Chapter 14: Leadership Principles and Values
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Description
NOTE: This Chapter includes three Clips.
Dr. Sawaya begins this Chapter with a statement about how it is key to recognize the individual when implementing complex plans, such as those he undertook to develop the Brain Tumor Institute. He explains how individual recognition a motivator is and how a leader must balance recognition of individual efforts with a larger vision. He states that the Brain Tumor Institute has reached a point of “maturity” that must now be maintained. He then acknowledges that the Brain Tumor Program trains high-level leaders and that some senior faculty are leaving to lead other departments and programs. He also notes, however, that individuals often see so many advantages at MD Anderson, that they do not feel the need.
Dr. Sawaya next explains that he always had an “inner drive” to be a leader. He explains that he saw the difficulties arising from a lack of good leadership while he was at the University of Cincinnati. He notes that integrity is essential in leadership. He tells a story about attending a leadership course at Rice University.
Dr. Sawaya summarizes his philosophy of integrity and honesty. He tells a story about a senior leader at MD Anderson who made a promise to Dr. Sawaya, then did not stick by his word during a public meeting. Dr. Sawaya specifies that this was not an instance of someone changing his mind and failing to communicate. Next he talks about his experiences in the Faculty Leadership Academy (2005) and in the leadership course offered at Baylor (2008-2009), a course he helped plan and then attended. He then explains that an institution must provide leadership training because physicians and researchers do not cultivate those skills during their professional training curricula, and they inevitably find themselves in situations where they must pay attention to systems and direct complex activities. He notes that his faculty have ambitions to chair departments, but lack skill. He then tells a story about a woman in one of his leadership classes who was not suited to administration.
Dr. Sawaya then talks about the composition and function of the Executive Management Committee, which he serves on from 2005 – 2007). The committee included executive vice presidents and three other individuals “from the trenches” to ensure that the vice presidents were not too separated from the working reality of MD Anderson. Dr. Sawaya explains that the Committee gave him an inside look at the working of the institution at a very high level and changed his perspective on top leaders.
Identifier
SawayaR_03_20130625_C14
Publication Date
7-16-2013
City
Houston, Texas
Interview Session
Topics Covered
The Interview Subject's Story - The AdministratorLeadership; On Leadership; Character, Values, Beliefs, Talents; Professional Values, Ethics, Purpose; MD Anderson Culture; The Administrator; Professional Practice; The Professional at Work; Ethics; Leadership; Character, Values, Beliefs, Talents; Professional Values, Ethics, Purpose, Commitment to Work; MD Anderson Culture; The Administrator
Transcript
Tacey Ann Rosolowski, PhD:
It’s also different getting kind of an insider’s view on how people work together to plan and strategize. And I wanted to ask you a little bit about that process. I mean, you’re working with a lot of very high-intensity people, probably very independent. And yet, they’re all working together. What’s the philosophy of the group? How do these meetings run? What kinds of questions do you look at?
Raymond Sawaya, MD:
It’s a very, very good question. And obviously, anything complex like this doesn’t have one answer. Clearly, from a philosophical standpoint, you must recognize the individual. Whenever you’re dealing with a group of people, you can’t lump them all together as one person. So recognizing each person’s strength and role and programmatic areas—so each person brings their own strengths. And that’s why they are a part of the group. So we can never lose sight of that. You recognize them and reward them for their strength and their excellence. Once that’s done, then they feel secure. They feel they are accepted, their role is there to be valued. Then the challenge is, how do you reward collaboration, because scientists sometimes tend to want to be in their own corner and doing their own thing. That’s where the carrots are used—is the funding. And it says if you as a group come together to accomplish this combined effort, we’re going to help you fund it. So that’s a major incentive for people to work together. Now some see the need for their own program to reach out to one particular lab, because they have something to offer and they can collaborate in that way. We don’t discourage that—on the contrary. And what also helps that is this plan of putting everybody on the same floor. So now they bump into each other. Now they see—they know what each program is doing. And so that also is another way of encouraging this collaboration. But ultimately, to have the vision that we have this bigger plan than just this individual effort. But, again, I go back to my first point, because I think it’s critical. You let each person know that they are valued, that what they are bringing to the table is of great interest and great importance. We do not want to interfere with their individual plans. On the contrary, we want to support those. When it comes to all of us being together to create a bigger structure, then their participation is essential. So you have to balance the two. And so this has happened over a long period of time, and I think we have reached a point of tremendous maturity when it comes to that. And now the challenge is to maintain that strength—is to maintain this level of high performance, getting major grants, getting people to talk to each other. And in fact, we are expanding on that. We have some faculty who are now looking at creating their own PO1 program project grants in addition to the SPORE that we have. I mean, we are large enough that we could easily have more than one major grant of that magnitude. And so that’s part of the goal.
Tacey Ann Rosolowski, PhD:
Just seeing what you’ve put together—is a really interesting and productive training ground for people to perform at these very high levels.
Raymond Sawaya, MD:
Yes. In fact, several of our faculty who have become senior are moving on to leading other programs. We just lost one of them, Dr. [Vinay K.] Puduvalli, to go to Ohio State where he was given the directorship of their brain tumor program there. That’s a major role of leadership and recognition of his effort. He was a key member of our group here. I have some faculty in my department, neurosurgeons, who have been considered for chairmanship of Neurosurgery in other places. Fortunately, so far they have elected to stay here. I think part of that is exactly what I said earlier. That is they are being recognized for their own strength. They are not being stifled. They are not being kept down from growing and reaching high levels of leadership. Now, there can only be one chairman of Neurosurgery in this institution obviously. Sometimes a person is itching so much to become their own chair that—you know—if that position is not available at MD Anderson, then yeah, they might leave and go somewhere else. But I think there is so much—they see so many benefits of being a member of this place, this institution, this program—the patients that come to them and the recognition that they receive through that makes it that it’s so rewarding that they don’t feel the need to go somewhere else. So that’s an overview of the development of our brain tumor program that has taken twenty-five-plus years in the making. And that has really reached a level of recognition that I think is very, very valuable and very valid.
Tacey Ann Rosolowski, PhD:
Well, we certainly raised the issue of leadership a number of times over that discussion. And it was an area that I wanted to ask you more about. As I mentioned before we turned on the recorder that you had said last time quoting an article that had been written about you that you think big. And that is often a characteristic of leaders. But thinking big doesn’t necessarily mean you have the skill to lead. So I wanted to ask you how you developed your own leadership skills.
Raymond Sawaya, MD:
It’s hard to know. But in my own personal situation, I think there is a desire to do so. It’s not like somebody forced me to do it. It’s not like, “Well, I happened to have gone to this school.” No, the drive is an inner drive. When I was a junior faculty, before I joined MD Anderson, I had a chairman who did not necessarily have all the positive qualities. In fact, he had several negative qualities. And as a result of my being there next to that person, I could see where there were lacks, where there were deficits, where perhaps I needed to step up to the plate, if you will, to provide what is lacking. And so—
Tacey Ann Rosolowski, PhD:
What were some of the lessons you learned from that? What were those lacks?
Raymond Sawaya, MD:
He did not seem to value the individual—that’s a major, major deficit—
Tacey Ann Rosolowski, PhD:
So you saw the results of that.
Raymond Sawaya, MD:
I saw that. He was too egocentric. So he wanted to control everything. And guess what? This drives people way. And that’s actually tied to what I said a few minutes ago, where if I want to lead a group of people, if I don’t make them feel valued in a sincere way—that what you’re doing is important, and I want to help you with that, I want to support you, I don’t want to block you—I have experienced the opposite. And this is why I left that place. Because I had my ideas, I had my vision, and I was just not being—in many ways—allowed to do it. For me to be able to go past these barriers, I used so much energy that it was counterproductive. So a number of factors like this. But I was eight years in that role in Cincinnati—eight years. So those eight years were like a laboratory of seeing, understanding problems—how they occur—and getting experienced in managing situations that help me deal with problems around me. Because he was very hands off. But that gave me an opportunity to be hands on. So again, if I didn’t have the interest and the inner drive, I probably would have shied away from it and just stayed in my corner. But I did have this interest. And once you get things done at that level where you get positive feedback that your influence, your effect on your environment, is positive and is appreciated—it only gets amplified with time. The more opportunities you have, the more you learn to do that and develop your skills even further. So I never built a program or a department before, and I was given that opportunity here and I saw the potential. Fortunately, I was able to do so. And the feedback that I’ve been given along the way was precisely that—that I care about people, that I care about supporting my team. And so trust is developed. Now whenever you talk about leadership, you have to talk about integrity. Because if there is no integrity, there is no trust. And so, it obviously is tied in together. Those are things I have learned through my life experiences. I did attend the Rice course for MD Anderson that involved some of the top leaders of MD Anderson.
Tacey Ann Rosolowski, PhD:
This is the Executive Development Program in 1991?
Raymond Sawaya, MD:
Exactly. And what’s incredible is that I had just arrived here. I came in September of ’90, and this course was like just a few months later, less than six months later. And I was sitting with several vice presidents and senior leaders of MD Anderson in that course. So I was hearing all these historic tidbits about—you know—“We did this. Dr. Clark did that.” So it was a crash course into the history of MD Anderson, which can only galvanize your efforts to do more, because of the wonderful success of this place. CLIP C: Leadership D: On Leadership A: Character, Values, Beliefs, Talents A: Professional Values, Ethics, Purpose, Commitment to Work B: MD Anderson Culture A: The Administrator Integrity: A Basic Leadership Quality
Tacey Ann Rosolowski, PhD:
Let me ask you—because you mentioned—(Dr. Sawaya sneezes) Bless you. You mentioned the word integrity, and I wanted to ask you more about how you understand that word.
Raymond Sawaya, MD:
For me, it has only one meaning. Be honest. When you say you are going to do something, you do something. When you say something, it is truthful. So with that comes commitment. You keep your word. There is a senior leader in this institution—I should say, there was—with whom I interacted around this time of 2000, 2001, that I had personal meetings with to address the issues I was facing and to get commitments from him so that I could move forward. That person indicated to me that he was going to support what we discussed. And then we go to a meeting with him and some other leaders, and he did the opposite of what he told me he was going to do. Needless to say, this leader is no longer at MD Anderson. But it was a very telling example to me of what poor leadership this behavior represented.
Tacey Ann Rosolowski, PhD:
What does that do to an institution when you have a leader who behaves in that way?
Raymond Sawaya, MD:
Either you lose people or you lose your reputation, or what’s more likely to happen—because these institutions are bigger than any person—they don’t last. Sooner or later they will be—what I would say—discovered. And this person was on the up and up and rising and so on, but I knew from that day on not to trust that person, and I haven’t ever since. So anyhow—that’s a real story that happened right here at MD Anderson showing me how not to behave. It does go back to the issue of integrity. My concern with that person wasn’t that he changed his mind. This is obviously—it would be his prerogative. But not to communicate—okay—that’s dishonest. To surprise me at that meeting by acting in a contrary way from what he indicated to me he was going to do. That clearly is wrong. And that’s lack of integrity as far as I’m concerned, and therefore, lack of leadership. Anyhow—
Tacey Ann Rosolowski, PhD:
Now you also participated in the Faculty Leadership Academy and also a leadership development course at Baylor. Tell me about those experiences and what you got from them.
Raymond Sawaya, MD:
The FLA, the Faculty Leadership Academy, this was put on at MD Anderson much more recently over the last seven or eight years. And it went on over several months. What’s good about it is that it was really, truly specific to MD Anderson. It took place at MD Anderson using real examples, because we had to bring with us examples of events and situations. It also got us mixed with many other areas of MD Anderson that we may not interact with. So it’s not like only people that we know. It was—and we have grown so much bigger also in the 2000s and in the ‘90s that a lot of faculty here and administrators we probably don’t know—maybe have never met. In fact, this did happen, so all these leadership courses create camaraderie and exchanges and so on. The Baylor course is more interesting in the sense that I was involved in the development of that course. So we had weeks and weeks of meetings with a small group led by the director of the Human Resource Department there. She is retired since—a wonderful lady who wanted to put on a leadership course for Baylor College of Medicine. And having gone through my own experiences, I have learned things of what’s important and so on. So I was able to participate in the planning of that course for the whole year. Then as an organizer of that course, I was invited to attend the course, which took a whole year. And so it was good to see all these principles being revisited, the discussions—it’s always a work in progress. You may be a leader, you may have leadership qualities, but you’re a human being. You evolve. You continuously learn from your experiences and build on that. So it’s a living organism. CLIP C: Leadership D: On Leadership A: Character, Values, Beliefs, Talents A: Professional Values, Ethics, Purpose, Commitment to Work B: MD Anderson Culture A: The Administrator Physicians and Researchers Need Leadership Training
Tacey Ann Rosolowski, PhD:
Why is it so important that an institution like Baylor or like MD Anderson foster these kinds of leadership programs?
Raymond Sawaya, MD:
Because the stronger your people are, the stronger the institution is. If people in leadership positions don’t have leadership qualities, that’s a major, major pitfall. That’s a major weakness that the institution is facing. And one of the reasons it’s so important to focus on leadership qualities, is—especially we’re talking about physicians and academics. I’m not talking about MBA-type people—is nowhere in your curriculum do you have that. Certainly not in college, certainly not in medical school, and in residency you’re beaten so badly to take care of your patient that where’s room to focus on what leadership is? What administrative strengths does one bring to the table? It’s not—it’s not part of what we’re being taught. And yet, somewhere in us—as in my own experiences, having taken my first faculty position in Cincinnati—I found myself surrounded by vacuum, surrounded with areas where there is tremendous need for paying attention to systems, paying attention to mechanisms of behavior and directing complex activities. Not only taking good care of patients and doing good surgeries—although that’s obviously the essentials. So you don’t get that training unless you’re really, really, really interested in that. And yet, so many faculty are eager to become chairs, because there is a stigma attached to that—a positive stigma in terms of, “Wow, I’m the chairman of so-and-so.” So there is this drive, which may be status related, but there isn’t the skill that matches it. And that’s the disconnect. So these courses, if they are well done and if they are specific enough and individualized enough, then they can strengthen individuals. It’s not for everybody. Although a lot of people go through these courses. In the FLA was a person that I happened to know. And the first retreat we had—because it’s a weekend retreat to kick off the year. We do it up in The Woodlands, away from home, away from distractions. The first big meeting where we had all the members—we were like thirty of us with the instructors—that person said, “Oh, you cannot teach leadership.” It’s almost like she was saying that it’s a waste of time. Well, it happens that person was the director of a section where she works, and needless to say, she is no longer the director. So clearly she lacked the skills. And she lacked the ability to discern. What I’m saying is that although you can learn a lot from these courses, there are some people who are beyond repair.
Tacey Ann Rosolowski, PhD:
They’re just not built for it.
Raymond Sawaya, MD:
They’re not built for it. You have to see. You have to be willing to change. That’s the other thing, because none of us are perfect. It’s obvious.
Tacey Ann Rosolowski, PhD:
I think with any complex skill like that, sometimes you just have to take a hard look at yourself and think, “Wow, I’ve been doing this, and it’s really counterproductive.”
Raymond Sawaya, MD:
Yeah, but it takes tremendous self critique or the ability to self critique yourself.
Tacey Ann Rosolowski, PhD:
And to listen to other people if they’re going to offer you critical evaluations.
Raymond Sawaya, MD:
Correct.
Tacey Ann Rosolowski, PhD:
And you have to be willing to have a tough skin and take that.
Raymond Sawaya, MD:
That’s not easy, especially if you want to be kind and you want to be nice and whatever. But you have to make the tough decision.
Tacey Ann Rosolowski, PhD:
I think also for very high-performance people who are used to being the best at what they do, to sort of admit, “Hey, maybe I’m not the top of every league.” You know?
Raymond Sawaya, MD:
She’s very talented in her field, but not in administration, not at all. So it was so obvious to see that.
Tacey Ann Rosolowski, PhD:
Another kind of leadership role that you were involved in was the MD Anderson Management Committee. I wondered if you would talk a bit about that.
Raymond Sawaya, MD:
This was a tremendous experience for me. Dr. Mendelsohn created this management committee, which includes obviously the senior leadership—these are all the executive vice presidents. That was the main composition. But he felt that he should include three additional individuals—one as a chair of a clinical department, one as a chair of a basic science department, and one as a division head. Because they represent pretty much the trenches, what goes on in the institution that is not purely administrative. And I was fortunate to have been selected. This was in ’05. It’s a two-year term and then you rotate off, and then another chair is selected in your place. So why was that important? It really gave me a very good understanding of the inside workings of the institution at the highest level—how decisions are being made, how decisions are being vetted, who is making decisions. How can you modify decisions to meet the reality of the place? Because sometimes as a president or as an executive vice president, you have your own ideas. And you say—I need to find you a good example. The point is, “Well, we are going to eliminate this kind of incentive.” I’ll come up with a better example. So—well—I mean, maybe viewed at their level, that makes sense. But understanding the true impact of a decision like this on the rest of the institution, they may not have that perspective. We are much closer to the faculty. We are much closer to the classified employees of the institution. And we can assess the impact of a major decision like this better than necessarily the VP’s can. And so that’s a tremendous feedback that is given on the spot. Because we are sitting at the table when this thing is being brought up. And we could say, “Yeah, but in our assessment—in my assessment—such a decision will be very negatively taken by the troops.” And you really have to—now they may still decide to do it, because there are other overarching factors that I may not see, as well. But not giving them that feedback— Another example that comes to mind is you would have the HR director come and give a presentation. Because every two weeks was the meeting—the executive meeting. They would invite different areas of the institution to present and kind of bring them up to speed on whatever. HR— (End of Audio 1 Session 3)
Raymond Sawaya, MD:
—would come and would give a glowing presentation of all the great work they’re doing. But we know, working here, that we can’t get anything done through HR. They may be better today. But I assure you, they have been through a lot of troubled times. And for the VP’s and the president to hear such a glowing presentation when in fact the reality is far from being that rosy—they need to hear that. They need to hear that, because they have to be careful of how they assess the strength and the weaknesses of this institution. So those are examples, but I think having people that are not so insulated at the high level is important. To me, it was an eye-opener.
Tacey Ann Rosolowski, PhD:
And was it a genuine effort? You felt you had a true impact?
Raymond Sawaya, MD:
Yes. And I felt appreciated. I felt that I really—that my contributions were very well received. And it gave me—actually, those of us in the trenches tend to view the top leaders with a lot of skepticism. They are clueless. They really don’t know what’s going on and this and that. But when you see the institution leader really caring about receiving positive feedback—maybe it was a period of time when our leaders were this way. I don’t’ know. It’s not always necessarily that way. To me, that experience was a very positive one.
Tacey Ann Rosolowski, PhD:
And did you stay one term?
Raymond Sawaya, MD:
I stayed two years. You do not get the choice of staying. But the other reason why it was good for me to rotate off is that I had taken on the Baylor role. Despite my role at Baylor, which was busy, I still made time to attend every one of these meetings. It was a busy period.
Recommended Citation
Sawaya, Raymond MD and Rosolowski, Tacey A. PhD, "Chapter 14: Leadership Principles and Values" (2013). Interview Chapters. 1550.
https://openworks.mdanderson.org/mchv_interviewchapters/1550
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