Question for a Leader

Really interesting question to help tease out leadership characteristics from passionate people:
How have you made a tough decision based on data?

Big Idea of the Day (BID): Allocating decision rights

Zimmerman frames the dilemma of allocating decision rights in a company as consisting of three dimensions
1) Who has decision rights?

2) What are the performance measures that we will use to know how we are doing?

3) What reward systems will we put in place to reward our people?

Passion – the ultimate competitive advantage

After 5 years of graduate school and thinking about my future career, there is one piece of advice that keeps coming up over and over. “Find your true passion” says all of the mentors, supervisors, coaches and peers that have advised me over the last several years. Yet I’ve struggled at times to reconcile this advice with the much more tangible signs of success (money, fame, prestigious job titles) that the very people who champion the “passion” line possess. Recently however, while listening to Alan Pesky who founded the Lee Pesky Learning Center, a very successful non-profit which tackles learning disabilities, I realized that the reason for his success was precisely because of his passion. Beyond his business model, decision making, management and people talents because he had a child with learning disabilities, he had a passion that led to a success that money could not buy. For example, in 12 years the Pesky center has been funded by $16M compared to similar now-defunct efforts started in the same time, the Schwab center ($200M invested) and the Cosby institutes for learning disabilities.

I suppose the next question really is what exactly is my passion then. I really don’t know and I think part of what gets me up in the morning is the excitement of not knowing precisely what is going to happen that day. That said, I do know that I love medicine and the promise of helping people, I love making that connection with needy patients. I love the excitement of learning something new, the excitement of building something new and lasting. Its interesting to be in the presence of people like President Kim who have devoted their whole lives to good work and being a great leader who has devoted his life to all those things and realizing that the one thing that is missing for me in a career like his is the instinct to have to make money.

It is interesting to hear President Kim talk about his struggles with his identity and confronting his privilege.

http://www.washingtonpost.com/wp-dyn/content/video/2010/03/31/VI2010033100606.html

Could it be that the socialization by my family and society in Taiwan may be a barrier to my eventual ability to be that transcendent leader that I could otherwise be?

Where everyone knows ur name

Jess put it pretty well describing her “happy place” of the future. I think similarly, I have finally figured out why NYC is just not for me. I find the impersonal aspect of it a bit daunting and cold. I think I prefer a city with a bit more warmth in it’s atmosphere and it’s people and while anonymity can be liberating. I far prefer to replicate the happy safe place of my childhood in some place I would call “home” than anything else. Take care of my inner child and all that jazz.

Don’t shoot the messenger!

I inserted myself (as I have a tendency to do) in the middle of a two folks who had a disagreement with each other. Note to self: Don’t do this in the future, people tend to shoot the messenger!
In this case, though I think both appreciated this and actually welcomed my interjection. In the process, I learned something about both people’s reputations. More importantly, I learned how important reputation is, how fast rumors travel and how as you develop a history, you travel with that history wherever you go. Success in life is often about pleasing the herd. One mishap in your past can easily spook the herd and lead a stampede away from you.

Texture of the day

I recently had a nice conversation with Krishna, a fellow MD/MBA who had a wonderful saying which I thought worthy of writing down. He said that far more important than specific goals or accomplishments was the “texture of the day”. Similarly I have found the most fulfilling days have been ones where I have been able to learn something new, feel a part of building something exciting, feel helped or helpful to someone else, and most importantly feel connected with people and loved.

Wine!

Randall Grahm from Bonny Doon vineyards came to talk and taste today. Awesome! Will have to follow up on Edmund St John, Renaissance wineries.

Learned the following

– Terroir means from the place and minimalist wines that allow for nature to influence the wine rather than ‘effort based’ wine which winemaker controls everything

-I love Albarino wine, gotta get to Galicia some day

-invest in good glasses

Pay attention to what is right in front of you

I have ADHD, Attention Deficit Hyperactivity Disorder. I am certain of it. According to the DSMIV aka the bible of psychiatric diagnoses, I have 5 cardinal features of the inattentive type of adult ADHD and 5 features of the hyperactive type of adult ADHD. Although technically one needs to have at least 6 cardinal symptoms in each category type, I am pretty convinced that I am on the spectrum and pretty durn close to meeting the clinical criteria for a diagnosis.

Unfortunately, the choices for treatment leaves the subclinical ADHDer much to be desired. One the one hand there is pharmacologic treatment which consists of drugs like addicting amphetamines and atomoxetine which is a non amphetamine but have a few side effects of its own like suicidal ideation (whoo hoo). On the other hand there are behavioral changes such as getting more regular sleep and exercise which if I could change on my own, I probably wouldn’t be writing/complaining about having ADHD.

Finally there is an interesting treatment I came across called Neurofeedback which is a form of biofeedback where one looks at an EEG while doing a series of attention and hyperactivity tests to literally adjust one’s responses in real time. The literature on it at first rub also seems to be quite positive including several studies that look out 3-5-10 years at children treated for ADD who on follow up actually sustain the benefits of treatment. I wonder why the lack of adoption? The great ADHDer that I am though, I bet I will forget about it eventually and move onto the next thing like I always do :)

http://www.neurofeedback-scotland.com/support-files/efficacyneurofeedback-kaiser.pdf

Good Residency Interview Questions

I am going to start keeping a log of good interview questions I think of along the residency interview trail, feel free to post yours!

-To Chair: How does this program balance education, research and clinical care among its faculty? For example, how much non clinical time do the core faculty have?

– To Program Directors: Please explain why you received a ____ year instead of a five year ACGME accreditation and whether you had any citations

– Tell me about a time you mentored an resident and what lesson you taught them
– If you were me, what opportunities for would you take advantage of in your CA-3 year?
– To resident: On average, how many hours of sleep do you get per night, how many hours of reading per night? Off the top of your head, who do you dread being in a room with?

-To senior resident: What frequency % decisions do you get to make? Tell me about someone who has mentored you here. What was the last change they made in the program as a result of resident feedback? How politically involved, how much research, extramural activities do the residents get involved with?

What really matters? A spoonful of water in a hot bath

After staying with Ariel, Dan and Jenny and their kids for a couple of days in SF, I feel like I have a deeper appreciation for what really matters. Its not the glitz or dollars. What really matters at the end of the day is having a warm comfortable place to come home to. Put another way, its the family, stupid.

I watched Amber, Ariel’s daughter have a baby bath today with her mom and grandma taking turns pouring cupfuls of water on her as she squealed in delight. Now that’s happiness . . .

Someone remind me to install a jacuzzi in my mansion . . . make that two, one for the mansion and one for the stretch . . . :)