Amy Compton-Phillips, Executive Vice President and Chief Clinical Officer for Providence St. Joseph Health, recalls what she learned from an assessment of her leadership style early in her career and how she changed based on what she learned. She also shares challenges as a woman leader given colleagues’ expectations in what has traditionally been a male-dominated profession. This story was recorded live during the 2016 IHI National Forum.
Mary Jane Kornacki: Amy, tell me about an early insight that you had about what leadership takes, or what leadership is or isn’t.
Amy Compton-Phillips: The story I’m going to tell you is an early one in my career. I’m an internist, and one of my first leadership roles was as Internal Medicine Department Chief. Our department had HR people who would help us build our leadership skills — we had a leadership development program, and one thing we did was take a test on our aptitudes. The test would tell us whether we were a directive leader, or an authoritative leader, or a pace-setter, or a couple other versions of leadership styles. The least effective one of all was directive — and I came out pegging the meter on directive.
And I was mad, you know? I knew I wasn’t directive. So, I marched into the HR person’s office and was telling him about how, “This can’t be right, I make sure I come to meetings, and I make sure that I show them, that I — ” and he stopped me after a few minutes and said, “Do you realize how often you said ‘I’ in the past few minutes?” And I said, “What do you mean?” We went over it, and he said, “What do you think you could do? How about if you ask how they are when you go in, and then just stop?” It was a real insight to me — this was a good number of years ago now — and as a young woman in a leadership role, I felt like I needed to know more than everybody else. I felt like I needed to demonstrate my competence and demonstrate my knowledge at all times, and that’s not what the docs I worked with needed. They’re smart people.
What they needed was someone to help them all work together and go in the same direction. They weren’t looking for someone to tell them what to do. They were looking for someone to help them see a new way, and that was my insight.
Kornacki: It sounds like there was an epiphany, if you will, fairly early on in your career. Do you remember how you changed, or the next time you went into a meeting, what you did differently?
Compton-Phillips: I remember, it was a slap in the face for me, and I made a promise to myself then and there to change. The action I took was twofold. One was I made sure that I would always start every meeting by listening. I would always share my opinion last. I would solicit everybody else’s opinion first, because if I said my opinion as someone in any remote leadership role, it cut off the conversation and didn’t allow others to express themselves, and I wouldn’t get a good sense of the room. That was a conscious decision early on. The other thing I started doing is reading some leadership books and actually learning, understanding that clinical knowledge was not leadership knowledge. I needed to gain leadership knowledge and skills.
Kornacki: You referenced being a woman leader. Can you talk for a minute about the challenges that you think women face in leadership roles, women doctors relative to male colleagues?
Compton-Phillips: Women often come to a leadership role, or come to life, with a slightly different style. Looking at the sociological literature, we tend to be more affiliative and social and team-based versus the authoritative, skill-based, with leadership abilities inferred automatically by looking at somebody in a suit and tie. I’ve had to learn to be comfortable in my own skin, learn to be authentic in who I am, and not try to imitate a person wearing a suit and a tie. In fact, if you ever see me at a conference, it is incredibly rarely I wear a suit, because I’m comfortable being who I am. My job is to bring out the best in other people, and that may or may not be a leadership style that would fit in a traditional masculine role. So, I think carving our own path has been the method.
Kornacki: Very often, at least a couple of decades ago, the only role models available were male, so making it in a man’s world has been a challenge to try to be yourself when the role models are more directive or authoritarian.
Compton-Phillips: Yes, it has been. Just a couple little things about that. One is that I have made it one of my purposes to mentor young women in how to actually build their leadership presence and be themselves, because I think it’s really important that the generation after us will have a slightly easier time because it’s been broken.
But it is interesting. I wrote an article in NEJM Catalyst [saying] that we tend to become leaders on a foundation of sand. It’s more that we sink down in these preconceived notions rather than a glass ceiling that holds us back at times — that we’re nice, we’re affiliative. People don’t necessarily look to us to be in front of the room, because they don’t associate nice with tough or getting things done.
Another interesting leadership moment that I had is in my new role. I know people think I’m nice, which is good. It’s not a bad thing, but there’s nice and then there’s limits, and there are rules. I have expectations that things get done, but people see the nice without the expectations sometimes. I remember being in one meeting early on where I had asked two groups that do quite duplicative work to be in front of this large group and explain to us how their work is synergistic, so that we would understand it and be able to explain it to the organization.
We were in a room with probably 70 people, and they were presenting, and instead of together, they presented side by side. I asked them, “Can you tell me how your work goes together, so that it’s not redundant?” And they said, “We decided that it was self-explanatory, so we didn’t need to do that.” My answer was, “Well, that’s great, but I cannot protect your budget unless you can explain to me why I need two of you.” And in the whole room, you could not hear a pin drop for a good 30 seconds, and they said, “We’ll be back.” I said, “Thank you so much. I really appreciate it.” So there’s nice —
Kornacki: With accountability, nice with expectations. There’s nice coupled with doing what’s the right thing for the organization.
Compton-Phillips: Exactly. Nice does not mean pushover, and sometimes they can be misconstrued.
This story was recorded live at the Institute for Healthcare Improvement’s 28th Annual National Forum in Orlando, Florida, on December 4–7, 2016 by Mary Jane Kornacki on behalf of NEJM Catalyst and originally appeared on the NEJM Catalyst website on March 7, 2017. We wish to thank IHI for support of this project, especially Madge Kaplan for her technical advice and guidance. Click here for more Lessons in Leadership stories.