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Joshua DeKlotz
LDRS 450: Contemporary Issues of Leadership
Dr. Josh Armstrong
September 30, 2020
Leadership Interview Reflection Paper
Dr. Helen Taussig was arguably one of the most accomplished and influential women to

grace the field of medicine. Born in 1898, she is commonly credited as the founder of the field of

pediatric cardiology and notably developed a procedure that extends the lives of babies born with

blue baby syndrome. What made Dr. Taussig especially remarkable was her ability to connect

and communicate with her patients. Dr. Taussig was mostly deaf as an adult, and relied on lip-

reading and non-traditional methods of communication. Astonishingly, Taussig was able to use

her fingers to literally “feel” the heart rhythms of her patients, allowing her to diagnose and

understand her patients in an unprecedented manner. Taussig went on to win numerous awards

and commendations, notably becoming the first woman to be the head of the American Heart

Association, and winning a presidential medal of freedom.

When I interviewed Dr. Paul Francis, a retired pediatric cardiologist, about leadership in

the field of medicine, he stated “it is important to realize that we are standing on the shoulders of

giants,” referring to Dr. Taussig as one of his personal heroines. Caring about legacy and how

one shapes the people that come after oneself was one of the major themes that Dr. Paul

emphasized in our conversation about leadership. Dr. Paul went on to narrate a story about the

first time he met Dr. Taussig, the joy emanating from his smile as he spoke of her. Dr. Paul went

on to talk about how he had received a plant that had belonged to Dr. Taussig, and as an act of

symbolism and rite of passage, he has given a leaf from that plant to each of the pediatric

cardiology students that he has helped teach and inspire. Dr. Paul was moved almost to tears just

recounting the story to me, which was incredibly inspiring as a young and aspiring physician to
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get a glimpse of the fulfillment and pride that come from a lifetime of teaching, leadership, and

mentorship. From this interview, I hoped to get a taste of some wisdom learned from a lifetime

of medical practice and leadership. I had the pleasure of interviewing Dr. Paul to discuss his

experience with leadership qualities, the practice of leadership, servant leadership, and some

personal philosophies about the practice of medicine.

Dr. Paul Francis is an exemplary model of a lifetime of leadership in the medical field.

Dr. Paul was the oldest child, a leader within his own family of sorts. He identified leadership

qualities in himself from a young age. His academic success was spurred in high school when he

won the “Harvard Book Club Award,” which partially led him to declare one day to his family in

the car that he was going to be a doctor someday. He attended UC Davis medical school and

graduated in the 5th cohort to come out of the newly established institution. Picking a specialty

was not a straightforward process. Dr. Paul was staunchly determined to go into orthopedic

surgery, but was discouraged from that particular career path after he witnessed a surgery in

which a drill bit broke while piercing into a bone, and a team member had to run down to the

hardware store to pick up a replacement. In his words, this experience made him say “no way!”

to orthopedics. Dr. Paul discovered his passion for cardiology in a unique way: listening to his

father’s records of heart sounds on their record player. Dr. Paul recounted how fascinating and

beautiful it was to simply sit and listen to the heart. During one of his shifts in the ER, the time

listening to the heart paid off, as he was able to identify a heart irregularity just by matching its

sound to what he recognized from the record player—a diagnosis all of his peers and higher-ups

were impressed with, no doubt.

Dr. Paul became more interested in cardiology, reading a book about EKGs over break.

His newfound knowledge of cardiology made him the “heart guy” among his peers. They called
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him the “heart guy” for a reason, as he received the leadership award and was distinguished

among his peers as a resident. Dr. Paul went on to do his fellowship at Cincinnati Children’s

hospital. Dr. Paul went on to hold other leadership roles including the chief of Pediatrics at

UCSF, chief of pediatric cardiology and of all pediatric subspecialties, president of the Western

Society of Pediatric Cardiology, and now teaches young pediatric cardiologists at the Oregon

Health and Science University—cementing his personal philosophy that a leader is someone who

is equally committed to both learning and teaching. As another fun fact, he is also fluent in

Spanish with a deceptively convincing Argentinian accent.

Dr. Paul and I began our conversation on leadership discussing how he had seen

medical leadership evolve throughout his tenure and what qualities he envisions in an effective

leader. Dr. Paul noted that when he was a younger doctor, he noticed that there were sometimes

flaws in the system that chose its medical leaders. He noted that it was common for people to be

promoted to leadership positions of given authority for “the wrong reasons,” including things

like research success, lucrative practice, academic reputation, or even skill as a clinician. While

Dr. Paul noted that all these traits are good and important, they do not necessarily make one a

good leader in practice. Leadership positions were sometimes seen as rewards--bestowed for

pleasing the people in charge. According to Dr. Paul, this led to some real “hit or miss”

leadership candidates. In his book, The Practice of Adaptive Leadership, Ronald Heifetz notes

that “the formal authority of your position is not enough to effect change” (Heifetz, 2009, p. 52).

In the past, it was simply a product of the system when underqualified leaders were put in

positions of authority. Heifetz notes that it is common for organizations to “get trapped by their

current ways of doing things, simply because these ways worked in the past” (Heifetz, 2009, p.

51). However, it takes leadership to notice ineffective practices and change them. Dr. Paul
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explained how he has seen a shift in medical leadership over the years, and how he has played an

active role in changing the way that medical leadership is cultivated. Dr. Paul discussed how he

took part in “leadership lunches” in which principles of effective leadership were discussed with

young people in the field. Dr. Paul believes it is a much rarer occurrence now to be chosen

wrongfully as a leader, since different leadership qualities are cultivated and appreciated in

modern medicine.

There is a saying that leading in medicine is like trying to herd cats. Dr. Paul noted that

there is some truth to this saying. When working with medical professionals, you are working

with a group of people who have all, for the most part, achieved great academic and professional

success in their endeavors. Some level of confidence, stubbornness, and ego tend to accompany

that success. Heifetz offers a similar observation, “As tried-and-true patterns of thinking and

acting produced success for the organization, they also produced success for the individuals who

embraced those patterns…Moving away from what has worked in the past is especially difficult

for people in midcareer who have enjoyed considerable professional success” (Heifetz, 2009, pp.

51-52). Alas, medicine is a dynamic field. With new technologies, procedures, laws, finance, and

protocols affecting medicine every year, flexibility and adaptivity are crucial to the success of a

functioning medical organization. An effective leader must be able to diagnose situations,

manage the self, and energize others. Dr. Paul believes the key to this is maintaining personal

relationships. To paraphrase, he told me that the most important thing one can do to cultivate

relationships as a leader through every interaction is to make the person you are talking to feel

like they are the most important person in the world to you while you are with them. Leadership

is built from the ground-up by maintaining genuine connection with colleagues and creating an

environment in which they can best thrive. Our leadership literature discusses the importance of
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“getting on the balcony” to enhance your perspective of the systems and people around you. I

believe it is impossible to interpret a “balcony” perspective without context and relationships

built with the people you are observing. This is especially important in the field of medicine—an

extremely emotional, stressful, and human profession that is hard to understand fully from the

outside.

An effective leader is not necessarily the chief problem solver as much as they are the

chief cultivator and team builder. Dr. Paul noted that in one of his leadership positions at UCSF,

he was assigned the role of chief of pediatrics while doing a minimum amount of pediatrics. This

echoes a sentiment from O’Malley’s and Cebula’s Your Leadership Edge, in which the authors

note that “leadership on adaptive challenges is less about implementing solutions and more about

creating the conditions for those with the problem to solve the problem. Leadership is mobilizing

others to make progress on daunting challenges” (O’Malley & Cebula, 2015, p. 44). Dr. Paul

also emphasized this when discussion his idea of healthcare as a team effort among many

physicians, nurses, and specialists. One thing he said that stuck with me is that he would always

tell his students to start rounds by asking the nurse that was on overnight duty what they had

observed overnight before consulting the charts or data. A leader knows and appreciates the

contributions and worth of all members of a team and creates an environment for the team

members to thrive. Dr. Paul rejects the “I’m the Boss” mentality. Especially in healthcare, there

are no individual winners or losers; any success is shared success among doctor, nurse, and

patient alike. One other personal philosophy that Dr. Paul shared that I resonated with was that

he would never ask “can we….?” He would always ask, “how do we…?” I thought this was

another small indication of Dr. Paul’s commitment to the team mentality and “mobilizing others

to make progress” as mentioned in Your Leadership Edge.

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Dr. Paul also shared some other general advice and wisdom with me about how to be

successful and happy in the field. Firstly, we talked about the importance of keeping medicine

personal. It is becoming more normal to solve medical problems with technology, machines, or

medicines, but there is a significant part of medicine that cannot be done by mere technology.

The most vital part of medicine is the human aspect—the patient contact—that keeps medicine

personal and intimate. Dr. Paul expressed how he would do little things to establish physical

connection like putting a hand on a shoulder while listening to heart sounds. Small things like

this allow a patient to know that they are cared for by another human being who values their

physical presence. Another thing we discussed was the necessity for a deep desire to serve.

Medicine is a terrible field to go into if you seek power or glory. It is too hard, demanding, and

draining of a job to do without a deeply held passion for your work. At the heart of this passion

is the will to serve others which connects to the idea of servant leadership. Lastly, we discussed

the importance of keeping the wonder in what you do. The human body, mind, and spirit are

wonder-filled things, and maintaining a sense of awe and curiosity help to sustain one’s passion.

As Dr. Paul said, “listen to the heart,” which resonates in both the literal and metaphorical. After

reflecting on this experience, I am coming away with a reminder to keep my sense of awe, a

fresh perspective on what leadership means in the field of medicine, and a reminder to stay

humble, because we are standing on the shoulders of giants.

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References

Heifetz, R. A., Grashow, A., & Linsky, M. (2009). The Practice of Adaptive Leadership: Tools
and Tactics for Changing Your Organization and the World. Harvard Business Press.

O'Malley, E., & Cebula, A. (2015). Your Leadership Edge: Lead any Time, Anywhere. KLC
Press, Kansas Leadership Center.