A Short Note and a Short Break
I’m not going to publish a post this week, and I may not for a couple of weeks after that. My father passed away this week. I’ve built this blog around a belief that leadership and communication mean nothing if…
Voice That Moves
Leadership Lessons They Don't Teach in Medical School
Voice That Moves
Leadership Lessons They Don't Teach in Medical School
Dheeraj Raina
Leading Peers: How to Influence People Who Don’t Report to You
When I became chief resident 25 years ago, the title came with a $1,000 a year increase in stipend and authority over the call schedule — yet I still spent the year asking peers for favors. That paradox opens a hard truth about medicine: authority rarely works, even when you have it. Every physician is independently licensed, and replacing an unhappy one costs a fortune. So leaders at every level run on influence, not authority. Drawing on a spring-break scheduling standoff between two psychiatrists I once supervised, we see how to move people who don't have to move — asking before telling, letting facts speak, reframing the stakes, and let them find their way. And when influence fails? Protect the relationship and try a different key.
Why New Leaders Shouldn’t Trust Their First Instinct
Early in my first leadership role at a state psychiatric hospital, I learned that a patient was sitting on a locked ward, psychotic and untreated, because her physician had never filed a court petition for involuntary treatment. My first instinct was discipline — the union process, the medical staff committee. A mentor stopped me with one simple question that helped me see that the doctor wasn't indifferent. He was inexperienced, having never petitioned a court in his long career. A verdict reached in anger became a conversation, a learning moment, and a treated patient. This post uses that story to show new leaders why a verdict reached early may be wrong, and why having a mentor is a necessity when stepping into leadership.
What Physician Leaders Must Do Before Deploying ‘AI Therapy’
AI chatbots are everywhere. Some people now treat them as therapy. They aren't. This post draws a clear line between emotional support — comfort, listening, reassurance, available from almost anyone — and psychotherapy, which is a clinical treatment delivered by a trained professional who assesses, diagnoses, and is accountable for the result. Using psychiatrist Dr. Steven Reidbord's gym-versus-cardiologist comparison, it explains why tools engineered to be agreeable are excellent at comfort but unfit for care. Confusing the two has already cost lives. Physician leaders have a special responsibility to help their organizations see the difference. This post shows them how.
Why You Are Both Cabo Verde and Argentina
On Friday, a nation of half a million people took the defending World Cup champions to extra time. And lost on an own goal in the 111th minute. Cabo Verde's story is being told everywhere as an underdog triumph, and it is one. But there's a second story sitting on the other bench, and leaders need it more. Argentina nearly lost because their winning ways had quietly taught them the wrong lesson. This post reads the same match twice: first as the underdog who builds something the scoreboard can't measure, then as the champion whose success hides its own flaws. Because if you lead anything, you are both teams at once. And the best leaders learn to see both stories.
“Got a Minute?”: A Leader’s Guide to the Feedback Talk
You've thought about what you want to say. Then you sit down your mouth opens, and the words come out wrong. This post — the third and final in the Building an Honest Feedback Culture Series — walks physician leaders through the feedback conversation, step by step. Drawing on Crucial Conversations by Patterson, Grenny, McMillan, and Switzler, it covers four moves. You'll see how to Start with Heart, Master My Stories, Make It Safe, and STATE the Path. It shows how to share facts without putting the other person on the defensive. The post closes with the power of silence. It also covers what to do when feedback lands hard. And it shows how to handle the conversation when it's with a peer or someone above you.
Care Personally, Challenge Directly: A Feedback Framework
Even with the right structure in place for feedback, what we say is often shaped by our gut sense of what good feedback sounds like. Most of us often get it wrong. This post — the second in the Building an Honest Feedback Culture — draws from Kim Scott's Radical Candor framework. We will see the two ideas at its core that lead to the four quadrants every leader should know. We will spot the trap most well-meaning leaders fall into. The framework makes us rethink what "caring" really means as a leader. A quick self-test at the end helps you spot the quadrant you live in most often.
Why Not Everyone Gets Honest Feedback
Most organizations don't have a feedback culture. They have an annual review process and call it one. The two are not the same. This post, the first in a three-part series, looks at why honest feedback is so rare in physician-led teams. It explores three quiet factors that decide who gets the truth and who gets a polite smile: hierarchy, responsibility, and setting. Drawing on my experience in Toastmasters, where structured feedback is part of every meeting, the post argues that feedback culture is a structure you build, not a process you visit occasionally. It offers healthcare leaders a place to start.