The KISS Principle

Molly Rowe, for HealthLeaders Media, February 1, 2008

When Donald Trump unveiled Celebrity Apprentice, a star-studded twist on his popular television reality series, my skeptical side said, "Great, yet another show where virtually unknown D-listers try desperately for a shot at real fame." But the inner optimist (and reality junkie), screamed, "A business competition with big stars and huge egos? Where's the remote to my TiVo?"

Given the serious premise of the show--uncovering a business guru savvy enough to be the next Donald Trump--I hoped the show would attract some high-caliber celebrity contestants. That was unfortunately not the case (you know America's in trouble when a detox-based show called Celebrity Rehab attracts bigger names than a business competition), but the show nonetheless is a fascinating case study in business strategy and leadership style.

Take the recently fired Gene Simmons, for example. Metal music fans remember Simmons as the painted-face lead singer of KISS, a 1970s metal band, but today he may be better known as Trump's bossy former employee. As a leader, Simmons was arrogant, unwavering, Machiavellian. In one episode, he proudly dubbed his leadership style a "benevolent dictatorship." He manages with an iron fist, and he wouldn't know the meaning of teamwork if it knocked off his ever-present sunglasses.

As far out as it seems on reality TV, Simmons' style typifies what was until recently the traditional American leader. Twenty years ago, Simmons would have been elevated to the ranks of CEO or physician leader. Today, he's one of the first to be fired.

Simmons' firing reinforces the research of Harvard Business School professor Linda Hill. Hill's studied leadership around the globe, including in emerging markets like China and Eastern Europe. Her research points to the changing face of leadership. Leaders of the future, Hill says, will no longer fit the Simmons-esque style of management. Instead, they must be collaborative, flexible, and open-minded if they want to be successful.

The same is true in hospitals. Earlier this month, I wrote a column Docs Are People, Too. Unfortunately, they don't always act it. The traditional physician leader is often portrayed much like Simmons--inflexible, dictatorial, and a tad sexist. Physicians are perceived as all-knowing, and up until a few years ago, neither nurse nor patient dared question the authority of a physician--even if he was clearly wrong.

Beth Israel Medical Center in New York City has adopted the OR Empowerment Program to overcome this way of thinking. Under this system, anyone in the operating room has the power to stop a procedure at any time by calling an "OR stop." The person who called the stop, their supervisor, the attending surgeon, and the anesthesiologist then have an immediate discussion about why the stop was called, what might be wrong, and what can be done about it. "We want to get over the time where surgeons were the gods, the kings in the room that everyone's afraid of. That doesn't breed the environment where people will talk up or say something's not right," explains Dr. Donald Kastenbaum, the head of Beth Israel's OR.

A few weeks ago, I was talking to a friend of mine about healthcare. She's a successful executive--confident, outspoken, and opinionated. She wouldn't think twice about challenging her boss, but she said she's still not comfortable asking her doctor if he's washed his hands. Her comments reminded me that all the patient education posters in the world won't overcome the traditional image of doctors as indisputable experts. It's up to healthcare leaders to monitor the culture of physician-patient/physician-staff relations and to implement programs like OR Empowerment to ensure that necessary, life-saving questions are asked (and heard).

Business strategy experts say the Gene Simmons style of leadership stifles growth and holds companies back. In healthcare, however, heavy-handed leaders can have a much graver effect.

Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at
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