Leadership Lessons They Don't Teach in Medical School
Leadership Lessons They Don't Teach in Medical School
The New York Times obituary desk learned to write about suicide without hiding it or sensationalizing it. A leader I once worked for figured out the same thing years earlier. He built a culture around it. What leaders can learn from him about discussing hard things with their teams.
Most hospitals display their mission statement by the entrance, but it rarely comes up in leadership meetings. In this post, I explore why organizational purpose often remains just for show, how passion can sometimes lead to burnout, and Daniel Pink's idea that a clear purpose is only one of three things that make work meaningful.
Before I could explain it, a sickly childhood taught me this about good doctors: They make you feel better before you actually start getting better. Years later, Simon Sinek's "Start With Why" gave the lesson a name. This post walks through Simon Sinek's Golden Circle — Why, How, What — and pairs it with Daniel Pink's research on purpose, autonomy and mastery as drivers of motivation. It includes a short exercise to find your own Why, a candid admission that this blog’s Why only became clear to the author a year into writing it, and a bedside technique borrowed from addiction medicine: asking a patient why they want to change instead of telling them why they should.
As a debate rages over whether business schools should close, physicians already know where purpose comes from. Medicine instills the Why. What nobody teaches is how to say it. Through the story of a residency faculty member who pushed trainees to see patients faster with no reason beyond “that’s real life,” this post shows what fills that silence, and offers one fix: the “Because” Test.
A terminal cancer patient, offered a copay-free MRI, declines it. Instead, she chooses to keep her MRI at the hospital where all her doctors are. That decision anchors The Standardization Tax series' final argument: when a load-bearing wall comes down, someone pays for it. Physicians absorb unpaid time for conversations and documentation that the schedule doesn't allow. Patients absorb the cost of fragmented knowledge or flattened preferences. The post closes with practical advice on scope rather than sacrifice, and a direct, honest answer to the pre-med student who opened the series.
Post 2 in the series was about doubting your own judgment and attention enough to follow a checklist. This post is about doubting it enough to ask the patient what they want, and to trust knowledge you didn't personally build. It covers two kinds of load-bearing variation: the wall built by patient choice (Wennberg's preference-sensitive care and the shared decision-making it requires) and the wall built by a physician's earned knowledge of a patient over time, i.e., continuity of care. Standardizing either wall away doesn't reduce waste. It reduces choice or erases knowledge whose value nobody understood until it was gone.