Mary Jane Kornacki, MS, interviews Izabela Nowosielski, MD, CPE, FHM, MBA, Chief Medical Officer for the Greater Hudson Valley Medical Group, recorded live during the 2017 IHI National Forum.
Mary Jane Kornacki: I’m at the IHI National Forum on Quality Improvement in Health Care and I’m sitting down with Dr. Izabela Nowosielski, who is CMO of Greater Hudson Valley Health System Medical Group and also the Director of Hospital Medicine. Dr. Nowosielski, can you think of a leadership story, an example that you would like to share, something about your leadership journey?
Izabela Nowosielski: When I first heard about speaking on this subject I thought to myself: let me take it back to what happened with my own personal story, going back to the first job as a hospitalist and the types of projects that I was involved with. I was naturally progressing from being just a physician to being more of a leader. This progress felt natural to me. The first lesson I learned in leadership was, there were innate abilities and skill sets that I had that were percolating with time. I was finding myself in places where it felt natural for me to apply my skills.
Through the first several years, I was involved with a few quality improvement projects in the Hospital of Medicine, and then [an] opportunity [was] presented to me — stepping up to a chief role leading a larger hospital service. Initially, I said, “Well, I don’t know.” It’s not quite for me, but then after reflecting on my values and what I have done and how things progressed for me I said, “I think this is it.” So I stepped into the role and I loved it. I felt that I was doing the right thing. During those years as a leader, I learned about relationships and that I had to form those relationship first to be effective in my role, both within my team but also outside of my team. I was spending a lot of time getting to know people and understanding their needs and wants. Only then I was able to navigate the system to deliver the change. The amazing part was that I was getting really good at it.
At the next stage, I learned that one always, at least from my perspective, seeks progress and, in many ways, one to apply same leadership skills to the bigger things, and take on the next opportunity to have a bigger impact. With that comes looking for your next possible role that would allow you to have even a greater impact, a greater ability to influence more people and bring bigger changes. I’m relatively young in my leadership career, but this is my second larger role as Chief Medical Officer for a multi-specialty medical group.
In the past, I used to manage internal medicine physicians. Now, I have to oversee surgeons and specialists, and that in itself created a challenge. By doing it for about 3 years now, it’s also a journey of understanding who I am as a person. There is one point about this: somewhere along the path of leadership, every leader probably should understand who they are as a person. One must think: What are the core values that personally appeal to me and who I am? And then the goal is finding that alignment, and that connection, with something within the environment or the organization that one can connect with. Until that internal analysis is done, and that alignment is found, there may be some struggles. Not everybody is all about productivity or personal efficiency. There are people who, like myself, [who] are more about the collaboration, the equity, the fairness. What I’m doing in my day-to-day work is looking to connect on a global level. It is all about bringing up those values and connecting those values with what the organization needs, and that creates a positive change.
Kornacki: That’s really interesting. What I’m hearing you say is that part of your leadership journey was an inward journey, that there was reflection and thinking very deeply about your values and who you were, and what you wanted. Was it helpful to have an external assessment? Did you go through any process of 360 [degree] evaluation, were you open to feedback, and how did that come into play?
Nowosielski: Yes, and I think it’s one of the things that I experienced working with other leaders. What I learned is that the great leaders can be the greatest, but you still need help, and it’s okay to sit down with the mentor, the coach, or whoever you trust and go through that analysis. So that’s what I’ve done as well. I did have a coach and I have a few mentors, and I went through analysis through 360 and other tools, and that helped me prioritize some of what I needed to work on this.
Kornacki: For people listening or reading, how has a mentor been helpful to you? It’s a subject I’m curious about, how a mentor helps nourish and foster leadership in another person. Any thoughts about good mentorship, what it looks like?
Nowosielski: Yes. It’s so interesting that you asked that, because I have at least three mentors, and there has been only one of those who has been very good in mentoring. I think there’s a skill in being a mentor, and I think you can be a mentor once you go through certain levels of leadership. Mentorship is really about the years of experience, and various levels of exposure to different settings and environments. I guess in many ways what I was doing was using my mentors as a sounding board and listening for an objective feedback regarding my decision-making process, or politics, or whatever else I was facing in my own environment.
Kornacki: What do you think the best piece of advice a mentor ever gave you was?
Nowosielski: One of the first conversations I had with one of my mentors was around organizational dynamics, also known as politics. I will just use a board description: political environments exist in all organizations but they’re very different. It’s very easy for a young leader to get caught up in reactivity at times, not understanding how to navigate, and make quick and impulsive decisions. I remember, initially, when I presented a situation to my mentor, I remember he said, “Just hold off, do nothing.” I was urged and thought, “Why can I just respond to that annoying email today?” I remember it was hard take a step back, sit tight and think, and then come back to it in a couple of days and see how it looks at that time.
Kornacki: Cooling off period.
Kornacki: Many leaders I know have learned from their experiences, especially the ones that didn’t go so well. Is there a learning you’ve had that you’re willing to share with us?
Nowosielski: I think I’m learning every day but, obviously, I’ve had a couple of moments in my career so far that allow me to say, well, let’s take a moment here and see what happened. To some extent, I’m trying to reflect a little bit about being a woman in a leadership role and how that shaped me in certain situations. And one thing that I have to say [is that] as a leader, it’s an extremely tough job. It seems like most of the time you’re working upstream against many different forces, and resilience is very important.
I had a moment where I was working with physician leaders in more organizations and there were multiple political forces working at the same time, and I was getting messages that they were not supporting me and what I wanted to do. I went home that day and I said to myself, “this is not for me; let them do what they want and I’m out of it,” and then unfortunately, I dropped the project. I let it slide and the positive change that I was working on so hard was not delivered. I was reflecting on it and I felt that that was a moment where I really didn’t have enough resilience to do the right thing. As a leader one’s purpose is to propel positive change, do the right thing, sometimes no matter what others may feel about
That taught me a lesson. Resilience is something that I keep working on every day. I know that, as a woman, as a leader, and as a person, being liked or not liked by others should not influence my vision. As a leader you’re probably not going to be liked by many people, but being okay with that is something that not everybody can do well. What helps is developing that resilience, but also keeping relationships and being respectful. At the end of the day, as a leader, you have to be out there on the front lines delivering positive change.
Kornacki: Exactly, bigger purpose. I’ve thought that if a leader is trying to promote a change, it’s not a way to win a popularity contest, and so as you say, you can’t care about that as much, but keeping your eyes on the prize, the higher purpose or what you’re really trying to bring about for the better clinical outcomes or for the patients.
Well. Thank you, very much. This has been delightful to sit down and talk to you.
Nowosielski: Thank you.
This story was recorded live at the Institute for Healthcare Improvement’s 29th Annual National Forum in Orlando, Florida, on December 10–13, 2017, by Mary Jane Kornacki on behalf of NEJM Catalyst. 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.