Episode 177: Please the Purpose, Not the People with Dr. Leo Spector

You're listening to the Healthcare Leadership Excellence podcast. A space for real conversations about what it takes to lead well in one of the most complex industries in the world. Hosted by executive coach Carl Pester, this show brings together healthcare leaders, experts and change makers who are in it every day navigating tough decisions, building strong teams and showing up when it matters most. Each episode is grounded in practical insights, honest stories, and clear steps you can take to strengthen your leadership. Whether you're leading a department or shaping an entire system, this podcast is here to support your growth. Here's Carl. Like to thank our listeners for being with us today on this episode of the Healthcare Leadership Excellence podcast. Sometimes we have pragmatic, sometimes we have theory. Our goal on this podcast is obviously always to have you, our listeners, walk away with things you can do today. So when I came across a possibility of the guest we will talk to today, it was an exciting combination of the two because we have a surgeon that still practices and at the same time is CEO of very large orthopractus in the Eastern part of the United States. So there's that marvelous blend of I do the science, but I also have to work with people and that is a rare combination. So Dr. Leo Spector, thank you for being with us today as CEO of Ortho Carolina. Oh, thanks for having me. Appreciate it. So give us a brief background on your career trajectory and what takes you to talk into us today. Yeah sure. Born and raised in the Boston area. My late father was North Peter Surgeon so kind of at a very young age. I was kind of destined to go that route. Did all my training up in the Northeast and actually my wife got a little tired of the cold and so we came down to the Carolinas for my fellowship and after about three months my wife fell in love and so she told me I better find a job here at Belong commute to see my family. So here we are 20 years later. And you know I did my fellowship at Ortho Carolina and I told them I was going to go back to practice in Boston with my late father and then three months in I told him hey I need a job and so you know either I did a really good job as a fellow so they can't be around or I was the worst fellow and they didn't want to send me out into the real world. I'm not sure which one but we always joke that I've had the longest fellowship at Ortho Carolina because it's been 20 years. But in all sincerity it was a great opportunity for me because I got to go and practice my mentors and it was a great opportunity being part of the at the time we thought large we were about 50 or 60 physicians at the time we've since you know grown to over 110 but to be a part of an independent physician-owned and operated practice and my late father was an independent practitioner most of his career in solo practice by the end of his practice that they could have grown to like five to ten people. What he saw at Ortho Carolina at the time was quite unique and so he was excited for me to stay here in practice and I got the opportunity early on to really get involved and so I got involved in our physician committee structure eventually on our board and so our executive committee is the board of elected physicians that essentially oversees the running of the company just like any board of any other company would do. About a little more hands-on than your traditional board of a big big you know fortunate five-per-ter company. So I spent time on that really enjoyed starting to understand you know the way the group worked getting to understand the operations the finance and in hearing what the administrative side was doing because they would report out to us each month and about ten years ago we started to get very interested in value-based care and our CEO prior to me at two CEOs prior Dr. Dan Murray set up a quality improvement committee and this wasn't your traditional kind of quality insurance it really was to focus on how do we improve care for our patients and how do we get into value and he really knew that if we were going to be successful in value it couldn't just be low in cost it had to be gotten pretty quality and so he knew I had interest in that he made me the chairman of that we eventually developed a chief quality officer role and so I took on a part-time admin role so I was about you know half a day up to a full day a week administrative it was interesting didn't have any direct reports didn't have a P&L to manage so it was more of a physicianally is on role and after doing that for about you know five or ten years just really got the itch to go learn more about what it was takes to be administrator and so I kind of figured you know before I became a doctor I went to this thing called medical school and I got an education and so I said you know if I'm really gonna be serious about being an administrator maybe I'd go get an MBA and I don't think everybody needs to go get an MBA that being said I would recommend it to anybody it was phenomenal I enjoyed the learning I think it's the best all-around degree I've heard people argue that a lot of degrees the best all-around degree I think an MBA is better you learned to negotiate with your wife you learned how to manage your personal finances you learn how to market you learn all the different aspects so I completed that degree and you know timing in life is everything and just as I was kind of getting to the native of where I would be with my role chief quality officer my immediate predecessor Dr. Bruce Cohen had served as our CEO for eight years at a phenomenal job he had enough it was time for him to step down and the group turned to me and so that's how I became a CEO and just a quick funny aside was I remember one of my partners interviewing me that was on the search to me and she said to me so now that you've got your MBA are you ready to be the CEO and I said I'm as ready to be the CEO after getting my MBA as you and I were to be physicians after we got our MD and you know I think she got that and I said you know I've got the book learning but you're gonna be my internship in residency and the last two years has been a crash internship in residency on how to be an administrator but it's been it's been fun it's been challenging and I love it so let me just jump in right into one of the tougher questions and you know like we mentioned in the pre-call this turn into a conversation not a bulletin interrogation of questions here I've run up as I've worked with different hospital systems and large practices that it's a struggle for a lot of leaders to encourage newer doctors to sign up for leadership opportunities it's definitely and not stereotyping here but there seems to be a trend of if you're gonna pay me for it I'll do it but extra stuff not really on my agenda how do you net is that something you're seeing or and if you do how do you navigate that yeah I mean we definitely see that and and the way I try to navigate that you know with with physician leaders within our group or say is to say if you want to be a part of the solution if you want to be a part of improving the way this practice runs we care for patients how we operate efficiently or on the other side how we work with our hospital partners to make it a better experience you know you've got to be willing to step up and be a part of that now should you be compensated appropriately for your time I think everybody should but you're not doing it to make money you're doing it because you want to be a part of the solution and not a part of the problem and so I think the folks that really want to be a part of the solution they're not asking how much are you gonna pay me I think their real question is how much impact will I have is I think what they really don't want to do is serve on a committee just so that that either are practiced with the hospital can say oh what was a physician committee okay but did the physicians really have a voice so I think it's I think for the folks that really are good leaders who want to serve it's less about what are you gonna pay me for my time and are you gonna value my time in that I'm gonna be able to contribute after you get past that yeah I mean everybody's everybody's time is valuable and you need to be compensated when you look at the folks that are focused just on what are they gonna compensate it they're doing it for the wrong reasons absolutely I want to jump back to your example of your interview where in the same way that I was ready to be a doctor after I got an MD and talking about the future for you would be your resident internship residency and fellowship we talked in the pre-call about the overused phrase but very accurate you don't know what you don't know so a lot of the people that listen to us right now are in the new leader I really don't know what I don't know I don't want to sound too insecure but I'm kind of swirling here what steps would you recommend to that new section head neurosurgeon who has just been asked to be section head real case here of 75 people and she's maybe five 10 years out of fellowship suggestions for her as to what to do and not do yeah it's such a common scenario I think you know first off you have to start by realizing that you're not the smartest one in the room anymore and that's okay as physicians as surgeons you know we're highly trained and highly proficient at what we do and in that arena we need to be the smartest one in the room right so if I walk into my operating room and I say hey guys what do you think we should do today right right they wouldn't know what to do they'd run to administration say you know Dr. Spector's lost it let's get one of his partners here quick so in that In that regard, we're taught to be the smartest one in the room. We're taught really to show almost no chinks in the armor. It's very much a command and control setting. When you move into the administrative role as physicians, we walk in thinking we still have to be the smartest one in the room. And that becomes a huge detriment because then we don't ask good questions. We don't listen. We feel the need to kind of protect our ego, protect ourselves. So what I'd say, first off is check here you go at the door. It's a safe space not to be the smartest one in the room. And actually, where we can use our intellect, because most physicians are pretty smart people, is go back to being a medical student when you were asking great questions because everything was new to you. And it was safe and it was expected and it was okay. Ask good questions. So I think the biggest thing we can do in those roles is to listen. And we don't understand something. It's okay to ask and say, I don't understand. And that's okay. We make the mistake of not doing that. Pretending we know what's going on, feeling like we have to be the smartest person. And so I think that's the biggest thing. Listen, don't be scared. Ask good questions. You're not the subject matter expert anymore. And that's okay. But you still are the subject matter expert being a physician. And that's why they want you in the room. So they'll ask you questions about the physician perspective. That's when you are the smartest one in the room and you should share that. But in all other aspects, you're not. And you have to ask, and it's really hard for us to surgeon, especially physicians in general, but especially surgeons. It's really hard for us. And I struggle with it every day. You can ask my team. I mean, by no means do I have this down, Ron? I still drive them crazy. I'm sure. So I want to flip a bit on the question. I had a situation several years back where I was brought in, I do conflict resolution in health care leadership settings. And the administration had made a really big decision. They had left out their entire physician core on this, on this question. And they were a bit taken back of how upset the physicians were. And it was kind of, you know, for an outsider, it was, I hate to be simplistic, but this seems pretty obvious. Just as an administrator, and I, what key this thought doctor was your point of doctors are very smart individuals. They have to be to get to what they do. And I hope that the person operating on me is the smartest one in the room. So two levels of the question. Why do you think that administration sometimes creates a silo of you do medicine and will do the business when they have this brain trust of brilliance that they can access. So talk to me about how they can access it and how physicians can step up better in administrative decisions when they don't have an MBA. Yeah, no, it's a great question. And I think it really has to do with how the two interact and choose to communicate with other, each other. And usually when it breaks down, it's due to a lack of that communication that occurs. I think sometimes administrators will look at physicians at, you know, cogs in a wheel and look at us as, you know, replaceable parts as opposed to appreciating the unique talents and skill sets that each physician brings to the table. That being said, the physician sometimes forget that that they are replaceable to. And the physicians seem to think that they are the end all be all. And so I think both sides need to learn to respect each other a little bit more and value what they bring to the table. I think that he is, you know, for administrators, they have to understand that they are not involved in the day-to-day care of patients and they are not the experts there. And that while they're charged with running a large organization that has a lot of complexity to it. And to the day, their job is to deliver care to patients and the people that are delivering that care on the front line to the physicians, the nurses, all the other, you know, practitioners. And so you've got to engage those folks on those big decisions. Now, you got to be careful. You can't ask, if you ask 100 surgeons, you're going to get 100 different opinions, you're never going to get anywhere. Right? And so that's where you have to engage with and have a leadership structure. I think on the reverse side, the physicians have very little understanding of what it takes to run a large organization, be it an orthopedic practice like ours, let alone a hospital system. And I think too often the physicians take the approach of, hey, you know, these are a bunch of folks up in their offices. They've never seen or touched a patient before. What the heck did they know? Just give me what I need and let me go care for the patient. And the problem with that is, as physicians, we don't realize as if the administrators did that, we wouldn't be able to care for the patients because the hospital will be out of business in about one day. Right? Maybe we've lost two days because we don't know how to run a business. Right? That's not what we're highly skilled or trained for. And that's where you see most doctors getting troubles. They start to think because they're so intelligent, they can do that in a million other spaces. And that's where you see doctors getting all kinds of, you know, various bad business decisions. So I think it really just goes back to everybody checking there you go at the door, understanding that both play an important role within the delivery of care to patients and to show each other a modicum of respect and decency. And there you can then build relationships up together where you can build that trust. But I think it starts at that kind of base level. So you said something that primed yet another question. It's the difficulty of coming to a decision, asking for input, honoring that input. But at the same time, not getting in the. Mind field of consensus that everyone's voice because they have a voice, they have a part in the decision. So your organization has, I think you noted 110. Physicians. And you mentioned that if you ask 100 surgeons, you'll get 100. How do you manage the, tell me what you think and our decisions may not resonate with what you think? We're doing that right now. I mean, as an example, we recently purchased one of our ambulatory surgery centers away from the physicians, from individual ownership to group ownership and lots of reasons we've moved in that direction. And we're in the process of doing that with one of our other centers. And at the center that we purchased, we had to make a decision about which vendor to use for implants. And we did a very fair, open, transparent process, put a request for proposal out there, had submissions by five companies. It came down to three finalists. We interviewed the surgeons about their preferences. We got all the pricing. And at the end of the day, you know, came down to two vendors that were, you know, half the docs like one, half the docs like the others. And we went through the numbers and the numbers showed a clear story and we picked that company. Now the folks that liked the other company that didn't get picked, they, you would have thought, you know, we just, you know, murdered their, you know, firstborn child. And you know, they're having all the reasons why we should have picked the other and why it was biased. And at the end of the day, that's where to say, listen, we got your feedback. We got your information. But it's our job as administrators to look at the whole picture and to make a decision that's in the best interest to the organization. And at the end of the day, half of you are going to be happy, half of you are going to be sad. And that's okay. We got to go by the finances of it, what, how do the two? And you move on from that. But you do have to show them that it was a fair and transparent process. And that we heard their voice, it doesn't mean that their voice won the day. And I think that's the key. That's hard, you know, for them because they think, well, just because they say, well, like this one, that's one we're going to choose. No, we're getting your opinion. And, you know, so it's a delicate balance and it's hard. I found out the hard way when you don't do that. And I've trust me done it many times and just ignore them and go straight to the decision. And that's the right decision. It's not the right process. And so what I always tell my team, you know, there's a difference between, you know, making a good decision and having a good decision, making process. And having a good decision, making process is far more important than a good outcome. Because I'll be able to say, well, how do you know you made a good decision? Right? I remember this in business school and all the classmates and all the scientists, well, you measure it by the outcome. And the answer is no, it's, did you have a good decision making process? Because that's repeatable over and over again. You can have a good process. You might come and make a decision and things outside of your control turn out, they actually have a bad outcome. But that's outside of your control, right? And so to me, it's all about if you've got a good process in place. So I want you just to imagine that you have a couple of thousand people in your auditory. I mean, you're at the whiteboard because you have hit one of my absolutely favorite topics. Is that a process? I like to quote by the author James Clear of Atomic Habits, you rarely rise to the level of your goals who will fall to the level of your processes. And so teach us for a few minutes here how the doctor's specter brain looks at a problem and develops a process. this is so important. Yeah, now I think It starts with that, right? You've got to ask, what is the problem? What's the problem you're trying to solve for? Right? Everybody has solutions that are looking for a problem. You've got to start by saying, what is the core problem? You really have to take some time to find that. And I think it's important to have a team around you and really to have a team that has differing opinions, differing backgrounds. And you've got to put the problem out to them. And you can't start by telling them your opinion, right? As the leader, once you do that, confirmation bias suit, right? Sues. You've got to put it out there and try to go around the room and get that information from them. And I think it's your job to synthesize that, or lay back what you're hearing, and then begin to formulate what the potential solutions are. And again, you can't then bias it by saying, I think that's the best solution. You have to say, OK, this is what I've heard. Here are the possible solutions to the problem. Once you've agreed that you've defined the problem properly, which that takes time and on itself. Right? I think it's Einstein said if he had a problem, he'd spend one hour, he'd spend 55 minutes on the problem and five minutes on the solution. Right? But we all, especially as surgeons, getting back to the original conversation or car, as surgeons and as doctors, we jumped to the solution. We can do that because we've had the 10,000 hours of training. Right? We've highly repeatable, we know the answer because we've seen the problem a million times before. But in business, you've never seen the problem before. They're always new. You can relate back to some similarities or different experiences, but it's always a new thing. And so you start the process by discussing the problem, defining the problem, getting the input, synthesizing it, and then getting people to put in solutions. There's lots of ways people do it. Right? Sometimes people write down their solutions on a card and put them into the middle and everybody reads them out because you know once one person says their solution, people start to change their opinion. Right? And so there's different ways you can handle those type of things. I do also think, you know, for really big decisions, I always loved the concept of pre-mortem. Right? As physicians, we're great at doing post-mortems. Right? We do that greatest physicians. We've got our morbidity and mortality rounds. We are well trained to look, okay, complication occurred. Look back. How could we have prevented it? But in business, you really need to look at a pre-mortem, okay? We define the problem. We think this is a solution. Now let's talk about all the ways we can fail. And if we start talking about all the ways we can fail, then we can say, okay, how are we going to avoid that? How are we going to avoid that? So for big decisions, but that takes time. And what in business in today's world or everything needs to be done really quickly, we don't want to take the time to do it. And I find that a concept reminds myself when I try to go fast, it takes me more time. And so I always tell my fellows, as I'm teaching them in the OR, you don't want to be a fast surgeon. You want to be an efficient surgeon. And I said, if you're a fast surgeon, you're going to end up going a lot slower because you're going to cause more complications. Be efficient. Don't be fast. We're having a great conversation today. And I hope it's sparking some thoughts for you. Let's take a quick break. If you're looking for tools and insights to lead with more clarity, confidence and consistency, visit www.coachinggroupink.com. Carl shares real world strategies for navigating conflict, building trust, and staying grounded as a leader. And if you want to quit practical content on the go, check out his YouTube channel. Just search the coaching group and subscribe for weekly videos that help you lead better. We'll find the link in the show notes. Now, back to the episode. And so translating that to a business environment, because you've hit on such a key aspect, I call it the tyranny of the time frame. We have till 12 o'clock and we need to do it. There's no possible way our agenda can be done by 12, but we're going to do it anyway. And then we just start to spin. So as a physician executive and speaking to physician executives in our audience, what are some key steps to be efficient and just not fast for a business person? And I think it's, again, it's really hard for us because we do want to just jump right to the answer. So I think you have to, you know, whether it's count to ten on your head or bite your tongue or whatever you need to do to kind of rain yourself in. And, you know, I've got to practice what I preach. So I'm always trying to do better at that, but really take your time. Now, as the leader in the room, as you see the conversation start to kind of head sideways, or you realize that it's no longer being productive, you do have to be willing to interrupt and say, hey, great conversation, great point. Let's take that offline and let's deal with that separately. But let's either refocus back on the question that we were trying to answer that we got sideways on, or, no, we're going to have to move on to the next point, you know. And so I think as a leader, you have to sense that. You don't want to stime a good conversation. When good conversations occur and you're getting that good flow, just because the agenda says ten minutes, you can let that go 15, 20, 30 minutes because that's good stuff. When you see that it's either stagnant and move on or when it's starting to really go off the rails, that's when you got to kind of pull it back in and say, you know, we're kind of going down a little rabbit hole here. So let's put that in the parking lot and let's move forward. And so I think it just takes your awareness. But to do that, you've got to step back a little bit and listen and see what's going on. It's like, you know, it's like being a good conductor of an orchestra or being a good coach or of our analogy, you like to use. So you've said a couple of things that take me to another topic. I think of you with 110 searches. That's just the mind boggling number of brilliant minds. And letting half of them know that they're not getting the implement they chose. We also just talked about in a conversation to look at Carl and say, we're on the edge of the rabbit hole here. Let's pull it back. Both of those comments on situations may not lead me to like you. And one of the big things I hear with growing leaders is they're still in the, I want people to like me as a leader. And you know that that's just an explosively bad thing. So can you walk us through how to develop the thicker skin, the mindset, whatever so that you can lead effectively and still be able to sleep at night? Yeah, it's a great question. Great point. And such a problem. And one can't lay probably one of my biggest struggles going into this. Because by nature, I am a people pleaser. That's just my nature. And you know, I think to be a good leader, first of all, you've got to learn who you are. And that takes some real introspection. And so you've got to put some time in to understand who you are, what makes you tick? How did you get here? What are the things underlying you that naturally biases you? Because if you don't understand that, then you're kind of on autopilot, right? So you've got to really intentional about understanding yourself. And so a big thing for me was understanding that part of my, as my executive coach likes to refer to it, my default operating system, my DOS, as opposed to my new iOS intentional operating system. So that's his phrase, which is a great one, I think, you know, because DOS is old iOS, it's new if you're an Apple person, is to be a people partner. And as a leader, as you point out, that gets you in trouble because you can't please a hundred insurgents. You can't, you can't please too. What I really focus on is being really clear on what your purpose is, what's your purpose is an organization. So for us at ortho-carolina, our purpose is to make lives better, right? Our why is our patients. And so if that's the purpose, then I say my job is to please the purpose, not the people. And so if I look at that and I say, okay, we made a decision and it was in the best interest to make lives better, to lower the total cost to care, to deliver, you know, in this case, probably equal outcomes at a lower cost, which in the value equation that increases value to our patients, I have pleased the purpose. Now I have displeased half my partners and I have pleased half my partners, but I don't really care. What I care about is that I pleased the purpose. I think the other part of it, you have to be careful of as you can't, you got to check yourself every day. What is the purpose, right? Because if the purpose is to make more money, or if the purpose is to elevate yourself, then that's not a good purpose, right? And if that's what you're doing, then, you know, then you shouldn't be a leadership, right? But you have to look and say, what are your personal values? What are the values of your organization? Do they align? And if they do, keep that as your true North, never lose sight of it, and you're fine. And there'll be tough times, you know, I love to sail. And so, you know, using analogy of fog rolls in and you kind of lose sight of the horizon. But, you know, even in the old days, you're still at a compass, and you could still say, well, that was North. And so, if you got your true North, and you still had in that direction, I think that's the key. And so, get into your question about that, because you're right, that's the hardest thing. My mantra is, you're here to please the purpose, not to please the person. That is classic. I love that. I hadn't heard that before. I want to hit a real case scenario. We know that even though we have many times teen-based medicine, et cetera, that there are multiple settings where there is truly a hierarchy. medicine. When you walk into the room like you said, if you want to get people talking really fast, it's the, what do you think we should do today when you go in for a total joint? That would not set well. And yet those very people who would not set well, many times battle against this inherent hierarchy. So how do you leave within a necessary hierarchy? How do you lead people who are it's easier to lead when there's a differential? Because I respect you because you have a higher education, you have more tenure, whatever it may be. But leading peers, especially highly educated peers, who can match you step by step in many settings, how do you lead, motivate, and influence people who are just maybe not wanting to be led, influenced or motivated? In that category, those folks should just can't lead. And the folks that do not want any of that, some of those folks should just have to ignore. And there is that 10% that you just have to ignore. There's that squeaky wheel that they don't have any solutions, they don't want to follow, they just want to complain, they just want to be the problem. Those folks you kind of have to ignore because you can't spend that 90% on that 10%. But when you look at the other folks, that's when you talk about how do you get out of this typical command and control structure that we're used to as physicians, where your title, your rank is all you need for people to follow you. And then learn that when you're dealing with your peers, it's about really the power of persuasion. And I mean that in a good way, right? You have got to be able to make a thoughtful and a logical and a cogent argument as to why they should believe you trust you, follow you. And it really, I think again, goes back to if you're committed to the purpose, and they see that, and they know you're not doing it for self-serving reasons, and they know you're doing it for the bigger picture. They will follow you over time, but it takes time, you got to build that trust with them. And I think that takes willingness to listen to engage with them. Now again, the ones that are totally unreasonable at some point, you just got to cut that off and say, okay, I can't, but other folks, you've got to be willing to reason with them, to talk with them, to hear them out. And I think one of the biggest things is when you do make a mistake, when you're wrong, own it, apologize for it, say, hey, I got that wrong. I should have listened to you. You know, again, I was true to purpose. We went through the process, but at the end, it was the wrong decision. Own that. And I think that gains you a lot of trust from the folks because they see, okay, he's human like me, we all make mistakes, he's willing to own it and learn from him, and show that you do learn from it. So I think it's all about that building that trust, because that's people follow people that they that they apparently trust and believe in. If they think they're just selling a bunch of alone because you're doing something for your own personal gain, people aren't going to follow that unless it's in a command and control structure, they've got no choice. Otherwise, they've got to believe in you, they've got to trust you, and they've got to believe in the purpose. So when I do coaching people, especially at your level, this thing of apology really is kind of like, yeah, I completely agree, but don't ask me to do it because they see it as an admission of weakness. And unless I coach them really well on how to do an apology, I will get the, it's the apology plus then all the rationale of why it wasn't really their fault. So what does a real apology look like and what shouldn't you do when it's apology time? I think you just hit the whole rationalization, right? You've got to own it. As the leader, you've just got to own it. So last year, I think an example, we have a number of designated days off holidays, and it always comes up whether or not the day after Thanksgiving should be a holiday. And the physicians want to keep it open. And the argument is we want to gain access to our patients. We don't want the office to be closed for over four days in a row. And obviously, the employees would like that day off understandable travel, be with family. And our practice for various reasons has always had a good Friday off, which you could argue that's a very religious holiday, obviously, Christmas is, but you know, you know, you don't always see good Friday off. And so we have a council of employees to give feedback and we kind of heard from them. We'd love the day after Thanksgiving. And so, we're doing my team. I said, you know, maybe we should give people the option. A lot of people don't really care to take good Friday off, whether, you know, they're not of a Christian faith or not a deep Christian faith. It doesn't mean anything. For that sense, it doesn't match up with their kids' holidays. They'd much rather have things to give me option. Well, we didn't really fully think it through what that meant from a staffing standpoint, from what happens if, you know, someone is here working in April, but they're not in in November. We went out and we changed it and we said, we're no longer going to have good Fridays, a designated holiday. We're going to out of floating holiday, take one of the other. And it fell flat. It was terrible. The employees were unhappy. We hadn't given them anything. We had taken something away. And I could have come back and made a million excuses. Well, hey, this is the feedback I got from the employees. Hey, this is what HR suggested to me. I just owned it. They said, hey, made the wrong decision. Clearly, this was not a good decision. Brought the employee council back together and said, what would you all want? And they said, you know, we want to keep this a holiday. We'd rather have you add, you know, floating holiday. We could take anywhere we want. And so we went back and we changed it. And again, what we were clear about is that the tail is not going to wag the dog. Right? You can't just complain about everything. But when we make a decision, we're not above approach. And if clearly the decision we made where we're trying to accomplish something for the good turns out that it didn't, we're not going to double down on that. Instead, we're going to listen here and just say, hey, we made a mistake in our decision. The process was good, but the outcome wasn't. We can own that and we change it. And we do that. I think you gain a lot more trust and support because they say, oh, wow, you know, this is a leader that actually really listens. This is a leader that's willing to own up when they make a mistake or when even well intentioned things don't always work out. You know, it's no different than when you're dealing with patients, right? You know, early on, I was talking about career, how do you deal with complications? You know, there's two ways to do it. You bury your head in the sand, you run away from the patient, you run away from the family because you just can't deal with it or you attack it head on and you spend time with the family, spend time with the patient, you say, yeah, this was an unfortunate outcome. You know, this is a complication that occurred. It's not an emission of guilt per se, right? Because it's a whole medical league bless you. But it's the willingness to engage and have that conversation. And I think, you know, people recognize that that takes courage to do that. And I think ultimately they respect that. And so I think a good apology has to be a sincere apology. It's without any kind of precursors or rationales. It's just an apology. You own it. You take the heat and then you move on. And I find most of the time when you do that, most people will say, well, it's really good of you to do that, but you know, it wasn't completely your fault or this fine. But you don't start by making the excuses, right? You own it. That's your job as a leader. Excellent. So we're headed toward the end here. But this is a big question I'm going to ask. You said earlier that it's not wise for a person leading to give his opinion or her opinion. So I'm not going to give my opinion on this. We talked about it in the pre-call. But we talk about results. We talk about rees. We talk about high intellect. Talk to me as a surgeon, as a CEO about your views about emotional intelligence. Is it overrated? Is it just your audience about your views on emotional intelligence? Yeah, I don't think it's overrated at all. And I know it's become a big buzzword. It's become top of mind. And a lot of times when things become a big buzzword on top mind, they start to get overrated. I don't think emotional intelligence can be overrated enough. I think to be a good leader, you need the emotional intelligence to first and foremost be able to understand who you are, what makes you tick. Have that self-awareness. I don't think you could have self-awareness if you don't have emotional intelligence. I think to be a leader of people, if you can't read people and understand people, and there's really no way you're going to be able to relate to them. You can't get that trust. Now again, in that command and control environment, who cares? It doesn't matter, right? You're in the operating room, you've got a patient on the table. Nobody cares if Jay and the nurse had a bad day or the anesthetic. Nobody cares. The expectation is you come to work and do your job, but that environment is a very unique environment because everybody is hyper focused because you've got a patient on anesthesia that you're caring for. For a moment in time, people typically will put that, check it out the door, they'll come in hyper-focus so you can kind of ignore that. In the day-to-day running of any kind of business, hospital, any kind of human endeavor, people bring themselves to work. They can't help but do it. If they try not to, it's only underneath them kind of affecting it. When you see someone who's struggling, there's usually a reason. It's not the reason that's on the outside, typically what's going on inside. I think to be able to recognize that and to be able to channel that is so important to be an effective leader. I think emotional intelligence is hugely important. I don't think it's underrated at all. But I don't think it's an all or none, right? You need both. You need to have your IQ and you need to have your EQ. But if you had to tell me pick between one or the two to be a successful leader, I'd pick EQ over IQ every day. To be a rocket scientist, I'll pick IQ over EQ every day. And to be a successful surgeon, it's probably IQ over EQ as well in the operating room. Now in the patient room when you're taking care of a patient and you're counseling someone on surgery, now it's about your EQ. And you hear that all the time for patients, hey, he's a great surgeon, terrible bedside man. Now at the end of the day, if you had your choice between a great bedside manor and a terrible surgeon or a great surgeon and a bedside manor, you're going to take the great surgeon and the bed bedside manor because in that instance, all you really care about is, am I going to have a good outcome for the operation? But in business, it's a much more long term thing and I think it's the EQ that becomes much more important than the IQ. Do I have time to ask you one more question? Absolutely, yeah, for sure. So something you just mentioned, Qed, one of my big concerns, I'm working with a couple of people up in the northwest to address this. I'm seeing a trend and it may be regional, but I've seen it across the country in different engagements that I've had. The situation is this. We have a surgeon who is excellent and she in the OR in a very tense, firm voice told a scrub tech and I'm creating some of this, but tells a scrub tech that they need to do XY and Z pretty well right now because the field's open and aesthetic. There's been a couple of complications. It's running longer. We need to shut it down. Get it done. Get it through. And yet that surgeon, real case, had a complaint filed against her and I could give dozens of these examples that the scrub tech or the nurse or whoever felt unsafe, felt hostile work environment because Jane Doe, excellent surgeon, went into command mode. Now it's interesting that the more experienced personnel in the room that I interview say, Dr. Jane, she's amazing. I'd work with her any day. So you're nodding head says that this is not a new situation. Any guidance because these surgeons, now some truly, I remember one situation that a colleague of mine shared, one of his clients said, yeah, I threw a scalpel, but I didn't hit anybody. So what's the problem? You know, that's over here on the continuum. So how do you respond to someone who is acting in the purpose of the patient in a firm voice that other people in the room say was just firm? How do you deal with this? I felt unsafe and the surgeon gets blindsided. Thoughts? Well, I think it's a tough one. I think part of it, you are seeing some generational differences occurring. I don't want to just blame it on generational, but I think we are seeing some of those changes. But we have to be mindful of that. I think it probably starts with, you know, if you as the surgeon at room under normal circumstances is someone who is calm, level set, fair, if the situation arises where you then have to take that stern voice, the people that know you understand, wait a second, this is not this person being unsafe or threatening to me, they're acting in the purpose of the patient. But I think the other thing you can do is once the situation has come back under control, you as a surgeon can check in with everybody, can say, hey, that was a pretty tense case. How's everybody doing? You know, sorry, I had to get a little bit, you know, gruff or a little bit stern, but, you know, is everybody okay? You can check in with the team. And that's where that emotional television comes in, right? If you can see clearly that you flustered that person, at that moment in time, you should give a hood about that because your purpose is to take care of that patient. But you can in a non-apologetic way, right? Explain that individual afterwards, you know, hey, sorry if it felt like I was being tough on you, but at that moment in time, you know, we needed to do what we needed to give done for the patient because the purpose here was the patient, you know, sorry if it unintentionally offended you, it shouldn't have, but I understand that it might have, but, you know, you please don't take it that way. I think you can have that kind of a conversation, but usually if they know you well enough, and that's probably where the other people in the room know that individual, that doesn't bother them. It's the person that doesn't know them that could be offended or taken aback by it. And so, you know, I think if you can recognize that situation, then you address it afterwards, not at the time, but that is a tough one. But that goes back to your question about the IQ versus the EQ. If you don't have any of that EQ, you're going to miss that whole thing occurring and you're going to ignore that. And in today's day and age, yeah, it does set you up to get called to the principal's office. At that point, you know, as long as you were doing everything in the best interest of the patient, as long as you were respectful, then ultimately you are in the right in that scenario. But I still think it's a learning opportunity where you as the surgeon can work with that individual to help them become better scrub nurse and nurse and to help them along. As opposed just kind of saying, oh, they're soft skinned, they don't belong here. Well, Dr. Spector, this has just been one of the fastest hours that I've seen go by. Thank you so much for these insights, for your sense of humor, for your drill down humility. I really appreciate that. What is the best way of people want to learn more about ortho-carolina, your successes, your organization successes? Is there a place they can go to? Yeah, well, we've got a very active website. I've also got a pretty active LinkedIn where we try to put stuff out there about what ortho-carolina is doing so people can learn more about the organization and learn more about what we're doing. So that would just be on LinkedIn to search ortho-carolina? Yeah, ortho-carolina.com is our landing page, which brings you to our site, which I think from there they can click off to follow us on Facebook and Instagram and all those things. I'm obviously on LinkedIn myself and people can follow me there. Great. Thank you again for such a ample time this morning, very appreciated. Enjoy the carl. Thanks so much for the conversation. Thanks for being here today. If you found the conversation useful, inspiring, or just worth thinking more about, we'd love it if you'd leave a review or share this episode with someone in your network. This podcast is part of Carl's broader work in conflict resolution, coaching team facilitation, and leadership development for healthcare leaders and executive teams. If you're curious to learn more or start a conversation, there's a link in the show notes. Until next time, keep learning, keep leading, and keep showing up.