you know, unless they want to change.

You know, I, I wouldn’t be able to [00:27:00] change that. Yes, I think you’re, you’re absolutely right. And I think that, you know, to me that comes back to again the, um, the sort of team leader or most senior persons in the in the room role. Um, because I think the, um. They have a part of their role is beyond the sort of tasks of team leadership is, is, is, uh, is setting the context and setting the tone.

Um, so, so, for example, the context may, maybe that there are some safety critical issues, or maybe there have been, um, some findings of, um, um, um, some practice that, uh, led to unintended outcomes. Um, well, that’s part of the context for, for, for improvement here. So I think the, I think part of. Part of the how the team leader might work with that is by is by setting the context, you know, and there have been, you know, one or two examples recently that we’re aware of from findings of other, uh, other operations that, um, yeah, and so forth.

And [00:28:00] the other thing I’m interested in is, So I, I work in, in many different teams in different contexts. Yeah. So for example, you know, I work in a theater team, you know, and I, and I operate there and then, you know, we, we’re a team of consultants and, you know, and I, and I’m part of that team, not necessarily as a leader, but, you know, I’m a team member and then, you know, we might be sort of be doing projects, you know, sort of, there’s a transformation piece of work that, that I’m doing.

And then again, I go, you know, Um into that team again, not necessarily as a leader, but it is kind of I think I need to be very different person in different contexts You know if I use these three examples my in theater as a member of the consultant body, you know in a transformation team Um It kind of, it feels like, I don’t know, like I almost need an identity shift when I go from one to the other.

Is that normal? It is normal and it’s needed. Um, uh, and I would say this, uh, the same person with, [00:29:00] um, uh, playing different roles. Um, so I think, you know, be you, bring yourself to these different roles, um, but play those roles differently. So I think, you know, Just when we think we might be slightly clear on this thing called team leadership and how I might do that, if we change the sort of context or the roles, then, or the teams that we’re, we’re a part of or leading or working with, then, um, then things can change.

So you’re, you’re right that that needs us to play, you know, to play different roles and to be, uh, and to be slightly more, more agile in, in this, um, I think the, um, Um, and we know that within within health care, there are sort of systems within systems. So, for example, we may have a GP as part of a GP’s practice working as part of a, say, partnership type model.

And that could be quite different from, say, a commissioning or other part of the NHS that might work in a in a more sort of classical sort of [00:30:00] hierarchical way. So we’ve got these different systems with their own sort of norms and their own sort of default sets of. leadership and culture. Um, and it’s how do we work within them, but also what happens when we bring those different parts of the system together.

Um, so we’ve got a sort of, um, potentially sort of competing parts of, uh, uh, team leadership there. So I think this, I think the, I think what I’m saying here is that there’s Teams are complex. They’re messy. There’s rarely a sort of one size fits all and it really puts a premium on us being able to sort of adapt our, our approach and the style of leadership to, to the, to the, to the team that we’re working.

Can I pick your psychology brain? Okay, so I have, you know, let’s say. If I kind of think of my day, for example, so I might have a meeting at eight o’clock in the morning, which will be transformation meeting. And I’m having to think about, you know, the whole system. And I’m not a leader in that team, [00:31:00] you know, sort of I’m listening.

And then I have to So of flick like that, and then all of a sudden I’m expected to be to, to lead, you know, how the, the, the, how we, we run the theater team and then I have to flick my brain, and then I’m then a technical expert, you know, taken out a tonsillectomy, and then I flick my brain. And then sort of the, there’s a meeting of consultants, which is sort of, which we trying to collaboratively make decision with without that much in the way of hierarchy.

How, how does, how does that brain switch? Um, uh, not always is the answer, but the, um, the, um, maybe, maybe a way of looking at this is, is, um, uh, what, what’s the role that I’m expected to play here, but also, um, What is needed here? And therefore, what’s what’s the contribution that I might play? So you’ve got these two.

You’ve got these two sets of factors here, both of which could sort of guide you on how to how to approach this. [00:32:00] So, um, yeah, so I would say be, you know, um, work with work with both of those work with both of those things. It may be that in one team in one setting that that you’re there very explicitly because of your sort of tonsillectomy experience, for example, and that’s that’s the everybody knows that and there’s real clarity on that.

Well, great. There’s a good fit there between role requirements and you as an individual. It may be less obvious in say, um, Um, some of the sort of, uh, slightly non medical sort of settings. Yeah, I think that, that, that’s really challenging. And certainly I think for me, I think that that’s challenging because I take, I take the previous role with me to the next role.

And so I might be switching between roles, but I’m sure that things follow me. And I wonder if that accounts for, you know, sort of some of the, some of the stuff that we see at system level, which is, which is, you know, people, [00:33:00] people, people fight for their own corner. You know, if you imagine sort of, we’ve got a team that comes together and, you know, and everybody just fights for their own corner.

And they’re like, you’re not really working as a team because I’m thinking as the tonsillectomy expert. And when I’m in this team, you know, that’s all I’m thinking about, but actually that isn’t what the team needs from me. Um, one of the things that, that I’m, I’m, I’m part, I’m thinking of teams now. So I, you know, I, I’m part of teams.

Or, you know, or groups that don’t have a leader and I’m kind of thinking, okay, you know, we come together We’re doing a piece of work But you know who who’s leading? Like nobody there’s a bunch of us that get together and we all have expertise, but there isn’t anybody that’s leading So, you know, are we still a team or is there such a thing as a leaderless team?

Yeah, so my um, Uh, so so my response here is is based on my beliefs about teams And so one of my one of my beliefs is that teams need So you notice I used, I used the word leadership rather than leader. So it could be leader, [00:34:00] single, um, and very clearly sort of nominated. Um, and, and that may be absolutely fine, but the, uh, what I mean by leadership is that the team can find the leadership that it needs when it needs it.

So that may be, that may be the most senior person in the room. It may be the sort of. Nominated or designated team leader, the one on the sort of organization chart, but equally, it doesn’t have to be. It could be that, um, leadership is shared or distributed or, or is, um, Is passed between different team members and that that can, so I think part of this is about the sort of and passing of leadership, uh, depending on what’s needed and, and who is the best person to provide that at that, at that time.

So I’m really, I’m really interested in this idea then the, the difference between teams needing leadership rather than leaders, because I’m guessing that that. Most people will sort of say, well, you know, there’s a team leader and there’s a team leader, [00:35:00] actually sort of what you’re saying is, yes, there might be, you know, a team leader on top of a pyramid, but equally there might be leadership might move around.

I mean, how can, how does that work in practice, the idea that leadership moves around the team? Yeah. So I think the, um, I think this is, I think this has to be contracted for, uh, so that it’s so that it’s understood within a, within a team, um, rather than necessarily sort of assumed often what happens. It, uh, it just happens by sort of, uh, default or, or from, uh, habit over time.

But I think if, if this can be made sort of more explicit, um, and contracted for between sort of members of a team, then that provides the sort of clarity. Um, including it, including, for example, in sort of decision making within within teams. Um, so, for example, it may be that if you’re the most senior person in the room, um, uh, organization there, you’re the you’re the nominated team leader.

It may be that you’re you’re taking on some some rework, for example, that, um, that, [00:36:00] um, that would benefit from some from from some understanding from, um, another area. Um, it could be you’re working in a multidisciplinary team that that actually some real contextual understanding, um, may be valuable. And you just don’t have that, but others in the team may have that.

And so I think it’s you’re aware of that. And then, um, knowing that you can actively draw on that sort of contribution from from individuals. So it may be, for example, you say, Well, look, we need to make a decision on on a particular topic. Um, could you lead us through this? through this part of a conversation to reach resolution in the decision based on your experience.

Equally, it may be that somebody is too embedded in the context and has too much sort of knowledge about a thing. And it may be that there’s somebody else in the team that is a brilliant facilitator or negotiator, for example, and you might, you might draw on some of that in a particular circumstance to help, to help you work through a, a [00:37:00] logjam, for example.

I like that idea of contracting for that because I think, I think a lot of that probably already happens again, you know, if I think in theater, you know, the anesthetist is the person that knows how to anesthetize the patient, you know, not, not me. And likewise, you know, the scrub staff or the runners, they know where to find stuff.

I don’t know where to find stuff. So, you know, they, there’s a piece of kit that’s missing. Then, then, you know, I’m not going to be. leading on finding a piece of kit, am I, in the same way that, you know, a scrub nurse is not going to be leading on performing the tonsillectomy. So, so, so I suspect that, that, that we already do that in, in that kind of theatre setting.

Um, but it’s not, it’s not, yeah, I think it’s just, it’s just understood, um, that that’s how we work. But if I think of some of the other teams, um, yeah, sort of, I, I suspect it, it’s, it’s, It’s probably not, I don’t know that it [00:38:00] happens and sort of, or it might happen, but we’re not contracted for. Because often, I don’t know about some of the teams you’ve been working, but um, often what happens is there’s a few dominant voices, um, in, in the room.

Um, and, um, if you don’t have, if there’s not an understanding as to sort of how, how that leadership and airspace is shared, that, that’s problematic. Yeah. And I think I’m often guilty of that Declan as well, putting my hand up to that. Yeah. So, and I might put my hand up to that as well at times, Matt. So, yeah.

I mean, how do you, okay. So if I think the, the, For, for, for teams that, that are not, um, that, that, that, but there isn’t clear leadership and there isn’t sort of clear ways, clear ways of working, what, what can people do to try and move a team into something better, you know, a team member who’s part of a team, but there isn’t any formal leadership.

There’s not a formal leader. [00:39:00] How can somebody go into their team tomorrow and, and try and try and make some changes? I think there’s a couple of ideas here, Matt. One is, one is to think about the contribution that individuals might play, particularly a contribution beyond their sort of technical specialty, um, and there may be a time and a place and an appropriateness for them to play their sort of technical role, um, um, and there may be other things that they, uh, other skills, capabilities that they have that the team isn’t aware of.

So I think there’s a, there’s an inquiry here about, um, at an individual level about what else might they contribute that this team might benefit from. So I think as a team leader, we might, we might actively ask members that, so that we can then draw on that and encourage them to, to contribute that to the, to the team.

Often team members know that amongst themselves, but a team leader, particularly a new one, may not. When first joining a team. So that would be one thing. So what I’m talking [00:40:00] about there is is about strengths and contributions. And the other thing is, is, is really about, um, I think there’s two questions that is, uh, as a team leader, we might ask ourselves.

What’s going on in this team right now, and what does it need? And that, um, and it may be it needs leadership. It may need a bit of role clarity. It may need a decision. It may need, um, it may need some more resource. You know, it may need some additional expertise from outside of the team. So the answer could be quite different.

But I think trying to sort of step back from the sort of, uh, the sort of busyness of a team. You think about, um, What’s going on and what’s, what’s our experience here? And what does that tell us that this team, um, might really need, um, identifies the sort of gap there. And then we can, we can, um, open up a conversation about trying to, to meet that particular need.

That’s, that’s a shift from telling [00:41:00] people what to do to asking people and listening. Yeah. I mean, of course it, you know, based on, based on, uh, your, you know, that question that you might ask yourself about what does this team need? You might. Um, you might propose something, or you might say, I think the team needs this, um, and others may see that differently.

Um, so I think the, you know, I’m not decrying that, um, you may have an opinion about that, of course you might, um, um, uh, and others may do as well, and it may be, it may be different. So I think the, um, I think particularly in sort of multidisciplinary teams where they’re, you know, By, by their very nature, they’re broad.

We may just not know, but others, others may have a stronger sort of sense of knowing that. And I think this is, this is about, uh, not necessarily assuming, but asking the question. Um, I might bring us to a close, Declan, if that’s okay. And perhaps, um, if I could just invite you to summarize what we talked about and what will be your top tips for doctors at work.

Yeah, and [00:42:00] I think that let me start with an encouragement, which is that, uh, uh, uh, except that you may not have been trained to be a team leader, but help is there. You can get some you can get some training and improve as a team leader really quickly by by putting this into practice and getting some feedback.

So that’s that’s the first thing. I think the second thing is it is, um, he’s doing the basics. Well, so laying the foundations of. Who’s on the team? Who isn’t on the team? What are their roles? Why are we here at a particular time? And what’s the, what’s the outcome that we’re sort of striving for? Um, how do we make it sort of psychologically safe for everybody to contribute?

Um, so I think those, I think those are my sort of, my thoughts. Um, those are my sort of top tips about, um, laying the foundations for success and doing the, um, doing the basics well. So those would be my, my top tips there, mate. Wonderful. Thank you very much for your time. Thank you and [00:43:00] good luck, everyone, in your team leadership.

Welcome to Doctors at Work. My name is Matt Daniel and this podcast is about doctors careers. It’s part of my mission to help doctors create successful and meaningful careers. Today, we’re talking about teams and team leadership, and I’m having a conversation with Declan Woods. Now as doctors, our focus is all about developing our clinical skills as we’re training, but sooner or later we find ourselves in a position of leading a team.

David tells me that leadership is a different set of skills, one that can be learned and developed. It’s a mindset of listening, asking questions, and being open to try new things. It’s important to model psychological safety by acknowledging uncertainties, as that is the key to creating an environment where others feel safe to belong and to speak up.

And I love his [00:44:00] idea that leadership is something that can move around the team, depending on what is needed and what expertise the team members have. Perhaps a key insight is noticing what’s going on in the team. What is it that the team needs and asking how things can be better?

Welcome Declan, tell me a little bit about yourself. Thank you, Matt, and for the invitation to join you and listeners today. So, so I have a varied career starting as a, as an army officer and then moving into the foreign office before then moving into a corporate leadership role. And it was really mid career that I then trained as a psychologist.

Um, I think the thing that connects all of those different roles is Um, is change and a desire for change for the better in in organizations. And so it was, it was partly that that led me to retrain as a psychologist. But then increasingly I was doing a lot of one to one work and was looking for some other tools and ways [00:45:00] to, to inform that, that work.

And so that led me at the same time to, to start to train and practice as a coach. And so I started working with individuals and then over, over a number of years, that work, uh, increasingly. move to coaching teams. So I now, I now run a company called Team Genie, and we specialize in coaching teams in large organizations.

I guess the coaching is a real area of passion for me. I’ve, um, particularly the area of coaching teams. So I have a voluntary role for a number of years with one of the main professional coaching bodies, the Association for Coaching and design their global standard for coaching teams. So high quality work and work that really makes a difference.

That sort of means something to me. So I’ve been very, very involved in that. And then alongside all this is. As you know, um, I have a part time professorship at King’s in London. So that’s, that’s a little bit about, uh, about, about me. Thank you very much, Declan. And I’m glad to have [00:46:00] you here. And the topic for us today is how to be a great team leader.

And clearly you have a huge amount of practical expertise in that, you know, both from your own roles, but then also in terms of helping develop others. So, I mean, what does make a good team leader? Yeah, I think the first thing is use the experience that you’ve got. I think the, I mentioned earlier that I, I’ve got quite a varied career.

It probably made more sense looking back on it than it did looking forward. But the, but that variety of experiences in sectors, in organizations, in roles, has actually proved to be really sort of valuable. So, so often what I find is when we When we move into a new organization or take on the leadership of a team, often we forget what we’ve done before.

And so we’ve got this wealth of experience that sometimes we ignore or downplay. So what I would say is use what you’ve got, think about the experience that you’ve got, and then think about how that May or may not apply to the team that you’re working with currently and and think about how you might, um, how you might [00:47:00] find an outlet for that and use that.

So that’s the that’s the first thing I think maybe another thing is that, uh, although we’re here to talk about being a team leader, it would be easy to think a team is all about the team leader on. Ironically, it is. And this isn’t so. So to me, the what makes a great team leader is if the is if the team does the work.

So I think a key part of this team leadership role is for the team leader to create the conditions for the team to do the work. So this is very much about managing the managing the team as a whole, creating the conditions and the contribution of the team as part of a system in an organization. So I think those are.

Those are some of the things for me about, um, yes, teams need leadership, but the way in which leadership is exercises is through the team so that the team then delivers the work and delivers more than it could do through a collection of individuals. I’m interested then in this [00:48:00] idea of team then. So what makes a great team?

Yeah, well, I think there’s, there’s, there’s many things. And so, um, I think, uh, uh, typically teams are sort of thrown together, um, often with, uh, with high promise and high expectations. Um, but, But often without a great deal of thought. And so, um, teams that are really effective are designed and set up well.

So I think that’s the place to start for me is thinking about what do you want this team to do? What is it there to do and to deliver? And then setting it up well to achieve that. So thinking about who’s on the team, but also who isn’t on the team? Why is the Why is the team there? Why has it been created?

And what’s the work for it to do? And then how do you bring those things together and align, um, individuals in roles with, with the sort of with the aspiration for the team. So I think that’s a I think that’s probably a key messages is to really think about the what are the fundamentals of a team and to [00:49:00] really put those those foundational elements in place.

One of the things that for me is interesting is that as doctors, we work within teams all the time. And, um, but often it’s, it is, it’s like, if I think of a theater team, you know, there’s people occupy roles. Yeah. You know, there’s the, there’s the runner or there’s the ODP, the scrub nurse, the anesthetist, et cetera.

So, you know, people come in and everybody occupies a role. Um, and that’s what forms a team, but those people may or may not know themselves But they may or may not know each other as individuals. Yeah, you know, there’s a role that people occupy. I mean, how how how important is that knowing each other as human beings in a team versus coming in and occupying the role?

Yeah, I think there’s two things in what you said there Matt. One is that um, uh, you know, we’re human beings and so we have a Uh, there’s a we have a sense of belonging and need to belong to a team. So there’s a sense of being part of something. [00:50:00] And I think the, I think by just focusing on the roles, we forget or often downplay the, the individual within the role.

So I think that’s the first thing. And the fact that, uh, you know, we bring ourselves to roles, um, as, as individuals. And, and at the same time, um, being really clear on not only the role that you’re playing, but the role that others are playing is absolutely. And to make an effective team. Um, so what are you here to do?

And, and, uh, are you clear on that? And equally, am I, am I as clear on your role and your contribution and part in this team and vice versa, so that we, we can align those roles and sort of interlink in how we work together, rather than play tug of war. Um, or, or overlap with each other and sort of often trip over each other.

So I think role clarity is, is, is really important. And I guess in, in a sort of medical context, that might be assumed by, by virtue of the, uh, the label or title that, uh, a healthcare practitioner may [00:51:00] come with. But what that means for this, for this team right now, and this, and the work that this team is doing with a particular patient, um, May not be that obvious.

And so that may need to be, um, unpicked. It may need to be clarified, um, and reinforced. Yeah. So I think there’s, I think that’s a really important point about the roles that we play and how those roles come together. Because one of the, one of the core components of a team and what makes a team a team is, is the interdependence that members of that team have on each other.

Um, so are we reliant on each other? To do the job and the work that we’re there to do. Um, and can we, can we do more together than we can, um, individually? So, uh, understanding who’s there to do what, um, and how we, how we need to rely on each other is, is really important. Um, part of this. Yeah. And I think the, the team leader.

plays a, uh, an important sort of orchestrating role in that. So there’s both the [00:52:00] functional role, but also there’s the, the role beyond the sort of function, beyond the sort of technical expertise. So it may be, for example, that, um, um, you might be a brilliant surgeon, but it may be that you have a, Um, uh, uh, a theater nurse, for example, that he’s a brilliant communicator.

Well, it may be in a particular scenario that actually the team needs to dial that up. Um, well, that goes beyond the sort of technical role and brings it, brings to play the sort of individual in the role. And so these things, um, if they’re known about, can be sort of more actively sort of drawn upon. A challenge for us as doctors is that all our training is focused on our clinical skills, our technical skills.

And you know, that, that is a massive part. And of course, that kind of makes sense because you know, if you’re a patient, you want a doctor who knows how to be a really good doctor, whatever their particular area is. Um, the problem then arises is that one day you find yourself being a fully qualified GP or a fully qualified [00:53:00] hospital consultant.

And, you know, one of the things that maybe I discovered is whether I want to or not. Then all of a sudden, everybody else thinks that I’m a leader. It’s nothing to do with the fact whether I want to be or whether I believe that I should be there. So it’s just by virtue of the fact that I’m a consultant, everybody else sees me and treats me as a leader.

Um, and why is it, why is it so difficult to kind of make that transition? between being a clinician with a clinical skill and then there’s a whole other set of, excuse me, there’s a whole other set of skills that are needed. And as you said, they’re not, they’re not necessarily the same thing. So why is there this tension between our technical, technical clinical skills and our leadership team management skills?

Yeah, I think that’s, um, I think there’s really something in this map because of course when we’re at school, when we’re sort of setting out thinking about the work we want to [00:54:00] do and the career we want to have, um, we don’t start by saying I want to be a team leader. We might start with I want to be a medic and I’m interested in surgery or.

orthopedics, uh, or whatever. Um, and so there’s, there’s an identity question for this as well. And typically what we see, and this is not just true of medics, but more generally, um, anyone in a sort of specialist role typically gets promoted, uh, because of their success as a technical specialist, and then suddenly finds themselves in a sort of managerial or leadership role.

Um, which is often quite, quite different. And we, you know, certainly we see that, uh, with, uh, with, uh, team coaching work that we do with very senior academics. They’re trained to be researchers, but not necessarily, uh, not necessarily leaders of big, complex organizations. And the same is true for, for sort of medics as well.

So I think there’s, um, that can often come as a surprise that, um, the role that we, you Um, suddenly find ourselves in his is very different from the role that, uh, [00:55:00] that has led us to where we are now. And often we’re not we’re not trained in in how to lead teams. So I think that would be a that would be, um, that would be a great place to start is seek some training or some mentorship or some guidance on, um, how to lead a team.

Typically, how people go about that is they, they look left and right. They look at teams they’ve worked with in the past and they and they imitate they copy. Well, Um, it helps if you’re copying somebody that’s a great team leader, but often, um, as I say, we’re not trained and and may not do that particularly well.

So I think that’s that’s the first thing leading a team is a is a skill we can we can improve and get better at it through both training, but also through practice. Your original question was why, why do people find it difficult to make that transition? Well, um, I think the, you know, um, uh, as you, as you mentioned, you know, we know that there’s, you know, a long and demanding training to become a medical doctor.

Um, and some, uh, so [00:56:00] not surprisingly, some real sort of professional pride in, in, in that. And in some respects, the, um, becoming a team leader, um, puts an emphasis on a different, uh, on a different set of skills and one that requires you sometimes to sort of let go of, uh, of your sort of technical abilities and sort of prowess, um, to, to inhabit and take on a, a new role.

And so that, that letting go is often, is often not easy because of the, you know, the years of sort of training, um, Um, and the, uh, the rewards, um, and the promotions that we’ve got from, from our medical sort of knowledge and prowess. So I think letting go and, and, um, um, putting on a different coat, trying that out, um, um, and inhabiting that is, is a, uh, is as much as a sort of mindset, uh, mindset and identity shift as, uh, as one of, uh, sort of skills and ability.

So I think the, um, I think let it, letting go is, is, uh, um, is an important part of this. So it’s [00:57:00] interesting because as you say, if I think for me when I become a consultant, you know, I’m, I’m, I’m an expert, you know, this is the operation I do. I’m an expert in this operation in managing these conditions. Um, but then you’ve said when it comes to being a team leader, you know, I might not be the expert.

Because there might be somebody else who’s a better communicator or there might be somebody else who’s a better completer finisher, you know, yes, I might be the best surgeon in the room, you know, or the only surgeon in the room, and therefore the best surgeon in the room. But, but I might not be the best communicator or the best, the best, you know, resource investigator, whatever else it might be.

So it is that letting go of my identity as me who is the expert and recognizing that actually. When it comes to other tasks, other people are the experts. I’m not the experts in everything. Yeah. So, yeah. And that requires a certain amount of humility. Um, is, of course, the other part of this is the, is the way that, um, [00:58:00] um, other, other healthcare professionals might project their own sort of hopes and fears onto, uh, onto you as the team leader, um, and, uh, and being the sort of, uh, all knowing specialist.

And so there’s, there’s some humility in this. There’s, um, I think making that transition from, um, a technical medical expert to a leader of a complex team, particularly one in, in a sort of very multidisciplinary setting, um, can often necessitate, um, the team leader working outside their comfort zone, maybe with, um, uh, areas and, and, uh, perhaps patient groups that are, that they’re less familiar with.

And so becoming uncomfortable, uh, becoming more comfortable, being uncomfortable and not knowing, uh, is all part of that. Um, I think there’s some, some other sort of, uh, so called sort of softer skills in this around, um, listening, for example, to other healthcare professionals, their opinion, [00:59:00] um, their attitudes, um, being curious about, uh, what’s going on, what you’re noticing, um, being able to ask some, some great questions to sort of draw out that, uh, expertise and perspectives as, of others.

Um, And critically, I think, uh, trusting, trusting more, you know, whereas previously you may have trusted yourself, but sort of, um, trusting others, um, and that their, that their, that their intention is a positive one, um, to, to really sort of leverage and, and draw on the strengths and, and, uh, capabilities that they bring to this team.

You’ve mentioned, um, training. So, I mean, what, what kind of training, what is there out there and what kind of things did you have in mind for training? Yeah. Yeah. I think the, you know, it’s, um, let’s, let’s not turn this into rocket science because it doesn’t need to be. I think this is about, this is about doing the basics well and consistently.

And so, um, You know, I think a short program of [01:00:00] sort of two or three days that really, um, bring into awareness aspects of, um, the team leader’s role and, um, how a team leader can create the conditions for the team to be successful, um, is often enough. Team leadership is a, is a contact sport. So I think the, what really makes a difference is, is taking what you’ve learned on maybe a short, very skills based program and putting it into practice and then getting some feedback on, on that.

Um, so I think there’s, yes, there’s some, some, uh, some training to give you some skills, but I think what really makes the difference is, is, Putting that is putting that into into practices application and then getting some feedback on on that. And then testing it out. You know, Matt, I’m going to try something today.

Can I have your feedback on on that and how that landed? What was the effect of that? Did it lead to a better outcome both for us as a team, but also crucially for the for the patient and the patient outcome? You know, did that lead [01:01:00] to, um, yeah, a better end result? Yeah. So I think that’s, um, yeah, I think that’s all part of it.

So that’s, that strike me as a real mindset shift. Yeah. You know, if you go from that identity or of a doctor is an expert, whereas, you know, what we’re now discussing is a doctor that goes out there and asks for feedback and tries different things and different ways of working, different thoughts and behaviors and, and wants to know how that lands and what everybody thinks.

So, I mean, what, what, what did you need to make that change? Mindset shift from I’m the expert. I know everything into I’m going to ask for feedback and i’m going to experiment and try some different things Yeah, well, I think it, um, I think it depends on your sort of theory of change. But, uh, you know, one, one way of looking at this could be the, you know, to change behavior, we need to change mindsets.

Equally, you might say, well, actually, I’m just going to try some things out. And then that, and then the results of those [01:02:00] experiments may lead me to thinking, actually, this team leadership thing does work. It does make a difference. It does lead to better outcomes. And therefore, okay. I’m going to stick with it.

I’ll give it a go. So I think in some ways, it doesn’t matter whether you start with sort of behavior and acting differently or whether you start with, um, changing, changing some beliefs about the role of contribution that you’re playing. Um, I think the, you know, my encouragement would be to Give it a go, you know, to experiment, to try some things out, start small, um, um, uh, gather some feedback, um, often it can be helpful sort of, um, cueing people, teeing people to, to the fact that you’re trying something differently, so they’re not confused about what you’re, about what you’re doing, um, and, um, And then adjusting it from, from there.

And this is all part of the, I mean, what we’re talking about here is, uh, is an imperfect science. So it’s about, uh, it’s about adapting to, um, based on, um, your experiments and having tried things out, um, and, and learning not only [01:03:00] what works for you and the team, but also, um, leads to the outcomes that, uh, that you want.

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Um, so there’ll be people listening who are going to think this is great. I can apply or even I already do some of that. And there’s going to be people listening who are going to say, you know, well, I have colleagues that are just terrible team leaders. You know, they don’t listen to anybody else’s point of view.

They talk all over everybody else. They just push and drive their own agenda. Um, and sometimes that’s probably me as well, Declan. So, but, so when the people are going to think, okay, you know, this, there’s these people that just drive their own agenda. They don’t listen. Um, and [01:04:00] like, there’s no having discussion.

with this kind of person. I mean, how do, how, how can, how can maybe I, as a colleague, help those kind of people change or influence. If I have leaders that are like that, or if I have colleagues that like that, or let’s sort of say, you know, other, other staff come to me and say, do you know what, you know, so, so, and so it is just, you know, rude and they don’t listen, how, what, what can I do in those circumstances?

Yeah, I mentioned earlier that that I’m a psychologist. I’m in the business of changing people’s behavior and people only change if they want to, you know, if they can see the benefits of changing and doing things differently. Um, and so, uh, often the, the catalyst for that is some, is some feedback. So that may come from you directly, but either it may come, it may come indirectly, possibly from a patient in a particular outcome, or maybe from a professional peer who’s, you know, Who’s opinion that they, they respect.

But I, you know, there’s a number of sort of different [01:05:00] entry points, but I guess the, um, I guess part of the answer here is, how do we, how do we create an agenda for change so that people are open minded about, about this and at least willing to, um, consider and try some things out, not necessarily make a wholesale shift or, or change, but, but be willing to sort of entertain and try and try to do things differently.

Sometimes a sort of useful question, uh, to help with that might be something along the lines of, um, um, Are we, are we satisfied that the outcomes were as good as they could have been here? And it creates a, an opening for new possibilities. I think that leads me on to a second point here, Matt, which is, um, less about the team leader themselves, but, but, but about how the team, the team leader’s role in, in, Uh, setting, um, setting that culture for the team where the team is, is willing and able to try different things.

And so the sort of technical term that I’m talking about here is sort of psychological safety. [01:06:00] Um, I mean, this was not created, but popularized by Amy Edmondson at, at Harvard. And in effect, it’s, at its heart, it, it, what it talks about is, um, can I be included and accepted as part of this team? And, um, is it safe for me to speak up and speak out?

Uh, including if I, if I, if I have or think I might have a sort of minority view, can I do that in a way that I know I’m not going to be, um, censured or subject to, uh, uh, criticism or, or ridicule kind of go, actually, I’m not sure about this or, um, um, I think we might be heading towards a mistake here, something like that, or the team leader plays a vital role in this because they set the tone for this.

So the team leader saying. I’m not sure, or I think we may have some different options here, or particularly I made a mistake. Um, it legitimizes others doing that. So I think the, the team leader has a role in, in setting the tone and role [01:07:00] modeling the sort of behaviors for the, for the rest of the team to follow.

If the team leader, the most senior person in the room is willing to do that, it sends a very clear signal to everybody else that, That’s okay. And it’s okay for them to do that. Um, and that, that takes some real, some real humility, some real courage, uh, a willingness to take some, some risks. So I recognize that that, um, you know, that may be alien, but this is really important.

So, so Google did some work trying to work out what, what makes a great team, what makes an effective team in, in a project called Project Aristotle. And what they found was not what they expected. What they found is that psychological safety was the. The single biggest determinant of what made a team effective, and the team leader, as I said, has a has a really critical role in in in that.

Yeah, so I think that’s, you know, so there’s both a personal aspect of that about, um, uh, a medic’s practice. But also, um, as that medic transitions into a more [01:08:00] leadership role, how they then, um, set the tone and create the conditions for others to do that as well. I think this is going to come as a shock to a lot of people, the idea that, you know, you find the consultant or the team leader in whatever context that I would say, I don’t know, because, you know, people come to me for answers, you know, people say, you know, Matt, what do we do?

And there’s an expectation. That I, or a consultant, GP, team leader, will know what to do. Um, and, um, yeah, sort of the kind of the acknowledging, um, when mistakes were made. I think, you know, that, that, that can be tough also. Um, but actually for me, you know, that, that, that idea of, of, of, you know, apologizing when you’ve done something wrong.

That’s, I think that’s probably relatively simple for, for most of us that are normal human being. But, uh, but acknowledging that, that we don’t know the answers. I think that’s, that I think is really tough. Yes. Yes. I agree. I agree. So a place to start with this might be some selective disclosure. Um, [01:09:00] so it may not be appropriate or, or, and that it may not be willing to make that full step to say, I don’t know.

So there’s, there’s some steps or some scaffolding that they might take along the way. And it might be that, um, say in a particularly complicated piece of surgery that there are. Uh, there are two surgeons in the room, so it might be that you have an agreement between you two. You might say, well, actually, I’m, um, can you look out for this in my, in my practice, for example, and I’ll do the same for you.

So there might be a sort of reciprocity in that. So these things often start small, um, and then we sort of see if there’s, if it leads to a difference, um, and then if it does, we might continue doing with that and then sort of, um, widen that out. So I think the. Um, um, then that would be a, that would be a way of sort of working with this and making, making a start.

And the key thing then also is going back to do people want to change? Because again, you know, I’m thinking if there are people around me or [01:10:00] somebody listening, then if that person doesn’t want to change, then, you know, I’m never going to change. managed to change them. No matter, no matter how much I see a problem in the matter, how much I try, you know, unless they want to change, you know, I wouldn’t be able to change that.

Yeah. Yes, I think you’re, you’re absolutely right. And I think that, you know, to me, that comes back to again, the, um, the sort of team leader or most senior persons in the, in, in the room role. Um, cause I think they, you know, They have a part of their role is beyond the sort of tasks of team leadership is, is, is, uh, is setting the context and setting the tone.

Um, so, so, for example, the context may, maybe that there are some safety critical issues, or maybe there have been, um, some findings of, um, um, um, some practice that, uh, led to unintended outcomes. Um, well, that’s part of the context for, for, for improvement here. So I think the, I think part of. Part of the [01:11:00] how the team leader might work with that is by is by setting the context, you know, and there have been, you know, one or two examples recently that we’re aware of from findings of other, uh, other operations that, um, yeah, and so forth.

And the other thing I’m interested in is, So I, I work in, in many different teams in different contexts. Yeah. So for example, you know, I work in a theater team, you know, and I, and I operate there and then, you know, we, we’re a team of consultants and, you know, and I, and I’m part of that team, not necessarily as a leader, but, you know, I’m a team member and then, you know, we might be sort of be doing projects, you know, sort of, there’s a transformation piece of work that, that I’m doing.

And then again, I go, you know, Um into that team again, not necessarily as a leader, but it is kind of I think I need to be very different person in different contexts You know if I use these three examples my in theater as a member of the consultant body, you know in a transformation [01:12:00] team Um It kind of, it feels like, I don’t know, like I almost need an identity shift when I go from one to the other.

Is that normal? It is normal and it’s needed. And I would say the same person with playing different roles. So I think, you know, be you, bring yourself to these different roles, but play those roles differently. So I think, you know. Just when we think we might be slightly clear on this thing called team leadership and how I might do that, if we change the sort of context or the roles, then, or the teams that we’re, we’re a part of or leading or working with, then, um, then things can change.

So you’re, you’re right that that needs us to play, you know, to play different roles and to be, uh, and to be slightly more, more agile in, in this, um, I think the, um, Um, and we know that within within health care, there are sort of systems within systems. So, for example, we may have a GP [01:13:00] as part of a GP’s practice working as part of a, say, partnership type model.

And that could be quite different from, say, a commissioning or other part of the NHS that might work in a in a more sort of classical sort of hierarchical way. So we’ve got these different systems with their own sort of norms and their own sort of default sets of. leadership and culture. Um, and it’s how do we work within them, but also what happens when we bring those different parts of the system together.

Um, so we’ve got a sort of, um, potentially sort of competing parts of, uh, uh, team leadership there. So I think this, I think the, I think what I’m saying here is that there’s Teams are complex. They’re messy. There’s rarely a sort of one size fits all and it really puts a premium on us being able to sort of adapt our, our approach and the style of leadership to, to the, to the, to the team that we’re working.

Can I pick your psychology [01:14:00] brain? Okay, so I have, you know, let’s say. If I kind of think of my day, for example, so I might have a meeting at eight o’clock in the morning, which will be transformation meeting. And I’m having to think about, you know, the whole system. And I’m not a leader in that team, you know, sort of I’m listening.

And then I have to So of flick like that, and then all of a sudden I’m expected to be to, to lead, you know, how the, the, the, how we, we run the theater team and then I have to flick my brain, and then I’m then a technical expert, you know, taken out a tonsillectomy, and then I flick my brain. And then sort of the, there’s a meeting of consultants, which is sort of, which we trying to collaboratively make decision with without that much in the way of hierarchy.

How, how does, how does that brain switch? Um, uh, not always is the answer, but the, um, the, um, maybe, maybe a way of looking at this is, is, um, uh, what, what’s the role that I’m expected to play here, but [01:15:00] also, um, What is needed here? And therefore, what’s what’s the contribution that I might play? So you’ve got these two.

You’ve got these two sets of factors here, both of which could sort of guide you on how to how to approach this. So, um, yeah, so I would say be, you know, um, work with work with both of those work with both of those things. It may be that in one team in one setting that that you’re there very explicitly because of your sort of tonsillectomy experience, for example, and that’s that’s the everybody knows that and there’s real clarity on that.

Well, great. There’s a good fit there between role requirements and you as an individual. It may be less obvious in say, um, Um, some of the sort of, uh, slightly non medical sort of settings. Yeah, I think that, that, that’s really challenging. And certainly I think for me, I think that that’s challenging because I take, I take the previous role with [01:16:00] me to the next role.

And so I might be switching between roles, but I’m sure that things follow me. And I wonder if that accounts for, you know, sort of some of the, some of the stuff that we see at system level, which is, which is, you know, people, people, people fight for their own corner. You know, if you imagine sort of, we’ve got a team that comes together and, you know, and everybody just fights for their own corner.

And they’re like, you’re not really working as a team because I’m thinking as the tonsillectomy expert. And when I’m in this team, you know, that’s all I’m thinking about, but actually that isn’t what the team needs from me. Um, one of the things that, that I’m, I’m, I’m part, I’m thinking of teams now. So I, you know, I, I’m part of teams.

Or, you know, or groups that don’t have a leader and I’m kind of thinking, okay, you know, we come together We’re doing a piece of work But you know who who’s leading? Like nobody there’s a bunch of us that get together and we all have expertise, but there isn’t anybody that’s leading So, you know, are we still a team or is there such a thing as a leaderless team?[01:17:00]

Yeah, so my um, Uh, so so my response here is is based on my beliefs about teams And so one of my one of my beliefs is that teams need So you notice I used, I used the word leadership rather than leader. So it could be leader, single, um, and very clearly sort of nominated. Um, and, and that may be absolutely fine, but the, uh, what I mean by leadership is that the team can find the leadership that it needs when it needs it.

So that may be, that may be the most senior person in the room. It may be the sort of. Nominated or designated team leader, the one on the sort of organization chart, but equally, it doesn’t have to be. It could be that, um, leadership is shared or distributed or, or is, um, Is passed between different team members and that that can, so I think part of this is about the sort of and passing of leadership, uh, depending on what’s needed and, and who is the best person to provide that at that, at that time.[01:18:00]

So I’m really, I’m really interested in this idea then the, the difference between teams needing leadership rather than leaders, because I’m guessing that that. Most people will sort of say, well, you know, there’s a team leader and there’s a team leader, actually sort of what you’re saying is, yes, there might be, you know, a team leader on top of a pyramid, but equally there might be leadership might move around.

I mean, how can, how does that work in practice, the idea that leadership moves around the team? Yeah. So I think the, um, I think this is, I think this has to be contracted for, uh, so that it’s so that it’s understood within a, within a team, um, rather than necessarily sort of assumed often what happens. It, uh, it just happens by sort of, uh, default or, or from, uh, habit over time.

But I think if, if this can be made sort of more explicit, um, and contracted for between sort of members of a team, then that provides the sort of clarity. Um, including it, including, for example, in sort of decision [01:19:00] making within within teams. Um, so, for example, it may be that if you’re the most senior person in the room, um, uh, organization there, you’re the you’re the nominated team leader.

It may be that you’re you’re taking on some some rework, for example, that, um, that, um, that would benefit from some from from some understanding from, um, another area. Um, it could be you’re working in a multidisciplinary team that that actually some real contextual understanding, um, may be valuable. And you just don’t have that, but others in the team may have that.

And so I think it’s you’re aware of that. And then, um, knowing that you can actively draw on that sort of contribution from from individuals. So it may be, for example, you say, Well, look, we need to make a decision on on a particular topic. Um, could you lead us through this? through this part of a conversation to reach resolution in the decision based on your experience.

Equally, it may be that somebody is too embedded in the [01:20:00] context and has too much sort of knowledge about a thing. And it may be that there’s somebody else in the team that is a brilliant facilitator or negotiator, for example, and you might, you might draw on some of that in a particular circumstance to help, to help you work through a, a logjam, for example.

I like that idea of contracting for that because I think, I think a lot of that probably already happens again, you know, if I think in theater, you know, the anesthetist is the person that knows how to anesthetize the patient, you know, not, not me. And likewise, you know, the scrub staff or the runners, they know where to find stuff.

I don’t know where to find stuff. So, you know, they, there’s a piece of kit that’s missing. Then, then, you know, I’m not going to be. leading on finding a piece of kit, am I, in the same way that, you know, a scrub nurse is not going to be leading on performing the tonsillectomy. So, so, so I suspect that, that, that we already do that in, in that kind of theatre setting.

Um, but it’s [01:21:00] not, it’s not, yeah, I think it’s just, it’s just understood, um, that that’s how we work. But if I think of some of the other teams, um, yeah, sort of, I, I suspect it, it’s, it’s, It’s probably not, I don’t know that it happens and sort of, or it might happen, but we’re not contracted for. Because often, I don’t know about some of the teams you’ve been working, but um, often what happens is there’s a few dominant voices, um, in, in the room.

Um, and, um, if you don’t have, if there’s not an understanding as to sort of how, how that leadership and airspace is shared, that, that’s problematic. Yeah. And I think I’m often guilty of that Declan as well, putting my hand up to that. Yeah. So, and I might put my hand up to that as well at times, Matt. So, yeah.

I mean, how do you, okay. So if I think the, the, For, for, for teams that, that are not, um, that, that, that, but there isn’t clear leadership [01:22:00] and there isn’t sort of clear ways, clear ways of working, what, what can people do to try and move a team into something better, you know, a team member who’s part of a team, but there isn’t any formal leadership.

There’s not a formal leader. How can somebody go into their team tomorrow and, and try and try and make some changes? I think there’s a couple of ideas here, Matt. One is, one is to think about the contribution that individuals might play, particularly a contribution beyond their sort of technical specialty, um, and there may be a time and a place and an appropriateness for them to play their sort of technical role, um, um, and there may be other things that they, uh, other skills, capabilities that they have that the team isn’t aware of.

So I think there’s a, there’s an inquiry here about, um, at an individual level about what else might they contribute that this team might benefit from. So I think as a team leader, we might, we might actively ask [01:23:00] members that, so that we can then draw on that and encourage them to, to contribute that to the, to the team.

Often team members know that amongst themselves, but a team leader, particularly a new one, may not. When first joining a team. So that would be one thing. So what I’m talking about there is is about strengths and contributions. And the other thing is, is, is really about, um, I think there’s two questions that is, uh, as a team leader, we might ask ourselves.

What’s going on in this team right now, and what does it need? And that, um, and it may be it needs leadership. It may need a bit of role clarity. It may need a decision. It may need, um, it may need some more resource. You know, it may need some additional expertise from outside of the team. So the answer could be quite different.

But I think trying to sort of step back from the sort of, uh, the sort of busyness of a team. You think about, um, What’s going on and what’s, [01:24:00] what’s our experience here? And what does that tell us that this team, um, might really need, um, identifies the sort of gap there. And then we can, we can, um, open up a conversation about trying to, to meet that particular need.

That’s, that’s a shift from telling people what to do to asking people and listening. Yeah. I mean, of course it, you know, based on, based on, uh, your, you know, that question that you might ask yourself about what does this team need? You might. Um, you might propose something, or you might say, I think the team needs this, um, and others may see that differently.

Um, so I think the, you know, I’m not decrying that, um, you may have an opinion about that, of course you might, um, um, uh, and others may do as well, and it may be, it may be different. So I think the, um, I think particularly in sort of multidisciplinary teams where they’re, you know, By, by their very nature, they’re broad.

We may just not know, but others, others may have a stronger sort of sense of knowing that. And I think this is, this is [01:25:00] about, uh, not necessarily assuming, but asking the question. Um, I might bring us to a close, Declan, if that’s okay. And perhaps, um, if I could just invite you to summarize what we talked about and what will be your top tips for doctors at work.

Yeah, and I think that let me start with an encouragement, which is that, uh, uh, uh, except that you may not have been trained to be a team leader, but help is there. You can get some you can get some training and improve as a team leader really quickly by by putting this into practice and getting some feedback.

So that’s that’s the first thing. I think the second thing is it is, um, he’s doing the basics. Well, so laying the foundations of. Who’s on the team? Who isn’t on the team? What are their roles? Why are we here at a particular time? And what’s the, what’s the outcome that we’re sort of striving for? Um, how do we make it sort of psychologically safe for everybody to contribute?

Um, so I think [01:26:00] those, I think those are my sort of, my thoughts. Um, those are my sort of top tips about, um, laying the foundations for success and doing the, um, doing the basics well. So those would be my, my top tips there, mate. Wonderful. Thank you very much for your time. Thank you and good luck, everyone, in your team leadership.

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