“If your actions create a legacy that inspires others to dream more, learn more, do more and become more, then, you are an excellent leader.” — Dolly Parton, singer-songwriter
Stephanie Abbuhl, MD, is Professor and Vice Chair of Faculty Affairs in Emergency Medicine at the Hospital of the University of Pennsylvania. She is the Executive Director of FOCUS on Health and Leadership for Women, a dean-funded program at the Perelman School of Medicine which focuses on two missions: advancing women in academic medicine and promoting research in women’s health and leadership. She is also the winner of the 2012 Association of American Medical Colleges (AAMC) Group of Women in Medicine and Science Leadership Development Award.
Today, she takes me through her own leadership journey.
Dr. Abbuhl started her career with a residency in Internal Medicine, but during her residency she spent a lot of time in the Emergency Department. She liked her work and training in the ED so much that she took up a faculty position in that department after she finished her training. She saw a real opportunity to improve processes in the ED and took on that challenge.
Q. Did you have a clear career goal when you started out in your career?
A. No, I did not. I started out just wanting to do a great job at being a clinician and teacher. My path has been more of being an opportunist and taking on different positions over time – all the while learning about my own strengths and weaknesses and enjoying a variety of roles and challenges.
My taking up the position in the ED at Penn was a perfect example of an opportunist approach to life. I have spent my whole career in the Department of Emergency Medicine at Penn, but I have reinvented myself several times over the decades.
These days if we are lucky enough to live a long life we are capable of doing many interesting things. One of the great things about Medicine is that there are so many different paths you can take and there are many ways to challenge yourself with new opportunities.
Q. Can you give me some examples of how you reinvented yourself?
A. At the beginning of my career I was focused on being the best clinician I could be. At the same time I was also interested in operational research in the ED so that I could establish a defined area of scholarship for promotion at Penn.
Just a few years into my career, while I was still quite junior in the department, it became clear to me that there were some leadership opportunities on the horizon. When the current leader left, I was offered the Interim Chair position. That was an amazing leadership experience over about two years. It was completely eye-opening for me because I was at high-level meetings with other Department Chairs and leaders of the institution as an Assistant Professor and as a woman. It was a window into the very upper echelons of leadership.
At that time, in 1992-1993, there were very, very few women in leadership positions – I believe there was one woman department chair out of 28 departments. I knew that women had so much to offer but yet there were so few in leadership positions. It seemed like such a loss of talent.
This experience completely changed the focus of my career. I became fascinated by leadership and the qualities necessary for effective leadership that can really drive an organization ahead:- the team-building skills needed, and knowing how to create an environment where people feel valued and want to work together for a common goal. I wanted to help women in particular attain these positions because they have so much to offer and our medical centers need their expertise, perspective and leadership.
Q. Was that the start of your interest in the FOCUS program?
A. Yes. The FOCUS program was started around 1994 by Jeanne Ann Grisso,MD, MSc, a wonderful woman who cared a lot about these issues and had the vision to start FOCUS. When JA Grisso left Penn in 2001, I became the Executive Director and have continued in that position since then. It is important to point out that any success that FOCUS has had is due to 3 key reasons: the support of the Dean, the budget that allows us to have some salary support for the program leadership, and the passion of a multidisciplinary team that works together to develop the initiatives and do the research to advance women faculty.
Q. Is FOCUS only for Penn Faculty?
A. Yes, it is for Penn faculty and trainees (residents, fellows and medical students) but we hope that through conversations like the one we are having today to encourage others to do this kind of work at their medical centers. I have been invited to visit other institutions to give Grand Rounds and provide consulting advice on how to start a “Women In Medicine” program or to further develop their existing program.
There are also other programs that offer this kind of leadership training. The AAMC has a terrific Early and Mid-Career Development program for women faculty. Many specialty organizations have their own seminars and leadership programs to support women in their field. The ELAM program is an outstanding one-year fellowship providing leadership training for women from medical schools across the country.
Q. What would one or two major points be that you would advice women physicians when looking for leadership opportunities?
A. One of the major points that I think is important took me a long time to realize and appreciate. When we think of leadership, we often think of titled or institutional leadership, like Chairs of Departments or Presidents of specialty organizations. But these traditional leadership positions are only one kind of leadership. Don’t get me wrong – these are critically important leadership roles. But there are a lot of ways to be a leader. If you have a broad view of leadership you realize how many opportunities there really are out there. You can almost create your own leadership opportunity depending on how much energy and passion you have for something. I have come to realize that in many ways, leadership that is not institutionally embedded is sometimes as exciting (if not more exciting) and just as creative (if not more creative) than some of the more traditional positions. People are all different and have different combinations of skills needed for leadership.There are so many different dimensions and women (and men!) need to understand their own strengths and weaknesses – often faculty have not really thought about their own leadership qualities and how best to develop them further and find their potential. Faculty in general need to feel confident to go for whatever kind of leadership position their skills and personalities are most suited for. The leaders that are not institutionally embedded have a little more leeway to take risks and push the envelope because they don’t represent an entire organization.
I have a huge respect for women, and men, who create their own leadership jobs out of their passion and their commitment to a cause. They have opened my eyes to the vast opportunities out there.
But we do need both kinds of leadership. What we should really think about is that any one in any position, who because of their skill and talent, can influence other people towards a common goal, is a leader.
Q. What, then, would you tell women who want to pursue these traditional or non-traditional leadership roles but are hesitant?
A. I would tell them:
If Leadership seems daunting or scary, just remember that leaders are leaders of a team. They are not solo. If they are solo, they are not leaders because they will not be effective.
Many women (not all!) are team-oriented. So if you think about leadership as being part of a team, it seems less daunting, less frightening, because you are really not out there alone. You are actually buoyed by the team you put together.
Q. Is that the reason you think many women are hesitant to pursue leadership roles? The fear factor?
A. On that I actually have a theory of three reasons:
- First, for some, there is an element of intimidation by the role or position. You may lack the confidence or you feel you don’t have the talent and skill necessary. My thought is that often this is an “unconscious bias” turned inward – the women usually have more than enough skills! As an example – we had a young woman in our department who was fantastic, just brimming over with talent and leadership skills. We asked her to be the Chief Resident. What do you think she said? She said no. We were very surprised and we could have taken that answer and walked away. But instead we encouraged her and with that she took the position and blossomed. The point of the story is that at that critical moment in her life she needed the encouragement and support we provided and with that she took off.
- Lack of role models: It is hard to imagine yourself as a leader if you don’t have some one to look up to and emulate who looks like you.
- Women are also worried about work-life balance. They are worried that if they take on more they will not be able to meet their most important goals both at work and at home. There are some leadership jobs which do require a lot of time and effort although they are worth it and they can be managed by negotiating effectively and sometimes by integrating life and work more effectively. What I mean is that if you take on a big job, you give up something else or be sure that you have the administrative help you need, the salary for appropriate compensation, learn the skills of delegation and take advantage of mentors. It is hard when you have so many opportunities out there but you can’t just keep adding to your plate. You have to have a plate that’s manageable – and sustainable. A lot of women shy away from leadership because they believe it will make their lives simply not manageable. But we have to negotiate for manageable, sustainable jobs that we can be productive at, not exhausted.
So women physicians need to look at all three of these reasons and see if they can strategize on how they can approach these potential barriers. And the good news is that there are many incredibly successful women leaders in medicine today and they are each different, each tapping into their own skills, values, perspectives; and providing us with new models of leadership. This is very exciting for the future of medicine.
Question: What one way have you reinvented yourself in your career?
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