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Delivering Effective Leadership: 10 Lessons from a Chair of Otolaryngology

By John Oghalai, MD
Chair, USC Caruso Department of Otolaryngology – Head and Neck Surgery


What makes a capable clinical leader truly exceptional? The task may seem daunting, but the solutions are often simple.

During my 20-plus years as an academic otolaryngologist — as well as 5 years as a department chair at the Keck School of Medicine of USC — I absorbed a spectrum of leadership characteristics and experiences that supply the core pillars for how I manage people today.

Below, I want to share my 10 best practices that I use regularly to focus on big-picture projects and daily interactions.

The common thread: communication. Smart leaders strategize their goal pathways by informing and involving their team, and by learning from their errors and unexpected detours.

During my nightly commute, for example, I recall an important exchange from the past day — whether it be with a supervisor, a colleague or a trainee. What made our conversation effective and meaningful? What could I have done better?

Here is a portion of my thoughts — adapted from a piece published recently in The Laryngoscope — that are applicable not only to otolaryngologists but to anyone seeking to strengthen their leadership role in clinical medicine.

  1.       Set a positive example for everyone to follow

Embody the behaviors and attitudes you want your colleagues to emulate. I believe this is the most valuable rule and it sets the tone for everyone, at all levels, to deliver exceptional care and clinical efficiency.

Think about the small but vital housekeeping details, such as finishing your charting after a long day and keeping your calendar up to date — and the big stuff, including grant applications and new program development. If you don’t do it, nobody else will either.

  1.       Practice kindness, in and out of a care setting 

It may sound cliché, but there’s value in being nice. And the act needn’t be limited to your practice: Remember the big value of simple gestures, such as helping a lost hospital visitor find her way or thanking support and custodial staff across the organization.

Good leaders know that their presence is noticed. Likewise, don’t forget that your behavior, be it kind or otherwise, is a constant model for others.

  1.       Acknowledge (and celebrate) diversity in thought

Sure, you might be the boss, but you aren’t the only voice in the room. It’s important to listen to those around you — from medical students to senior faculty — and to consider and apply their input accordingly.

Of course, your core objectives must remain a key focus, even when opinions are split. This may require you to figure out what your people want and then reframe the issue to achieve it collectively.

  1.       Hire a balanced team to offset your shortcomings

Beyond having diverse thinkers in your corner, any clinical practice will benefit from a well-rounded team with different skill sets. Tapping into this resource will allow you to more carefully evaluate multiple strategies and make informed decisions to advance care delivery.

To that end, don’t fear a colleague who politely speaks out: They may have valuable insights to guide the team to success.

  1.       Recruit colleagues who have energy and enthusiasm

There’s nothing like the energy of a self-starter. You can see it on their faces, in their eyes and in their smiles. Seek to hire vibrant, motivated individuals; the results for your practice will be unmistakable.

After all, those who you must push to pursue greatness are less likely to achieve it. Team members who are inherently driven to pull you along will give the enterprise the momentum to take it to the next level.

  1.       Always have your team’s back

Mistakes and unexpected things can happen. Avoid the response to blame your team members. Strong leaders are loyal and offer unwavering support to the whole, no matter what missteps occur.

This dedication can be particularly challenging if your colleagues are vocal or place high demands on you. Leaders have a heavy load to carry, but I can attest that the effort (and endurance) is worth it.

  1.       Carefully strategize your needs and plans

Whether a project is large or small, you must plan for contingencies that affect your vision. A prime example is construction, which often takes more time and money to generate revenue than anticipated.

That’s why it’s critical to stay grounded and realistic. A first and most definitive option isn’t usually the best choice; an option that saves money or that can be expanded when your initial investment begins to pay off is the smartest bet.

  1.       Don’t lose sight of your biggest challenges

With a mountain of day-to-day tasks on your plate, it can be easy to lose sight of the horizon — aka the big-picture plans that could change the game for you and your patients. Make a concerted effort to think broadly among the chaos, strategizing ways to clear the next hurdle.

Good leaders can delegate and manage routine tasks; great ones strive to make a real difference with long-term implications. Strive to carve out time to identify new ways to execute these achievements.

  1.       Ignore the naysayers and follow your instincts

Even the most optimistic leader may find themselves sidelined by pessimism. Many people may try to convince you that a hard — yet important — task isn’t worth doing, or that it’s too complicated (“the time isn’t right” is a common refrain).

Ignore it. To accomplish big goals such as applying for a grant or creating a new training program, you need nerve. I recall the words of Walt Disney, who said “the way to get started is to quit talking and begin doing.” If you fail, that’s OK. Assess your mistakes and try again.

  1.   Make a mistake? Apologize and own it

It’s true: Strong leaders are humble, and they know when to admit they’re wrong. Having the conviction to offer an apology when it’s due also makes you a better communicator. The reason? You must think carefully about what to say (and how to say it) to resolve the situation.

A genuine apology can acknowledge the people who were wronged and provide feedback for you. In most cases, the recipient will respect your candor and transparency. And, as I can say from my own experience, the more you apologize the easier it gets.



To conclude, it’s critical to remember that leaders are recruited to drive change — and not to maintain the status quo. Evolution is rarely easy, and the process can be messy, time-consuming and stressful. It also requires vigorous discussion and debate.

By treating your employees and recruits with respect and taking their ideas and concerns into account, you are priming the organization for success. Even if the outcomes aren’t perfect, there’s no question your team will be stronger and more cohesive when tackling future endeavors.