Build Leaders Through Delegation

Everyone has their area of weakness, and my area of weakness is delegation. As a surgeon, you tend to be a micromanager, but that is not the effective way to build and lead leaders. What you really need are leaders who are able to make decisions, can have authority, and yet be held accountable. That was not something that I really learned in my training, so I had to learn it from scratch.

When I was a chief resident — so I’m in my final year of residency — but not a fully fledged surgeon yet, and overseeing all the interns, we would go and make rounds on the patients in the morning. We’d set a plan, and then they’d be expected to deliver on the plan. Discharge Mrs. so-and-so. Get X-rays on this other person. Change the medicines on Room Number 3. And then I do a little check in the middle of the day on the computer and see that, “Oh my god, none of this has happened yet.” And the easy thing to do, which I did all too often, is just go ahead and fire in the orders myself and say, “I’d asked you to have all of this happening. Why hasn’t it happened? Let’s talk about it at rounds in the afternoon.” I always felt, “This outcome is too important. I’ll just do it myself.” And that was never going to get to the better result that we’re all aiming for, which is a system that’s going to work for the patient.

So I had to be either patient enough to then inquire at the end of the day, “Okay. What went well? What didn’t go well, and why? And how can we do better?” Or if I didn’t feel that was safe, then go speak to this person myself rather than fire in the orders in their place. I had to be able to empower them to solve the problem. Either there were problems I didn’t recognize, and that’s the reason why things hadn’t happened and they’d exercised some judgment that this was the right thing to do, or they weren’t able to perform and we needed to be able to talk through and address that.