Sept 28, 2017 | Jennifer H. Mieres, MD, FACC and Stacey E. Rosen, MD, FACC
WIC Book Review

Total Leadership is a must read for all women in cardiology, as it highlights the importance of improving your ability to function in all the significant areas of your life: work, home, community and self. As female cardiologists, we continue to focus on addressing the reasons we have been unable to increase the number of women entering our field over the last several decades. This is occurring despite the fact that women make up half of the entering classes in medical school and half of the interns beginning their training in internal medicine. The challenge of managing a demanding profession while also “having a life” is frequently cited as a concern for many young female physicians.

The book offers a structured approach to optimizing the intersection of your career and personal interests, particularly when you have multiple responsibilities tugging you in different directions. The focus on our “whole person,” not merely our “professional person,” is the central theme behind what Dr. Freidman refers to as, “four-way wins – better results at work, at home, in the community and for yourself.”

The efficacy of Dr. Friedman’s technique is related to the fact that the reader is asked to define the issue, starting with the multiple responsibilities and challenges that he or she faces. The next steps are to define your domains and establish a time schedule for different tasks. 

Dr. Friedman asks his readers to begin by considering the following three principles: 1. Be real, 2. Be whole, and 3. Be innovative.

To be real is to act with authenticity by clarifying what is important to you.

To be whole is to act with integrity by recognizing how the different parts of your life (work, home, community and self) affect one another. One needs to have overall respect for the whole person.

To be innovative is to define what is important to you and find the connections to work, home, community and self. You act with creativity by experimenting with how things get done in ways that are good for you and for the people around you.

As you build bridges between domains of your life, you learn to create boundaries that allow for the important and meaningful components of your daily life. Viewing your needs as a “whole” rather than a balance of competing needs removes the idea of a work-life balance, where the needs are somehow competing and fundamentally representing a trade-off. Instead, it allows each of us to make decisions that are tailored to our different life experiences and situations.

Total Leadership begins with:

1. Identifying what is important to you – What is your life story? What are your core values? Who are your heroes?
2. Identifying your personal domains – What is work, family, community and self? Define these domains based on their importance and the percentage of time spent focusing on them.
3. Using those insights to define your leadership vision – What does your “achievable future” look like?
• Creatively explore possibilities for experiments
• Select and implement a few at a time

The idea is to design experiments – small, short-term adjustments to your daily routines that incorporate and mutually benefit the various aspects of their lives.

A few highlights from the book worthy of immediate implementation are:

Act with authenticity by clarifying what is important.
This process is the critical starting point and requires focus, reflection and honesty.
You begin the process by thinking, writing and talking with peer coaches to identify your core values and describing your leadership vision. Identify the current alignment of your actions and values, thereby clarifying what is important.

Finding a coach may be useful.
Coaching provides an outside perspective, or sounding board for your ideas, and personal challenges. It gives you a fresh way to see the possibilities for innovation and helps hold you accountable to your commitments.

Design an experiment to improve all domains of your life.
Friedman describes nine key components for success: 1) Tracking and Reflecting, 2) Planning and Organizing, 3) Rejuvenating and Restoring, 4) Appreciating and Caring, 5) Focusing and Concentrating, 6) Revealing and Engaging, 7) Time Shifting and “Re-Placing,” 8) Delegating and Developing, and 9) Exploring and Venturing

Three of the nine components highlight critical components for success:

1. Tracking and Reflecting
• Key components to getting to know yourself are strengths and limitations.
• Keep a record of activities, thoughts and feelings (and perhaps distribute it to friends, family, and coworkers) to assess progress on personal and professional goals, thereby increasing self-awareness and maintaining priorities. For example, record visits to the gym along with changes in your energy levels and track the times of day when you feel most engaged or lethargic.
2. Appreciating and Caring
• Have fun with people (typically by doing things with coworkers outside of work), care for others, and appreciate relationships as ways of bonding at a basic human level to respect the whole person, which increases trust. Join a book group or health club with coworkers.
• Devote one day a month to community service. Spend time describing how these activities impact your overall well-being.
3. Time Shifting and “Re-Placing”
• Working remotely or during different hours increases flexibility and thus better fits in with community, family, and personal activities. This increases efficiency while questioning traditional assumptions and trying new ways to get things done. For example, work from home, take music lessons during your lunch hour, or work during your commute in order to do something that you previously did not have time to do.

Total Leadership gives you the tools you need to achieve “four-way wins”— improved performance in all domains of life: work, home, community and self. The individuals cited throughout the book are very relatable and represent many of the challenges we all feel. Total Leadership is about creating sustainable change to benefit you and the most important people in your life. It provides a structured series of steps that highlight the importance of equilibrium among the different parts of your life as a leader. The book debunks the concept of "work-life balance” and focuses on creating harmony among the different parts of your life as a leader.

Professor Friedman provides a programmatic method which helps define the things that are important to you, strengthen connections with the people who matter most to you, teach you how to produce stronger results at work, find clearer purpose, feel less stressed, and gain greater support for the vision of your future. Overall, it is an excellent and engaging read!

---

This article was authored by Jennifer H. Mieres, MD, FACC, professor of cardiology, associate dean of faculty affairs at Hofstra Northwell School of Medicine, and senior vice president for the Center of Equity of Care, Chief Diversity and Inclusion Officer at Northwell Health, and Stacey E. Rosen, MD, FACC, associate professor of cardiology at Hofstra Northwell School of Medicine, vice president for Women’s Health at The Katz Institute of Women’s Health at Northwell Health.