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MCH Working Conference:MCH Working Conference:The Future of Maternal and Child Health LeadershipThe Future of Maternal and Child Health Leadership
Dominick P. DePaola, D.D.S., Ph.D.Dominick P. DePaola, D.D.S., Ph.D.The Forsyth InstituteThe Forsyth InstituteApril 19, 2004April 19, 2004
LEADERSHIP LEADERSHIP
AND AND
THE PUBLIC GOODTHE PUBLIC GOOD
SUMMARY THOUGHTSSUMMARY THOUGHTS
• The true test of leadership is to ask: “Are those who would participate in leadership equipped to serve the common good?”
• Leadership is the practice of helping people envision and then participate in creating a better world
• Leadership is about creating a caring culture: People Come First!
• Leadership is about exceeding expectations (Disney)
• Influencing change is the business of leadership!
““A leader is one who mobilizes others A leader is one who mobilizes others toward a goal shared by leader and toward a goal shared by leader and
follower”follower”
Willis, G., Certain Trumpets – The Call of Leaders, NY, Simon and Shuster, 1994
LEADERSHIP WORKING DEFINTION ILEADERSHIP WORKING DEFINTION I
““Leadership is a Leadership is a dynamic relationshipdynamic relationship based on mutual influence and common based on mutual influence and common
purpose between leaders and purpose between leaders and collaboratorscollaborators in which both are moved in which both are moved to higher levels of motivation and moral to higher levels of motivation and moral
development as they effect development as they effect realreal, , intended changeintended change.”.”
LEADERSHIP WORKING DEFINTION IILEADERSHIP WORKING DEFINTION II
Roast, J, Leadership for the 21st Century
New York, Praeger, 1991
INGREDIENTS FOR SUCCESSFUL AND INGREDIENTS FOR SUCCESSFUL AND EFFECTIVE LEADERSHIPEFFECTIVE LEADERSHIP
LEADERSHIP FOLLOWERSHIP
• Agreement on process of establishing common goal
• Agreement on common good (goal)
• Context
• Environment
• Agreement on outcomes (success) measures/intended change
COMMON COMMON GOOD GOOD
(GOAL)(GOAL)
ATTRIBUTES OF THE EFFECTIVE LEADERATTRIBUTES OF THE EFFECTIVE LEADER
The ABILITYABILITY to
move multiple constituencies
be flexible and tolerant of disparate positions
be “savvy” about the political/social landscape
create coalitions, partnerships and collaborations
nurture interdisciplinary and cross-cultural approaches
The WILLINGNESSWILLINGNESS to
take risks and push the envelope
challenge traditional values and the status quo
exhibit sustained resolve
In order to achieve the common good, leadership must have definitive characteristics:In order to achieve the common good, leadership must have definitive characteristics:
LEADERSHIP STYLES ARE JUDGED ON GOALS LEADERSHIP STYLES ARE JUDGED ON GOALS AND THEIR PURSUIT:AND THEIR PURSUIT:
+ Arrogant - “our” goals are best
+ Confrontational - conflicting goals
+ Plodding - meeting perceived needs
+ Regressive - low level goals
+ Status quo - goals may be good but implementation is slow
+ Visionary - pushing the “envelope” – true shared vision
Leadership: Eight Steps to Rapid ChangeLeadership: Eight Steps to Rapid ChangeEquipped with the necessary attributes and passion, leaders spring into action:Equipped with the necessary attributes and passion, leaders spring into action:
1. Sound a Bugle
2. Give Them a Compass
3. Unleash Your Change Ninjas
4. Shake Up the Status Quo
5. Sing from the Same Songbook
6. Focus Your Workforce
7. Ignite Unbeatable Performance
8. Let Go of the PresentMcPherson, C., Wittemann, K., Inspiration or Desperation: Companies Change When People Care, Summerville, 2004
If Benjamin Franklin had If Benjamin Franklin had tried to be a General and tried to be a General and George Washington had George Washington had
tried to be an Inventor, we tried to be an Inventor, we would probably be living in would probably be living in
a British Colony without a British Colony without electricity!electricity!
Do Thine Own ThingDo Thine Own Thing
Questions To Ponder I:Questions To Ponder I:
1. What kind of leadership do you practice?
• Simple
• Transformational
2. Does the leadership you exhibit move both leader and collaborators to a higher level of moral development?
3. Do you take public need and social responsibility seriously?
4. Who is on the leadership team?
• Does the team have the appropriate mix of qualities?
• Is there attention paid to cross-sector partnering?
THE COMMON GOODTHE COMMON GOOD
What is the “Common Good”?What is the “Common Good”?• Increase access to care and effective use of access
• Eliminate oral health disparities
• Engage the community in expanding the community capacity for enhancing the wellness of its pediatric population
• Expand community-based education and clinical care
• Improve public schools
• Improve science education and functional literacy
• Engage in health care reform debate, including appropriate reimbursement models
• Work toward a unified health system
•Scientific and technological advancements are at all time high
•Pediatric oral health care is in a crisis
high prevalence of disease
limited access to care
limited use of access
•Perceived value of oral health is still problematic
Public Paradox Relative to Children’s Oral HealthPublic Paradox Relative to Children’s Oral Health
A NATIONAL CALL TO ACTION TO PROMOTE A NATIONAL CALL TO ACTION TO PROMOTE ORAL HEALTHORAL HEALTH
ACTIONS:ACTIONS:
Change Perceptions of Oral Health
Overcome Barriers by Replicating Effective Programs and Proven Efforts
Build the Science Base and Accelerate Science Transfer
Increase Oral Health Workforce Diversity, Capacity, and Flexibility
Increase Collaborations
SG, Call to Action 2003
TO ADDRESS THE PARADOX, AN TO ADDRESS THE PARADOX, AN EFFECTIVE LEADER NEEDS:EFFECTIVE LEADER NEEDS:
•Legitimacy
•Public Trust
•360 degree view
•Communication and engagement skills
•Flexibility
•Courage
•Unwavering commitment to realizing a vision
OBSTACLESOBSTACLES are those frightful are those frightful things you see when you take your things you see when you take your
eyes off youreyes off your GOAL.GOAL.Henry Ford
These are some clips from real responses of These are some clips from real responses of students to exam questions (Jay Leno):students to exam questions (Jay Leno):
• H2O is hot water; and Co2 is cold water
• Water is composed of two gins, Oxygin and Hydrogin. Oxygin is pure gin and Hydrogin is water and gin
• Vacuum: a large empty space where the Pope lives
• The place where people speak Gaelic is San Francisco
• For a nosebleed; put the nose much lower than the heart until the heart stops
• Pyramids were built for shade
Gaining support and excitement from the community, Gaining support and excitement from the community, the effective leader must:the effective leader must:
• Exhibit caring, passion and compassion about the common good
• Communicate a shared vision for the common good
• Engage the consumer in an advocacy role
• This is where the rubber meets the sky!This is where the rubber meets the sky!
EFFECTIVE EFFECTIVE LEADERSHIP UNFOLDS LEADERSHIP UNFOLDS
FROM THE COMMON FROM THE COMMON GOOD!GOOD!
Questions To Ponder II:Questions To Ponder II:
1. Who should define our priorities?
2. Are your priorities connected to perceived and/or real public values and need?
3. Is the apparent public paradox related to oral health a failure of leadership?
4. Are health disparities in general a leadership failure per se or a failure to create leadership in the public good?
5. Is partnering with the community a critical approach to improve health outcomes?
LEADERSHIP AND THE PUBLIC GOODLEADERSHIP AND THE PUBLIC GOOD
A COMMUNITY-ORIENTED A COMMUNITY-ORIENTED HEALTH MODELHEALTH MODEL
Individual Patient Care
Access to Care
Direct Socioeconomic Influences
Broad Socioeconomic Influences
Global Health Influences
Domains of Professional Obligation Domains of Professional Aspiration
Model of Physician Responsibility in Relation to Influences on Health
JAMA, January 7, 2004, Vol. 292, No.1, Pg. 95
Community-Oriented Health ModelCommunity-Oriented Health Model
Communications
Community NeedsCommunity Capacity
Partnership(s) Contracts
Educators Practitioners Caregivers Citizens
Health Professions
Schools
Community Empowerment
HEALTH OUTCOMES
Determinants of Health
Outcomes
Higher Health Level• Safer environment• Decreased communicable diseases• Decrease chronic diseases• Improve immunization• Improve access to care• Decrease prevalence of oral disease
• Higher level of self-care• Improved nutrition/food supply• Improved literacy• Reduced poverty• Improve specific health status measures• Improve utilization of health services
Based on an understanding that a public good is worth Based on an understanding that a public good is worth pursuing, leadership must:pursuing, leadership must:
+ Understand community need
+ Understand community capacity
+ Be willing to engage societal issues consonant with academic or public health mission
+ Be willing to establish shared goals and implementation strategies
+ Be willing to understand community expectations
+ Be willing to measure success outcomes
+ Be willing to be both flexible and persistent!
PRACTICAL LEADERSHIP:PRACTICAL LEADERSHIP:+ Make work fun!
+ Use celebrations to create relationships
+ Equip people to make decisions
+ Become a “risk doctor” – help people recover from mistakes
+ Make your organization and personal mission, vision and values clear – then hold the reins loosely
+ Stamp out bureaucracy – make rules your servants
+ Deal with people, not positions
+ Train for skill – Hire for spirit, spunk and enthusiasm
+ Look for creative, unconventional ways to tell your story
+ When serving others (the community), make sure that “good enough” is never good enough Freiberg, K, Freiberg, J, Nuts,
New York, Broadway Books, 1996
Questions To Ponder III:Questions To Ponder III:
1. Can you define your customers?
2. Do you perceive leadership as a position of power?
3. Do you believe the “Lone Ranger” is an appropriate leadership metaphor?
4. Do you believe that leaders are servants by nature?
5. Do you believe people are born leaders?
MAKE VISION THE BOSS!MAKE VISION THE BOSS!
LEADERSHIP IS ALL ABOUT LEADERSHIP IS ALL ABOUT PEOPLE AND MAKING PEOPLE AND MAKING
THINGS HAPPENTHINGS HAPPEN
There is a Special Place in Hell Reserved for the Morally
Indifferent and Safely Neutral.
- Dante