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James Brink, MD, is chair of the Department of Diagnostic Radiology and a professor of diagnostic radiology. We had the privilege of speaking with Dr. Brink recently to discuss his leadership philosophy. He shared stories with us about the mentors who helped shape his leadership values and talked with us about the challenges facing leaders today.

When I was an intern, I spent one month on a private neurosurgery service at Methodist Hospital in Indiana that was known to be exceptionally demanding. Julius Goodman, MD, was an exacting neurosurgeon who worked tirelessly and expected the same of his house officers. However, it proved to be one of the most rewarding and memorable experiences of my medical career. Dr. Goodman always gave of himself as much as he asked in return. He treated each and every person on his service with respect and kindness, no matter how tired or emotionally drained we all were. In short, Dr. Goodman treated his patients, his trainees and his colleagues as if they were members of his own family.

Dr. Goodman taught me that strong leaders must be excellent communicators. They must communicate often and do so in a meaningful way. He taught me that good leaders must respect each person on the team and value each person for their accomplishments regardless of the magnitude of their contributions. Finally, Dr. Goodman believed in leading by example, a trait that I have sought to emulate on many occasions. I was sorry to learn that he passed away in 2008.

In 1988, I was a resident in diagnostic radiology at Massachusetts General Hospital when Jim Thrall, MD, took over as chair of the department. Although I didn’t fully appreciate it at the time, Jim faced a daunting uphill climb. The department was composed of many strong personalities, some held by individuals who thought that they should have been given Jim’s job. Moreover, the climate was one where individual academic accomplishments often trumped teamwork for the benefit of the patients.

Dr. Thrall entered this environment and began the slow and painful process of fostering cohesion among his faculty. He did this by building consensus within the department for some important new initiatives related to quality and safety, long before quality and safety were viewed with the importance that they are today. Dr. Thrall’s style was not that of an autocrat; rather, he brought people along with his ideas that led to a shared vision for a better department. His style was not to legislate but rather to build change slowly and consistently with buy-in from all major stakeholders.

I completed my resident and fellowship training shortly after Jim arrived, but I’ve had the pleasure of returning to the MGH in one capacity or another every few years. During these trips, I have come to understand what a major transformation that Jim had effected. The department had lived through some difficult times early in his tenure as chair, but his faculty emerged highly focused on best practices and efficiency in their academic missions.

Every leader should possess a willingness to lead collaboratively whenever possible. Decisions that are made collaboratively usually come from a vision that is shared and accepted by the leaders’ constituents. Good leaders must be willing to listen to divergent opinions and keep an open mind. They must be patient to build consensus and seek buy-in for their initiatives. However, sometimes consensus is not possible, and leaders must be willing to make difficult decisions without wavering, based on all available information.

The most important decisions are often the most difficult ones. And the most difficult decisions are those that involve a close call between benefit and risk. Should the department invest in new practice opportunities? How should the compensation plan be structured to return as much money to deserving faculty as possible while protecting the department for an uncertain future? While the specifics of these difficult decisions vary, the goal is usually the same—to best position the department for the benefit of its members and its missions.

The biggest challenge that I face as a leader is in building the careers of our junior faculty and staff. Clearly, they must do the heavy lifting, but my job is to create a vibrant environment in which they may grow in their clinical, research and educational endeavors. I view mentoring as an important part of my job, and I meet with each faculty member at least once a year to ensure that they are on a positive trajectory.

The first that thing that I consider when leading colleagues through a major transformation is to ensure that I have the right leadership team in place to address the many challenges that we will likely encounter. The benefits of the transformation must be clearly understood and accepted by the leadership team so that they may assist in communication and consensus building throughout the department. Transparency is critical to faculty member engagement in the change process, and potential barriers to success must be anticipated to ensure that sufficient resources are in place to effect change successfully.

A strong leadership team is a critical component of my leadership strategy, and I seek feedback regularly from my leadership team members. By encouraging them to express divergent opinions, I feel that we achieve a better outcome. Moreover, we all grow and develop as leaders through the feedback that we give each other in this process.

Remember that the world is rarely black and white. Most issues involve various shades of gray that can be very difficult to discriminate. No one, including yourself, is perfect. Try to find the good in everyone, and work to capitalize on each person’s strengths.