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On Service Leadership: Q&A with YCSC Chair Linda Mayes, MD

March 09, 2023

Launched in September 2022, the Yale Child Study Center (YCSC) blog On Leadership is led by Daryn H. David, PhD, who serves as an associate research scientist at the YCSC, as well as associate director for leadership development in the Yale School of Medicine Offices of Academic and Professional Development and Diversity, Equity, & Inclusion. Prior posts have addressed the concept of conscious accountability in various settings, including the importance of connection, collaboration, and compassion in professional and personal contexts. Beginning in early 2023, the focus of the blog is shifting to highlight various service leadership principles more directly. Through a series of Q&A discussion with leaders at YCSC and YSM, the relevance and importance of service leadership for enhancing work across all domains of academic medicine will be explored. The first of these posts will be shared in a two-part series with YCSC Chair Linda Mayes, MD.

Daryn David (DD): We kicked off this “On Leadership” column in the fall of 2022 with a series of monthly posts about conscious accountability. How do you define accountability for yourself and others, and how do you think accountability could be best practiced within our department?

Linda Mayes (LM): Accountability is often seen in a negative frame—how we are evaluated and where we fell short. Service leadership practices shift our perspective on accountability to how we help each other do a better job of helping each other. I’ve spoken about our being a learning organization—that is, we are regularly thinking about how we can do better with the structures and resources that we have, while also learning from processes or practices that are not optimal. Accountability is the same—asking for a yearly appraisal of how we are doing as leaders and where we can do more to be helpful.

DD: Speaking of service leadership, in many of your recent talks to members of our department, you have stressed the importance of service and developing others. What is your working definition of this concept?

LM: From my point of view, a leader’s primary responsibility is to their community, team, and organization – and to be sure that the organization is flourishing and able to sustain its missions over years to come. In other words, a leader working in a service leadership frame has a responsibility to the team, to ensure that everyone has what they need to succeed and thrive in their work environment. While that may sound fairly traditional (e.g., ensuring the “company succeeds and grows”), the emphasis here is not on the leader’s success but on how the leader helps everyone in the group move forward.

Implications of this kind of “inverted tradition” – that is, serving the community rather than the community following the leader – include a consistent three-fold focus on 1) who is coming after us (generativity); 2) the climate and culture of the workplace to ensure respect, inclusivity, and as much as possible, the resources individuals need to thrive; and 3) on “we”—i.e., on everyone as part of a larger whole with shared goals and values. Importantly, to the latter point, medical schools are inherently hierarchical with a strong focus on both individual success and leaders progressing based on their individual achievements. Service leadership is not counter to this perspective though it may seem so at first blush. Rather, service leadership can actually ensure that individual PI’s and other leaders will have even more productive and successful teams if the teams feel cared for and recognized for their contribution to the team or the larger goals.

DD: What are some of the other complexities or points of tension that you see in the service leadership framework?

LM: Service leadership does not mean that all decisions must be made by consensus. This is neither possible nor practical. In the end, the leader is still responsible for the organization and makes the final decision(s). But leaders operating in the spirit of service leadership should still be as clear as possible about the whys and implications of any decision and when possible, seek input and engage others in the process.

Additionally, service leadership does not mean that organizations will not have challenges or won’t have to change. Indeed, change is inevitable, particularly in the healthcare world. In fact, academic medicine has been steadily changing over the last decade and this has only accelerated with the pandemic. There is much more emphasis on clinical practice, financial sustainability, and explicitly stating the value proposition for having an academic mission woven into a very large and growing clinical mission. Across the country, the driving force in academic medicine has become the clinical mission, informed by research – but research is less the driving force financially than are the clinical needs.

In this rapidly changing environment, a leader following service leadership principles must still recognize the changing environment and engage community members in adapting to the continued changes ahead. Such adaptations should be designed collaboratively and not forced, but still need to happen for the overall health of the organization.

DD: What does service leadership mean for day-to-day operations and the way that we do business at the YCSC?

LM: I hope we are growing into this concept, for we are a traditional department in an academic medical center—and we are also part of a large center with diverse missions and needs. There are several ways I feel the concept of service leadership is already playing out in our diverse community, including that we have been explicitly talking about leadership and offering workshops and ways everyone can start to build specific leadership skills that will also serve the notion of service leadership – that is, bringing teams together, running effective meetings, being a more effective mentor and sponsor, and handling difficult conversations.

We also have a more explicit and increasingly structured emphasis on mentorship and skill development broadly. If everyone in our community feels they have opportunities to grow and learn, we will have a healthier, more engaged community. Another way in which service leadership is evident is embodied by our diversity action group and the work they have been doing to engender a climate of respect and inclusivity. Leaders can only serve their community if they are trusted, convey respect for diverse points of view, and remain open to discussion and critique.

Additionally, we have worked to be more transparent about the organizational structure of the center while also creating more opportunities for leadership experience across the department, with training provided for that leadership. We have also begun regular assessments of leaders at all levels so we can all be learning together. Dean Brown leads a yearly assessment of chairs which is very helpful to me – and we need to do this internally as well, so we can be learning and improving steadily with internal feedback.

Finally, I would like to add that I am always open to meeting with members of our community to hear about not only their needs but also any concerns and ideas. The only way a leader can function in this service mindset is to encourage and have open dialogue – and I endeavor to do this on an on-going basis.

Look for more on service leadership with Dr. Linda Mayes in April.

Submitted by Crista Marchesseault on March 08, 2023