I am a converted Red Sox baseball fan. I grew up in New Haven, Conn, and was an ardent New York Yankees fan growing up. However, during my many years living in Massachusetts, as well as having numerous contacts with players for the Red Sox at the University of Massachusetts Medical Center, I became a convert to the local religion, the Boston Red Sox, as well as a frequent visitor to their cathedral, Fenway Park. The 2018 Red Sox team had a spectacular season ending with crushing victories on their way to the World Series Championship. Sports writers have had a field day commenting upon the cohesiveness of the team under the superb leadership of Alex Cora. The media commentators have waxed poetic about Cora’s ability to lead, inspire, and support his assembly of highly talented players.
While listening to the many positive comments about this year’s remarkable Red Sox team and their efficient cohesiveness, I was struck by the similarity between professional baseball teams and medical center departments of medicine and/or subspecialty divisions. Both are staffed by extraordinarily talented individuals who continually strive for excellence in their respective positions. Both units require supportive, responsive, and intelligent leadership that understands the special qualities of each member of their team and seeks to enable the best possible performance by these individuals. Baseball players have special skills related to their position on the field of play and their place in the batting order. Some players are superb defensively, others have remarkable batting abilities. In order for the team to excel, each player has to strive for excellence while at the same time working closely with other team members. The same dictum holds true for Departments of Medicine and/or subspecialty divisions. The individuals comprising these units each has special skills, possibly multiple skills, but each member has to work efficiently and smoothly with the other team personnel. And, of course, there has to be a clear-sighted, enthusiastic, and supportive leader with a strong sense of fairness directing the medicine unit. If the members of this unit sense that the leader is “playing favorites,” team morale deteriorates.
During my long career in academic medicine, I have served under a number of outstanding section chiefs of cardiology and chairpersons of medicine. I cannot comment on the success of my own periods of section and department leadership because of obvious personal bias. However, it was always clear to me when a section or department was being run efficiently and with evident success, just as it was not difficult to distinguish units that were poorly run with resultant stress and inefficiency. Indeed, working in a section or department with poor leadership was an unpleasant experience due to the loss of enthusiasm and collegiality in the unit. Ultimately, work quality in these distressed units was not optimal, and personal interactions among team members could become acerbic.
What are the leadership qualities that distinguish a successful section or department head from those leaders lacking those inherent or learned abilities? My college roommate and long-term friend, David Gergen, has written a book that describes his close personal study of the leadership characteristics of the 4 US presidents under whom he served.1 Gergen’s keen observations led him to postulate that the following qualities distinguish a good leader from a poor one: personal character, idealism, political skill, and organizational strength. He notes that many believe leaders “are born, not made. It certainly appears that many of the best of the past century … had leadership in their bones. But each of them gained enormously by studying and drawing upon the experiences of others. Training and understanding of the past have been indispensable to the preparation of most leaders.”1
My experience in medicine supports David’s conclusions. Some of the leaders that I have worked under clearly had charismatic leadership qualities. They were idealistic, politically savvy, and scrupulously honest and fair. These individuals produced units with enthusiastic and efficient team members. Other leaders with whom I have worked lacked charismatic personality traits but were able to develop into effective chairpersons through study or coaching. A number of organizations offer effective leadership courses—for example, the excellent departmental leadership course offered each year by the American Association of Internal Medicine, comprised, in part, of chairs of medicine in the United States and Canada.2
In conclusion, I believe strongly that excellent leadership qualities definitely determine how well professional baseball teams and medical units function. Some managers and chairpersons are born leaders, but others have to make a conscious, strenuous effort to attain the necessary skills. As noted above, for those individuals not intrinsically charismatic, there are a variety of routes available that can lead to a successful career as a leader, such as the American Association of Internal Medicine course just mentioned.
As always, I welcome e-mail or written comments to any of my editorials at jalpert@shc.arizona.edu or on our blog at amjmed.org.
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-Joseph S. Alpert, MD
This article originally appeared in the February issue of The American Journal of Medicine.
