S5 Ep19: Limitless Leaders Edition | Leading Teams, Big & Small

S5 Ep19: Limitless Leaders Edition | Leading Teams, Big & Small

Hosted by: Donna Tepper, MD

Guest Speakers: Amy Moore, MD (OSU); Andrea Pusic, MD; Vedra Augenstein, MD 

About Enhance Your Practice

Enhance Your Practice is the official practice management podcast from the American Society of Plastic Surgeons (ASPS), featuring conversations with leaders in plastic surgery on practice management, leadership, innovation, and professional development. Each episode delivers practical insights to help plastic surgeons build successful practices and thrive throughout their careers.

Explore more educational resources from ASPS at plasticsurgery.org.

Transcript

SPEAKER_03 0:03

Hello and welcome to the Limitless Leaders Podcast Series, brought to you by Allo Gamesthetics, a proud partner of the American Society of Plastic Surgeons. I am Nicole Moad Nassar, Senior Vice President of ABV and president of Global Allergan Aesthetics. Limitless was developed to highlight the achievements of women plastic surgeons while also providing education, mentorship, and empowerment. The Limitless Initiative has evolved into a platform for storytelling and idea sharing, where accomplished women plastic surgeons offer insight and encouragement to future and existing women plastic surgeons. This season, this series will explore topics such as building resilience through life challenges, exploring non-traditional leadership opportunities, navigating conflict resolutions, and more themes specific to women's classic surgeons. Please enjoy this podcast episode and the entire Limitless YouTube channel for more content that explores what it means to be limitless and how allergy and aesthetics supports women's classic surgeons.

SPEAKER_00 1:15

Welcome to the Limitless Leaders Podcast Series, brought to you by ASPS, the Aesthetic Society, and the American Hernia Society, with the generous support of Allergan Aesthetics. I'm Napor Gangai, a pediatric plastic surgeon and craniofacial surgeon in Chicago, and the Limitless Leaders Chair. Join us for the Limitless Leaders Podcast, where we dive into the stories of extraordinary women making a significant impact in our field, breaking gender barriers, and inspiring the next generation of leaders.

SPEAKER_05 1:44

You are listening to the Limitless Leaders Podcast series brought to you by the American Society for Plastic Surgery with the generous support of Allergan Aesthetics. I'm Donna Tepper, your host for today's episode. Today I am joined by a celebrity of guests who are premier leaders in their field to discuss leading teams, big and small, the nuts and bolts of effective leadership. And it is my pleasure to welcome three very distinguished leaders, beginning with uh Dr. Andrea Pusick. Uh we have Dr. Amy Moore and Dr. Bedra Ogenstein. Um to welcome women. I appreciate you being here tonight. Uh I'd just like to spend a minute to introduce you uh to our audience. Uh we have Dr. Andrea Pusick. She is the chief of the Division of Plastic and Reconstructive Surgery at Bringham Women's Hospital. She is a professor of surgery at Harvard Medical Center, the director of Patient Reported Outcomes, Value and Experience Center. She has a clinical focus in breast reconstruction, including deep flaps, immediate breast reconstruction, and aesthetic surgery. She is well published with over 200 publications on a variety of uh breast topics. And she is developed the breast cue, uh, which people around the world use to uh analyze and measure how women feel about the results of their plastic surgery. Her training, uh, she completed her medical school training at the University of Calgary, general surgery at Dalhousie University, uh, McGill University for plastic surgery, birth certified in plastic surgery, and has fellowships from the Memorial Saloon Kettering as well as uh secondary fellowship at Memorial Saloon Kettering in microsurgery and oncologic uh reconstruction. So, Dr. Pusick, it is a pleasure. Um, we have Dr. Amy Moore. She is a professor in plastic surgery and the chair of the Department of Plastic and Reconstructive Surgery at the Ohio State University School of Medicine. She served on the advisory uh board for the International Society uh Symposium of Neural Regeneration and the Board of Plastic Surgery Research Council and the American Society for Peripheral Nerve. She does well over 100 journal articles and has uh led a federally funded translational scientific research investigation of advanced limb reconstruction. She completed her medical training at Virginia Commonwealth, followed by general surgery at Washington University in St. Louis, and advanced fellowship training in microsurgery, peripheral nerve, as well as orthopedic surgery. Um, and she is a nationally recognized leader in reconstructive surgery with a focus in complex nerve and upper extremity, not to be outdone by Dr. Edra Ogenstein, who is a board-certified general surgeon who specializes in hernia and esophageal surgery, abdominal wall reconstruction, or robotic surgery. She serves as the associate professor of surgery at Atrium Health, General and Complex Ebowel Surgery, a facility of the Carolinas Medical Center, which is an academic medical center and teaching hospital affiliated with Wake Fork School of Medicine. She is a committee leader for the American Hernia Society and the Society of American GI and Endoscopic Surgery. She has extensive research, lectures nationally and internationally. She received her medical training and uh completed her general surgery residency at the University of Louisville and then completed fellowship at Atrium Health Carolina's Medical Center in minimally evasive surgery. Wow, you guys are amazing. It's uh incredible to spend the next hour with you all. So thank you. Thanks. Um so I just uh thought we would start uh from the beginning. Um, Dr. Dr. Moore uh from Ohio State, um, where did you where did you get your leadership training? Um or how did you first see yourself as a leader?

SPEAKER_04 5:36

Yeah, thank you, and thanks for the introduction. Um I I think, you know, when I never aspired to be a leader, you know, when I started early in my plastic surgery career, it was more that I was eager to be involved. And so I got on committees. And what I do know is that maybe it's how I grew up, or you know, being the only uh girl on a on a men's soccer team. Um, I just thought that I had a voice, and so I would speak up and then eventually be like, well, why don't you chair this committee? Um, and so that gave me a platform to really uh get exposed to other leaders and opportunities to to witness those in leadership. And uh I felt that it was about um people. And honestly, when the opportunity to become my section chief at Washington University, it was more because there was a need and not so calculated that this was um what I had to do. And um, once I got a leadership position, I then did the background of like, hey, can I go and can you sponsor me to do a leadership training? And um it was fortunate to to do some of that within Washington University, um, which then in year eight of my practice was uh when I was getting recruited then to become chair of the Department of Plastic and Reconstructive Surgery at Ohio State. Again, not something I was looking for. Uh it was more that um, okay, let me put the work in. And then realizing when I'm in the interview, wow, I have the answers that they're looking for. Whoa, I can see their vision of where they want to take this. Oh, I too have this experience that I can see, you know, where we can go. And um, and so I hate to say that it wasn't calculated. It absolutely wasn't calculated, but uh I will be honest, being chair of my department's been the best job um I think that I could ever have, despite being a busy clinician loving patient care. I think my opportunity to help others achieve their career goals has been truly fulfilling. And and now as chair, I was chair for seven years, and I'm serving as the interim dean of the College of Medicine at Ohio State. And this new role of about 10 weeks has been even more eye-opening seeing it at such a high level of an institution. Congratulations.

SPEAKER_05 8:14

Congratulations on the interim dean. That's a that's a huge feat. I mean, it starts with speaking up, right? And having that courage inside to say, you know, to use your voice, right?

SPEAKER_04 8:27

Using your voice. And and I learned that. I learned with my mentors, and so um yeah, grateful for this opportunity to hopefully have a bigger impact, right?

SPEAKER_05 8:36

Yeah.

unknown 8:37

Dr.

SPEAKER_05 8:37

Vedra Augustine from Carolina Medical Center, what would you say would be one of your early leadership challenges? I mean, you have colleagues, you have residents, you have fellows, administrators. Um, what was one of those things that you can remember?

SPEAKER_01 8:54

Yeah, I mean, thank you so much, first of all, for being invited uh to this wonderful panel. Um, I I think uh this is a great opportunity to get together and brainstorm about a lot of these things. And I completely agree with Dr. Moore. A lot of these things just happen by kind of by accident. Uh challenges, I think, off course, uh, it's always uh been, you know, women in leadership. I think uh I was the only female resident in my surgery residency class. Uh I've been taking call with 11 men, and you know, I'm the only uh partner that's actually been a female. So it's always been a little bit challenging from that perspective. I'm currently the president of the American Hernia Society and only the second female president that has done that. So it's I feel like that has always been a little bit of a challenge, but I think that things are certainly changing. I remember being at meetings and it was just basically men, and then maybe just some of the reps would be the females there. Uh so I I felt, you know, it wasn't a super comfortable feeling, uh, but things are are are changing. I look around rooms now at any of our national meetings, and you have a good percentage, sometimes even it's 50% uh women in the audience. Uh so I would say that that probably uh was kind of the hardest thing to overcome because I'm not the most uh, I don't know, I don't want to say most social person, but uh it th those were challenges. Just thinking, you know, do I really belong here? You know, should I be at this meeting? Uh and I know knowledge-wise and skills-wise that you should, but then sometimes you feel maybe you're not comfortable to go where everybody else is hanging out and having a drink at the bar, and you know, and it's all men, and you just it feels kind of a little bit awkward, at least it did it, you know, many years ago. Now that I'm much older, those things don't feel as weird. And and certainly having a lot of uh women around uh is very, very helpful. I like it.

SPEAKER_05 10:47

Dr. Pisic, um, as chief of the division of plastic and reconstructive surgery and professor of surgery at Harvard Medical School, what do you feel like shaped your leadership style? I mean, I guess first, what do you think? What would you how would you describe your style and and what do you think shaped it?

SPEAKER_02 11:03

Yeah, thank you. And again, I'll echo what the others have said is just in terms of like thanks for organizing this. It's a pleasure to be to be part of this conversation. Um, I'll I'll speak to sort of leadership style, but I also just want to say, Amy, what you just said in terms of how you found yourself in leadership just so resonated with me because similarly, I just never sought leadership per se. Um, and I actually, when you were speaking, I was remembering when the Canadian Plastic Surgery Society nominated me to do leadership training with the in the through the American Society. I thought, really? Me? Like why? And and yet it's so, and that that feeling of just being motivated to want to be to contribute, to engage with something kind of bigger than myself and I'm and and help the the greater, you know, the the to be part of something really um resonated. So and I also I just have to say also to Dr. RSD, the the idea of so I'm a little bit of a quiet person, I'm a little more introvert, and so to try and be out there kind of um being there to sort of like the to shake the hands and do the his never it's always been a bit of a challenge too. So I just it's marvelous to be part of this conversation with these two incredible women. Um I will say in terms of my leadership style and how it's changed over time to answer the question, the um I think it it has evolved, um, partly as I'm learning and partly as it's as it's needed to evolve in terms of what the um the situation requires. I think um my leadership initially was was large. There's two things, I guess. There's my leadership in terms of my research leadership. And there I was just, I think both my leadership style I would say was collaborative, and also thinking about sort of, I've been really, I get I get excited about transformational ideas, about things that will actually change things in a bigger way, even if it's just a small idea, but I have a hunch that it might be a bigger idea that could actually make a big difference. And so that's my my work in patient report outcomes. That was where that all came from, um, was thinking about what it would be like if we really understood how patients think about things. And and um to echo some of the comments about women in the world, I think where it came from was a perspective of a lot of the procedures that we perform, say in breast reconstruction or aesthetic surgery, our patients are are are often predominantly women, and and yet we don't necessarily ask them what they think in terms we had not previously asked them um in any rigorous way about what they felt about the uh the um the effectiveness of our our of our interventions and what they thought really had the biggest impact. So that was so I would say that piece of it in terms of a transformational leadership style, in terms of I say it with humility, though I don't think it's a big word transformational, but but I love the idea of innovative ideas that might um change. But I would say then from a what I learned, which I've always intuitively felt, is that collaboration is the big effect, like that's the big effect multiplier. And so I'm I think I'm I'm a compulsive collaborator, and uh that's only become stronger over time. And I've I would say now in my my role in Boston, but I've I really love a leadership team uh because I feel that we um I get great ideas from other people, I get great insights from others, and we're also just much more effective.

SPEAKER_05 14:15

I like uh Dr. Busick how you mentioned that you have different styles depending, and it flexes based on the groups that you're work with, whether a research group or a patient situation, um, and probably in your department meetings um it flexes with that as well. Um, Dr. Vedra Augustine, president of the American Hernia Society, you had mentioned you have uh as well kind of a similar introverted um personality. And when we talk about leadership styles, we kind of describe them based on our or anchored to our behavioral uh patterns. What would you say your standard style is with uh maybe your colleagues? Is it more commanding control or is it situational changes or servant leadership? What would you say um your style is that maybe you gravitate toward, um, but you might have a backup in other situations?

SPEAKER_01 15:13

Yeah, I think uh I am a very non-confrontational person. That's not ever uh been something uh, you know, even in relationships, friendships, whatever it is, uh I don't like to be confrontational. And as you mature and you're leading a fellowship and leading residents and things like that, sometimes you do have to confront people about um how to make them better. And that's something that I've definitely have to learn uh with time. Um, so I think I've uh now as I'm getting older, it's becoming a lot easier to do that because uh you can kind of and I and I learn uh to tell people by example. Like for example, I used to do something like this, and I've noticed that you are doing something similar to that. Let's talk about it. So I try to kind of come from like a common ground versus uh just you know becoming um very confrontational. Um, I think that at least for me it helps. Uh, but I think there's definitely different ways to lead. I know that there are a lot of very successful people who are extremely very forward. Uh, it's just personally never been um, you know, my style.

SPEAKER_05 16:21

Yeah.

unknown 16:22

Dr.

SPEAKER_05 16:22

Amy Moore, uh chair of the Department of Plastic Surgery at Ohio State. You know, listening to these different styles, um, sometimes more of an inspirational, more sometimes democratic, sometimes more um with you know, more in the backseat. Um, what do you say would be your style now? And what would you would you would you want it to be something different in the future? Do you aspire to have something different?

SPEAKER_04 16:48

I think where I've had success is adapting to the situations that are in front of you. Like I would never consider myself confrontational, but I have learned by necessity to lean in and have the hard conversations. And I worked with uh, you know, an executive coach early on about the the, you know, how do I frame the conversation and and trying to keep the conversation from being confrontational at all. You know, I start my hard conversations with, you know, statements such as, this is going to be a hard conversation and neither of us are going to feel good about it, but we have to have it to move forward and and sort of setting things up in that type of way. Um, I learn leadership styles, you know, in the room. I learn it from the people who, you know, I work with, my peers, but also those who, you know, I, you know, I'm able to sit at the table with. And so I hope that I'm not such a defined one way as a leader. Um, I hope to continue to grow and be able to anticipate the needs of others. It's um really one of these aspects of, you know, I think I'm a pretty good surgeon. I think I'm actually a really good scientist. And leadership, I think I can tell it continue to aspire to be better every day. Um it's not something that's so inherent that you just walk in and you got it. Um, but I think it can be taught. I think having a coach and in learning, you know, different styles, practicing those different styles, was that effective? Asking for feedback for those who might have witnessed it. I think all of this is the growth in leadership style. Um, I know that seems a little bit wordy, but um I hope to continue to grow and to get better at it for sure.

SPEAKER_05 18:41

It's almost like when you said try try to anticipate, you know, the situations almost there's a component of um listening to your intuition, right? You're in that situation and looking at that person across either the OR or the room or whatever, but feeling like, is this the right moment to say it? And then having the courage to do it.

SPEAKER_04 19:03

Yeah, absolutely. I mean, I these days I'm not surprised by much, you know, although everybody is surprising, like people are interesting. Uh, and uh I also really come from a place where people are human and trying to understand that there's more sides to every story and and really trying to not judge but to be curious. I mean, we live we learn a lot by just being curious, so absolutely. I don't I don't think I know exactly, you know, what is the best way, but I'm hoping to continue to learn how to adapt.

SPEAKER_05 19:36

Right? Certainty over curiosity, or curiosity over certainty, right? That's Ted Lasso. We learned a lot from Ted Lasso. Believe and be curious.

SPEAKER_04 19:46

I love it.

SPEAKER_05 19:48

Um, Dr. Pusick, um, Brigham Women's Hospital. You know, uh, Dr. Moore had talked about feedback strategies, asking for feedback. Um, what do you what do you do to get an appreciation from your peers as to how things are going? Because you know, you can be involved in these meetings and um committees, and no one really tells you how things are going.

SPEAKER_02 20:09

But how do you how do you search out that feedback? So here in Boston, so we've recently had an integration. I was bringing a women's hospital and Mass General Hospital, and so I now actually have the great privilege, I'm delighted, and it's such a marvelous faculty to be leading both groups. Really, to be successful, I need feedback in terms of how it's going, in terms of my leadership. I have certain trusted people that I know we have the open lines of communication. We're we're totally aligned in terms of what we want for the for the group, which is the group to be successful and happy and and well and provide the the greatest, you know, the best patient care. And they can be honest with me, and they know I want them to be honest with me. So as an example, we had a we had sort of a mini retreat yesterday of our um, we do one at the beginning of the year, and then we do a six-month sort of thing. And and it was, and and they, you know, they they were very clear, like here's what went well, here's what I didn't think went well. I I really value that. So it's finding people that trust to give you honest feedback, they'll tell you what they think, and that's super valuable is to have people that in in your leadership circle that will won't sugarcoat it and just say, oh, that was great. You you don't want that. I mean, yes, it's nice to hear it, but you really want to know also kind of what what could have been different or what maybe what what might not have gone over quite the way you thought it did.

SPEAKER_05 21:26

So would you, for an example, would you seek out maybe you know, one of the nurses in the office, or maybe an OR scrub, or maybe um a colleague, a trusted colleague. Um, is that kind of like a you know a person that you've been working with that would is not gonna just tell you what you want to hear, but is that the kind of person that you might seek out for feedback?

SPEAKER_02 21:51

Um, I think yes. I think that I think what's challenging sometimes as a leader is some of the people that you've just mentioned won't necessarily always feel comfortable giving you that kind of feedback. I was what I've created, or like what I've been grateful to have the opportunity to have around me some really great people that I've actually I I do really well with the leadership team. That's just my style. And so I have people that are part of the leadership team, and we're all aligned in terms of wanting the division to succeed and to optimize patient care and our research and our education mission. And they're they know and they're expecting us to do a debrief about how did that go, right? And they know that I'm I'm open to um to well, that didn't go as well as we thought it would, or even this was great, but this maybe maybe we wouldn't do that again. So I would say I also I I also really rely on faculty. I have um administrators that I really rely on that I um I I value greatly their honesty that they will tell me when they they don't feel that they can't tell me that something didn't go well. Um so I I would say it's it's but they have to be sensitive to the fact that not everybody will feel comfortable giving you that feedback. And that's one of the challenges of leadership, is it not ever people don't tell you stuff sometimes because they don't think you want to hear it. And as the leader, they don't want to tell you that.

SPEAKER_05 23:07

Yeah, and you have to seek it out, right? They're just you can have a meeting, but at the end of the meetings, no one's gonna tell you how you're doing. They can say all the things that they hate, but it's it's almost like you really have to make a point of seeking it out if you want to know.

SPEAKER_02 23:22

Yeah, 100%. And yet it's the most valuable thing. So I think it's creating a circle of trust where people know that you honestly really want that feedback. You know, and because it's it's mission critical. It I it's not about my ego, it's really because we're all aligned and wanting the best thing for the division, for our patients, for our whole team. And I need to know what went well or didn't go well. I so I what I try to convey is is my sincere curiosity about what do you think? And you don't have to tell me it all went well because I know it didn't all go, and nothing ever goes perfectly.

SPEAKER_05 23:56

No. Dr. Um Agenstein, uh general surgery and president of the American Society for Um Uh Hernia Society, you know, Dr. Pusik has been talking about it's important to appre know who you're surrounded by, your team, um, and to be able to value their um their their their how they feel about you. Um what what are your how do you hire people? What's your hiring philosophy or how do you how do you search people out to help surround you with successful people or a high performing team?

SPEAKER_01 24:35

Yeah, so um I'm definitely at that part of my career now where I feel like a lot of times when I'm getting invitations to do different things, I would rather uh promote people around me to uh get up on the podium when I go to these society meetings. I I don't really care to be giving lectures, maybe moderating and things like that. Um I have we've had a fellowship for 15 years, uh, or actually longer than that. I've been part of it for 15 years, but um they've just so many wonderful fellows I've had, and then you know, looking at their skills, trying to uh promote them and others uh through the you know work of the Hernia Society. When I started out as a chair many, many years ago of one of the education committees, I just remember how it felt to be and and and wanted to get on the board, you know, what it took uh to actually get on the exec and all of those things. Uh so just really trying to identify people that are actually putting the time in, who really uh who really care, who have the values, who this is not um, as we all said at the beginning, nobody was really looking for these leadership positions. And I think that's what's really kind of remarkable uh that everybody landed in these dream positions that we never actually personally had dreams to become. It just kind of happened. It happened due to all the different things we talked about, the intuition. Uh first you have to have the skills, you have to have the adaptability uh to navigate all of these situations. But then I think we have a huge responsibility uh to kind of pay back because we've all had mentors along the way. Um, and you know, sometimes uh we may have uh, you know, if people did different things differently, if they helped us along, maybe it would have been an easier road to get there, because I'm sure it wasn't a smooth road for everybody to to where they are right now. Uh but just seeing a lot of uh young people around who are very dedicated and trying to do anything you can to kind of take down those barriers that potentially you you had uh while you were kind of um on that road to trying to get into the leadership positions.

SPEAKER_05 26:35

Yeah, I mean, so you had talked about you know hiring fellows. Um what do you I mean, what do you do? Or like is there an is there some questions that you asked, or is there something that where you're sitting down with them, I mean she have like 30 minutes and they could potentially be with you for a year and plus or more, and then potentially you end up hiring them. But is there some is there a strategy that you have in that interview process, whether it's a fellow or a nurse or a colleague, where you ask certain questions, or how do you get a feel for what they are going to be in that 30 minutes for what they're going to be a year from now when they're working with you?

SPEAKER_01 27:13

I mean, that's a that's a really good question. And you know, sometimes we'll do like eight of these in a day, and you know, your head is spinning and you just have the same conversation over and over, and I try to take some notes. Uh, I really, you know, I put a lot of weight on recommendation letters, especially if it's people that you know make phone calls and things like that. Uh, you know, in the in the 30-minute or however long the interview is, you really kind of try to get to know what kind of person they are. Uh, for me, you know, it's really important patient care. Are the people really interested? Uh, you know, are they gonna be there? Because you're really kind of hiring a junior partner, uh, at least in our fellowship. You want them to be able to take on the service, run the service. And even though I'm in the OR with them the whole time, uh, I still want them to feel like this is their uh, you know, this they're essentially the surgeon of record uh for the patient to know them and all of those things. So so really that that's the importance to see somebody who's willing to kind of be mature and take on uh the whole uh the practice and and take care of um uh patients. So that would be kind of the most thing. And it is hard to tell that in 30 minutes for sure. Uh so uh interested to hear what everybody else does it.

SPEAKER_05 28:24

Yeah, I mean, it's tough. Dr. uh Moore, how do you how do you do that? How do you sift through, you know, you got 10 people that you're interviewing that day, and and it's it doesn't really matter if it's a fellow or a nurse or an APP or you have a staff position available. How do you how do you figure out who that person is while you're sitting across from them and what they're going to be with there when they're hired? Is there a magical question that you can get to the ball did get the heart of the matter?

SPEAKER_04 28:56

Um it's great, it's a great question. And you know, I I totally could relate about, you know, how do you stay fresh when you're then the 10th one, right? And I've been fortunate to, you know, hire all those positions that you you um mentioned. When we think about faculty, what really matters to me is when I'm interviewing them, and I too want to hear what my colleagues think, but for the for the faculty member, I want them to be able to articulate what they love. And I I really focus on I have a job, but really my goal is to provide resources and remove obstacles and let you do what you love. Uh, and if they if they have a hard time articulating that, or they want me to say, like, oh, this is what you can and can't do, I have a harder time thinking, okay, this is gonna be a successful person on my team because I'm not a micromanager and I need people motivated to do what they love, and then they're gonna be successful. So faculty is there. Uh, when I think about, you know, our residents, our our staff members, I I like to ask the question about like, what are you know three things that you would, you know, your friends would say about you? And then I'd turn it and say, okay, what are how would three you know adjectives that you, you know, if your friends would say it, then what about your boss? And then, oh, what about your family? And I and you can see their reactions changed despite of what that would be. And I find that that gives some insight to them. Um, but a lot of times, you know, I try to hire much slower because it's hard to move people out of positions, right? I learned how hard that is. And so you want to get it right and and spend the time. And I totally agree with Dr. Argentine about um getting the references. I call all of my own references um for specific positions because I need to hear um what is said and how it's said because it is so important to the to the team to be successful that every member is someone who should be on it.

SPEAKER_05 31:08

Yeah.

unknown 31:09

Dr.

SPEAKER_05 31:09

PZ, Dr. Moore talks about how important it is to you know keep yourself around um people who are inspired and they have a passion for the work that they're doing. I have a question for you. So how do you how do you navigate making sure that everybody feels welcome and psychologically safe and yet maintaining your authority? For example, do you do you go out with your colleagues in a social situation? Are you friendly or you just do the retreats? Or is there a balance between how much you can be socially interactive and yet maintain your authority and your position? What what how do you strike that?

SPEAKER_02 31:50

Yeah. Um I think it's a balance that so um I that I'm still learning. I will say, um, I think what I want people is to feel they can get to know me and that I'm real and authentic and they understand people that were we're a team. At the same time, I think professionalism is important too in terms of um, and so I will say when I first when I, you know, my career trajectory was I spent many years at Sloan Kettering Cancer Center where I was, I came on as a fellow and then a very junior person. I kind of came up through the ranks, and it was a bit of a you know, coming, coming to Boston and realizing like I can't be friends with everybody immediately because I actually have to also be, I'm in like I'm their boss and um and I have to make sure that someone's not my favorite or my best friend. So it took me a little while to figure that one out. Um, but I do try, I would say that the most important, I I I just try to be really authentic with people, but at the same time, but like balance that balance between being authentic and being professional. I think it's and that that's just something I think it's I it's something I continue to learn over time. Um, but I I think there are there are different boundaries in in the professional world that that are different than if you sort of came through and knew this is, you know, we started in practice together and we've been together all this time. It it is different. It has a there's a bit of a higher standard, and I think that's important to maintain. I think people uh appreciate that.

SPEAKER_05 33:18

Right. It's a balance between approachable, also showing humility and transparency, but yet maintaining your professionalism in that relationship. I mean, you want to share um and yet still maintain that kind of separation.

SPEAKER_02 33:38

Yeah, I think I would summarize it by saying I think what I what I seek to convey to people on my team is that I care about them. I'm gonna I I care deeply about them. I'm not gonna overshare my personal life with them because of the our professional relationship. And so, but at the same time, I want them to know that that I'm real to them. I am um they really matter to me. And and I think that it's and so it is just a it's a different relationship than if it's someone who's just you know a friend that our kids went to school together with, that kind of thing.

SPEAKER_05 34:10

Yeah, yeah. Um, Dr. Ogenstein, you talked a little bit about mentorship, so switching gears to um mentorship. Um what do you, you know, people see you as president of the American Hernia Society and these leadership roles, um, as um, you know, both in the Society for GI and endoscopic surgery and you're lecturing nationally. So, you know, people are people look up to you and see what you've accomplished. Um, how do how do you find it best to navigate that role of mentorship? And do you tend to um have a handful of people at a certain part of their career? Do you meet with them on a uh quarterly basis or every six months? But what seems to work for you?

SPEAKER_01 35:00

Yeah, so I mean, growing up, I feel like uh the whole mentorship um was always it was not you know a forced type of uh uh relationship. I feel like when I was a resident, we didn't have mentors, you know, you just kind of you did your residency, you worked hard, whatnot. Um, but I feel like now when I'm seeing my residents and fellows, there's a lot more structure to finding a mentor. You have to have one mentor, two mentors, depends. And then looking back on uh my career, you know, I've had a lot of wonderful mentors along the way, but they were never, it was never an assigned, okay, this is your research mentor, this is your professional, this is your life mentor. Uh, so you kind of find different people for different times in your life. And I've never uh, you know, taken on like a I'm gonna be your mentor type relationship. I've I've done that for general surgeon uh residency, and and it's it's fine, you know, you meet things like that are very formal, but I've always made myself super available anytime anybody reaches out. Uh, I just feel like that's really important. I could not imagine if I got the strength and courage for somebody to actually ask, uh to ask them, hey, will you help me with something like that? If they block me, that would have that would have really kind of uh made me feel horrible uh because it would have taken a lot of strength, I think, for me personally to reach out to somebody and say, hey, will you, I'm struggling with this, can you please help me out? Uh so with my residents, fellows, uh colleagues, it's one of those things that I just really feel like it's just important to uh make yourself open. Obviously, we we we none of us have a lot of free time, you know, setting boundaries on work-related things, uh, going out with staff from work and and things like that. We all have very few time, you know, very uh finite amount of time to actually do this uh as a free time. So so that is hard because you don't want to offend people, you want to uh be seen as a leader, but you also still want to be approachable. So so it's a lot of those uh things going on. But I think you have to find some kind of a happy balance uh and and just uh stay true to your true values. Uh for me, it's always been really important uh to be able to open, be open with people, share uh mistakes, struggles, things that I've had along the way, and hopefully that they can learn from them.

SPEAKER_05 37:21

Yeah. Dr. Amy Moore, you know, uh Dr. Augustine had talked about this time management. I mean, you're busy, right? You have clinical work, you have teaching, you have research, you have your administration, it's registrated work. How do you balance that? And you know, what kind of advice would you give to, you know, mid-career or early? I mean, mid like what would you advise would you give to early career, and then what advice would you give to mere mid-career surgeons on how you've been successful at striking that balance?

SPEAKER_04 37:51

Yeah, thank you for the question. I would argue that I'm never balanced, truly. Um, and it's prioritizing in the moment. Um, but if I look over time, I feel like what an amazing balance, right? And so I know that's like sort of hedging the the question because I don't think you can have it all at all the time, but I do think that, you know, it as it changes as your priorities change, your boundaries or your guardrails change. And so for their early career, I I would argue that, you know, you've got to be good at your trade. You've got to be really good as a surgeon or as a scientist, or, you know, like you need to set your program up so that you're thriving in that space. And then know that you don't have to capture it all so fast. I think if I could do it over again, I don't think I would have pushed so hard so early. I happen to be in a place where, you know, nerve surgery just took off. So it was just a serendipity of like how my, you know, career took off. But but I think early in your career, you just need to make sure you're doing the right thing for your patients or for your science and you're putting that time in because that foundation sets up for your mid-career and and future state. And so that is how I would say, you know, don't wait to have those kids. Gosh, don't wait. Um, that would be my other, my other advice is like, yeah, you're not gonna be balanced, but you know, don't wait to have a family if that's you what you so desire. Um, and I say that both to my male and uh female uh faculty and staff. Um, there's never a good time. But I I would I know I seem pretty wordy every time I answer a question, Dr. Trevor, so forgive me.

SPEAKER_05 39:43

But that's what this is. This is the time it takes time to develop the idea and to communicate. It's not like three words, you know?

SPEAKER_04 39:52

It's a big concept. But that's what I would say. It's never balanced. But over time I look back, even I get a year, six months, I'm like, wow, we accomplished a lot. This is where it is. And and I think that part of feeling like, oh, there you can go up and down. I try not to go too high and I try not to go too low. But you know, what we do is hard and and it no one's given it to you. So you have to make sure that you feel aligned with what you're achieving or what you're trying to achieve, whether that be balance with family and making it home at five o'clock, or what weekend are you gonna put together to put that grant in. And um, I don't think balance should be what we strive for, except over time.

SPEAKER_05 40:37

Yeah, it's almost like follow your passion and your passion will lead to the balance. Yeah, oh, absolutely. And then we'll figure it out. And when when it's when you're not passionate about it, you know that's when you need to drop that.

SPEAKER_04 40:51

Yeah, or you have your guardrails. Like for me, it's my husband who was like, Whoa, we're not seeing you. This isn't what we signed up for, where you know, your kids are missing you, like having somebody in your life who can like also remind you, like, hey, is you're on you're like and can see outside of yourself because sometimes we just get in it, you know, and and it's really helpful to maybe it's your best friend who can say, Wow, you're what's going on? Like, we're not seeing you, or you don't seem happy. Like, I think it's really okay. We we we sort of get caught in these cycles of this is what I have to do to get it done, and and maybe giving a pause, but having people to help you do that, I think is critical.

SPEAKER_05 41:31

Right. Listening to that feedback, right? We have to be open. It's hard, it's humbling. And sometimes you don't want to hear it. Totally agree. Dr. Basic, um, Dr. Moore talks about you know all these pressures and and you know, trying to strike this balance or no balance. You know, as the uh chief of you know plastic surgery at Brigham and Williams and now mass general, you know, there's a lot of institutional pressures, right? Productivity or utilization, um, a variety of different metrics that they want to put, you know, how many clinic patients you saw, um, all that, you know, those all those issues are, you know, a variety of those issues, but how do you talk to your colleagues about that? You have your junior colleagues, um, and these are big issues, they're sensitive. Um how do you how do you you know review that with people and and hold it people accountable to to what you're being held accountable to?

SPEAKER_02 42:30

Yeah, I think um, yeah, that's the that's some of the really tough stuff. I think, you know, as Amy has said, I think some of the the the the passion, the sense of purpose, and we just go with it, we run with it, you know, and and as do the people that we've brought on as as as faculty and such. And and then there's the reality of this is this is the business of medicine as well, which can be complicated. And um I still in my mind, actually, uh the I I would say like that P my I feel that my job is to help my faculty, um, and my whole team, like because I think my faculty is my faculty, but there's our APPs, there's our there's there's all there's there's our MA team, there's a there's a lot of other folks involved. But I think um I think that's part of you know it's a challenge of the job, but it's also part of like it's the responsibility of the job is to make sure that works, which is all the nuts and bolts of making sure people have enough OR time. They get the feedback about their RVUs and such, but they get it in such a way that what I try to do is make it so that that is um stable and is to the greatest extent possible in their peripheral vision. I feel like my goal is to help people like follow their passion and their and their sense of purpose. And I really feel it have when people ignite around a purpose, then they just go. Um, and so I try, I I feel that my job as a division chief is to try and like make that noise not go away completely because people, you know, there's all these other realities, but I that's that's I feel that like. Like my job is to help facilitate that they can light, that they can go, that they get that that sense of and that and I try to like let try to help the other stuff become less of a burden on them. It is obviously there's there's things we just all have to think about, but um but that's that I feel is is my job as a leader, both to say to say, hey, your per your purpose and your passion is why you're here. That like it's about pay the best patient care we can provide. It's about sort of like what's your new great idea that you're gonna write as a grant and it's gonna be it's gonna change the field and and try to keep them from getting pulled down by a lot of the other stuff, which can pull you down for sure.

SPEAKER_05 44:38

Yeah.

unknown 44:39

Dr.

SPEAKER_05 44:40

Augustine, Dr. Pusick talks about, you know, staying passionate about your work. That's it's gonna help you maintain your productivity. But what about what about burnout? I mean, have you ever felt that in yourself? I mean, you love what you're doing, but you you can be it's easy to be pulled in a variety of different directions. You've got research, you have these different society obligations, you have your office work and the fellowship. Um, have you ever felt burnout? Um and what what did that feel like to you if you did feel it?

SPEAKER_01 45:12

I think we all feel kind of you know worn out at times. Um, I think uh we've all talked about passion, uh staying true to your goals. I think that's really important. We just have to see, you know, sometimes you kind of put up with certain things to get to a certain goal, and it's not always, you know, our jobs aren't always 100% satisfy satisfaction every single day. You're just constantly happy. There's obviously bad situations, there's, you know, uh the things we have to deal with with at home, at work, uh, you know, wherever else. Uh so I think as as long as you feel like you're getting things, uh, you're doing things the right way, I think that's a really important part of it. Um, you know, burnout is just, I think, uh, and I saw this recently, and I really kind of identify with it. I think we we've we all have kind of identified uh burnout to be kind of like an issue that we're people are dealing with, but a lot of times I think it's just where people don't feel like they're being valued and then they feel burnout because you feel like you're giving 100% of, you know, you're trying really hard, but perhaps you know, your boss or somebody around you is not seeing the kind of work that you're doing, and then obviously you're feeling burnt out. I think in situations like that, if you find yourself in those situations, you really have to kind of evaluate uh if this is truly your passion, you may not be in the right place. You may have to uh switch locations, you may have to go to either a different group, uh, but certainly if it's one of your goals, uh I would not want, uh you know, I don't want you, I would not ever advise anybody to change their goals uh if you feel burnt out. Uh obviously uh there's different kinds of burnout. Uh we all know as uh physicians uh that there's a lot of different things that can be going on and there are a lot of resources out there. I think keeping a close group of friends, uh close group of people that you can use to kind of tell you kind of, am I off base here? Am I doing this correctly? Uh we have a lot of colleagues that we have around us uh that you can always use and kind of lean on uh to ask them uh if you're acting appropriately.

SPEAKER_05 47:18

Yeah, I mean, Dr. Moore, what do you think? I mean, we we have to structure ourselves to you know be resilient to the stresses around us. Have you, you know, if you have you seen you know early signs of burnout in in some you know, early career surgeons or even in fellows? And if you have seen it, do you pull that person aside? What do you say? Is there have have you experienced that before?

SPEAKER_04 47:45

Yeah, absolutely. And and I was totally resonating with Dr. Agustin, the same thing. Like, you know, we I almost feel like in my moments of burnout, I didn't realize it until, you know, I was out of it. Um, and you know, and you're like, oh wow, that was low. Um, and when I see it with my junior faculty, I think that um they, you know, there's there's such this energy when they start, right? And they're like passionate and they want to be in everybody's rooms and they're excited to tell you about their cases. I and what I have noticed is, you know, when I get worried is when I start getting notices about them not getting their charts done. You know, when we get this list, like, oh, op notes haven't been done. And I'm like, oh, okay, then, or they're making the like, and it's not a naughty list. It's just basically like they're over either overwhelmed with the volume or there's something, you know, fundamentally we need to work on their infrastructure of how they're getting through their day. Um, and so it sort of clues me in. So that's sort of like my new signal is okay, you know, they're either pulling back from being this, you know, outward-facing, eager to like, okay, now they're having a hard time getting their notes done. And so I'm I'm checking in pretty often with my junior faculty, you know, and with my senior faculty, it's a bit, it's a really more challenging. Um, and that's the the group, my professors, where I I'm I get worried because I I I they're it's just not as an obvious trigger. They figured out the the baseline of what needs to get done. And and and more of that is me eager to ask them to participate. And and so that's one-on-one conversations. But I I find that the with the junior faculty, it's a little bit like, okay, things start missing, not showing up, or they're not getting their notes done. And and then I start leaning in and and thankfully trying to give them the resources and or the support. Um, because they may not even know they're in that burnout.

SPEAKER_05 49:49

That's a good point. All right, I can't believe this hour has flown by. Um I appreciate all of your um comments. They've been so important and um hit to like such a soft spar spot in my heart, and I'm sure in the audience too, that we could, you know, appreciate uh where that information is coming from. I thought it's been the the last few minutes just doing some rapid fire questions, like the first thing that comes to your mind, and we'll just do it as a as a sequence. We can do Dr. Augustine, Dr. Pusick, Dr. Moore. So we'll just start with um favorite leadership book.

SPEAKER_01 50:26

Gosh, I don't think I've read any leadership books recently, to be honest with you. I I would say good energy by Casey Means is the last book I've kind of read in podcast, but it has nothing to do with leadership, but it's all about health.

SPEAKER_04 50:39

I like it. All right, Dr. Moore. Yeah, my my favorite is I I subscribe to Harvard Business Reviews. Um, and I get a daily, you know, leadership um like Pearl, and it is worth it. Like I have found myself going into that, those Harvard Business Review um segments a lot more than than reading a full book. If the book it's I would say is I love it here by Clint Pulver. Um, and it is it is a great book to do with your team. I did it with my leadership team, sort of like a book club. Um and and that book sort of talks about like why here, why choose here, and and trying to create a culture that people can recognize like it's not always greener elsewhere, and and why do we choose to work here? So I love it. Here is the name of the book by Clint Pulver, but from leadership pearls that I get almost on a daily basis is I subscribe to the Harvard Business Reviews.

SPEAKER_02 51:39

I love it. Dr. Busick. First of all, just say I love better the fact that you don't have a ton of like I I always feel a bit intimidated when people have read like all the leadership books. I really agree. And so someone's like, well, I'm just kind of figuring it on my own. Thanks so much. But um, but so I love that. I'm gonna read, I love it though. I've written it down. I was doing the same thing. I was making okay, I'm gonna read that. Um, I will say I just in part because I've been sort of reflecting in this the integration across our two big academic medical centers and thinking about things that like what makes people tick a little bit. Um I um Drive by Daniel Pink and Deep Purpose. Um Golati is his um is the author's, I think, first name. Um but it's all they're both about self-essentially um self-determination theory and and the idea that how purpose is so such a big motivator for us. And that just resonates for me because I feel like for myself, I've always I I've like it was said very at the very beginning when Amy starts talking about sort of how did she, what was her leadership, how did she, her leadership journey? I think you know, it's I think all three of us, I think you've heard is that we're motivated by a sense of purpose and wanting to contribute. Um, and then everything else you kind of figure out along the way. I like it.

SPEAKER_01 52:58

Medra, favorite leadership course. I mean, honestly, I haven't been there. I've I have not been to any of these uh things, and I'm you know, I'm not like a chief or a chair of a department, you know. I I've been kind of uh stuck in the same position, and uh certainly I've I've not that's never been I I've never wanted to be a chief or a chair or anything like that. So it's not been something that I I've been going to. I've I've never been to one, to be honest with you. And I love that you can work, but I have not I've not been interested in any of those.

SPEAKER_05 53:28

It's love that you can share that because it shows that you can be where you are without having this incredible extensive training. You can learn it on the fly, you can use your intuition, you can anticipate someone's reaction, you can read the room, you can have um social intelligence and be highly successful and move the ball forward. So I love it that you can say You're very kind, but I'm I'm taking notes now.

SPEAKER_01 53:54

What I need to I'm looking forward to hearing the uh the next two wonderful speakers tell me what courses I need to sign up for in the next few months.

SPEAKER_04 54:02

Amy, did you do any courses? Um I I did, and I think the most impactful one was the one I did for that's like a women's um wash you like women leaders course in like 2018. And what it gave me is an eye-opening to other women who have have done it, and so they would bring in other leaders to talk about their journeys, and that was very impactful for me to see others making that happen um when I had just started my leadership journey. And and Vegua, the same thing is like it's okay to not know and to not done all the courses because I didn't take care of you know going to a bunch of leadership courses. Um, but that initial one in my own program helped me navigate within my own program at WashU. And so maybe starting there, you might find some benefit.

SPEAKER_02 54:56

For sure. Andrea, any courses? Um, I mean, I think the theme you're hearing also is we don't, it's I think leadership may sometimes be a bit of a surprise to us. So then you weren't necessarily like going to school in advance because it wasn't where you thought you were gonna be. Um, but then others, like as I say, I said early on, the Canadian Society, so I'm Canadian, so Canadian Society sent me to a leadership course, which I was a bit surprised by. But um, I guess my example I would say is this that for me, what's been um really helpful from a leadership perspective is when I came up to Boston, I felt a little bit um like I just didn't know who to ask for advice on a lot of leadership discussions. And then when another um wonderful female colleague became a division chief, um, uh, Dr. Christine Rohdy at Columbia, and she said, Can you can you help me? I need advice. I'm like, I think we both need advice on things. So we started a group of uh female chiefs and chairs in plastic surgery, and that's honestly been my go-to place to take questions, and it's been like a leadership course in and of itself because it's been some of the wisest women, and we've all been there in the same situation, and it's a really safe space. So that would say that for me, it's been a, it's, it's, it's, we've created create a community, and that's that's been its own. I wouldn't, it's not a course, but it's been in creating community in a safe space, and we really talk about the leadership challenges and and and and these women that are senior to myself and have been in these very challenging situations, or that we're or we're all in it together, like Amy and myself and different um different other members of the group, and we share that experience and we give each other advice.

SPEAKER_05 56:26

It's the best course, it's candid advice from people that share the same experience. We completely agree. All right, well, Dr. Piuseg, Chief of the Division of Plastic Surgery at Bringing Women's and Mass General, Dr. Augustine, president of the American Hernia Society at Caroline Medical, Carolina Medical Center, and Dr. Amy Moore, uh uh chair of the Department of Plastic Surgery at Ohio State University. It has been a pleasure to spend the last hour with you. I know your words will run resonate and impact future leaders. And uh this audience uh I know has many takeaways. So grateful for your time. Thank you.

SPEAKER_00 57:06

Thanks for tuning in to another episode of the Limitless Leaders Podcast Series brought to you by ASPS, the Aesthetic Society, and the American Earning Society, with the generous support of Allergan Aesthetics. We hope you enjoyed our conversation today and gained valuable insights and inspirations from our guests. Check out our other episodes on your favorite podcast platform or download them directly from ASPS at Net. Stay tuned for new seasons of exciting episodes where we continue to celebrate and empowering women leaders in our field.