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Ten Tips for Medical Leaders – David Haslam

Ten Tips for Medical Leaders Professor David Haslam


Being a medic is enough of a challenge in itself, and with the inevitable and never-ending onrush of change, increasing numbers of doctors will inevitably find themselves in unexpected leadership positions. Over and over again you will find yourself wondering, “How on earth did I end up doing this?” – a sentiment that I ponder almost daily. You can feel threatened, or you can feel stimulated and challenged. But you probably have more skills than you ever realised. Over the past few years I have found myself chairing or leading more organisations than I would have ever imagined, and I’ve made plenty of mistakes along the way.

So, if it really is possible to learn from someone else’s mistakes, can I share my experience with you? Here are ten simple tips:

1. Remember what fantastic skill you already have

Every day, in every clinic or surgery that you do, you are expected to be able to respond to anything and everything that comes through your consulting room door. You have no briefing papers, no script. You have an audience who – most of the time at least – are attentive and interested. What greater skill could you need for any form of public life? Even if you end up facing huge audiences, or talking on the media, just remember – everyone listening to you is an individual, and you spend every working day talking unscripted to individuals. It really should be no big deal for a doctor.

2. Turn accidents into opportunities

The ability to turn accidents into opportunities is probably the secret to a fascinating career. If an opportunity comes your way and it is of the tiniest interest to you, grab it. If I’m ever asked to consider applying for a role, the test I always apply is my “death bed test”. Imagine yourself looking back on your life. If a career opportunity comes your way, and you are wondering whether to apply, then ask yourself if you would rather have tried, and not been a successful applicant, or spend the rest of your life regretting not trying. “If only…” are two of the saddest words in the English language. And if you’re not interested, don’t apply. You won’t regret that either.

3. Be organised

When it comes to meetings, there are three simple rules. Start on time. Finish on time. Ensure that everyone has the right papers. These things matter, not just because they promote efficiency, but because your committee or board members will feel that they are in safe hands, and that you are in control. And that matters too. In addition, if you are chairing a discussion – be absolutely clear what decision needs to be made. If you don’t make this clear, then discussion will drift and waffle will beget waffle.

4. Be realistic

Don’t waste your time, or your energy, trying to change things over which you have no control. Focus on what you – you – can achieve. And when tasks look impossible, work out how to break them down into bite-size chunks.

5. Keep your sense of humour

I’ve always believed that a key rule of life is that “you don’t have to be solemn to be serious.” Not taking yourself too seriously doesn’t mean that what you do doesn’t matter. It means that you’ve got your priorities sorted out.

6. Surround yourself with good people

And let them get on with it. Constantly interfering and micro-managing will irritate and disempower your team. Your job is to set the direction, not direct the delivery. Supporting your team is absolutely vital – and never underestimate the importance of real team building (and that doesn’t mean paintballing on a dreary industrial estate on a Thursday afternoon)

7. Consulting skills work outside the consulting room

Some years ago, when I first started dealing with politicians, I realised that the key to a successful meeting was the same as the key to a successful consultation. If you don’t understand the ideas, concerns, and expectations of the person you are meeting with, then the meeting will end unsuccessfully. Just as it will in the consulting room.

8. Keep disagreements in perspective

Disagreement is probably inevitable. After all, if everyone agreed on everything, we would have worked out long ago how to run the NHS, or indeed the world. We didn’t. We haven’t. And when people argue vociferously against you, listen – but don’t take it personally.

9. Agree the values of your organisation, and stick to them

After the MTAS crisis some years ago that impacted on the lives of countless junior doctors, I was asked to co-chair the MMC Programme Board to help resolve the problem. The Board consisted on representatives of the Academy of Medical Royal Colleges, the Department of Health, the CMO, Junior Doctors, NHS Employers, the BMA, and so on. I was so far out of my comfort zone I might as well have been at the dentist. But on day one, I asked if everyone agreed with the core values of patient safety, flexibility, and caring for the junior doctors in the system. They did. This may sound cheesy, but it was critical. Every time we seemed to be getting stuck, I took us back to these core values. Almost always, the answer to a dilemma would become clear – and tribal attitudes would dissipate. I’ve used this technique with many boards and committees – it almost always works.

10. It can be lonely

Have someone that you can share your problems with. If necessary contact someone in a similar role elsewhere and meet occasionally. You are both probably struggling with the same problems, and knowing that you are not alone is the reason that self-help groups are so often successful. Pretending that what you are doing isn’t stressful is a recipe for it becoming exceedingly stressful. Just be honest.

And if I was going to have an eleventh rule, it would be simple. Have fun.

*** Professor David Haslam is Chair of NICE, Past President and Past Chairman of the RCGP, and Past President of the BMA.

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