Optimism in Healthcare Leadership: Finding Water in the Desert

Recently, after my last blog post, a physician colleague shared that in his opinion, “as usual”,  I was “overly cheerful and optimistic”.  His comment got me thinking.  Could this be true?  When conveying a complex message or guiding people toward an often difficult goal, can one be too optimistic?  Does optimism alienate people? Is it authentic?  What effect does it have on leadership?

Those who interpret a person as being overly optimistic likely think they see the world only through rose coloured glasses.  They may believe that optimism is misguided and ignores reality.  To be sure, there are daily challenges we face in healthcare which can be overwhelming. There often times when everything around us seems aligned to ensure our failure.  Given that, I wonder if it is best to bow to negative forces in our work and life, or counter them?  Is being pessimistic the same as being realistic and therefore is more authentic, or does it deny authenticity by closing the door on new ideas? Is being optimistic a delusional belief system or is it really an expression of hope?

“It’s snowing still,” said Eeyore gloomily.
“So it is.”
“And freezing.”
“Is it?”
“Yes,” said Eeyore. “However,” he said, brightening up a little, “we haven’t had an earthquake lately.”
― A.A. Milne

In  2001 I made my first foray away from clinical care in my medical career.  At that time I took on part time work as Medical Consultant in a new Ministry of Health agency called OFHN – the Ontario Family Health Network (now Primary Care Branch).  Primary care renewal and the creation of the first FHNs was a bold, disruptive idea and five physicians were hired as consultants to flesh out and promote the program . Essentially we were tasked with selling the idea of change to our peers at a time when there was discord and reform was not particularly welcome.  There was no formal change management process.  We were left to figure things out by trial and error.  Back then in public physician forums, I was told I was too young to understand, I was naive, and that I hadn’t experienced enough of the cold stark realities of the health system yet to be credible.  Some peers clearly stated that I had “sold out” and “moved to the dark side”.  Yet despite that, something encouraged me to press on and kept the spark alive.  What was that?

Upon reflection, I think I value certain traits in leadership that allow me to stay focused even in the face of adversity or uncertainty.  These include:

• an endless curiosity about the unknown
• trust in the process I am involved in even if the outcome is not yet known
• a belief that the only certain thing in life is change
• a general sense that things get better and that the future is exciting

Likely these traits encompass an optimistic world view.

Where do these traits come from?  Perhaps they are inherited.  Or they are learned as a child.  I look to my parents to think about the origins of my optimism, and think especially of my mother.  She was definitely a person whose glass was always half full.  She believed strongly that virtually all people were good at heart and that if given the choice between right and wrong they would almost always choose “right”.  Her favourite word was “fabulous”.  Even as her future was slipping away from her due to an aggressive form of cancer she joked, laughed, sang and remained positive about every aspect of life.  Maybe I am a reflection of that.

But the statement of my colleague that I was overly optimistic challenged my approach.  When I am leading with optimism, is it possible that I am overlooking something?  Am I avoiding the painful realities of the current state of health care, where budgets are tight, people are worked past capacity, supply and demand never seem to balance and pessimism easily prevails?  Is being optimistic simply missing the mark?  Hopefully not.  An optimistic approach to leadership does not neglect the real need for  critical analysis.  True optimists are not blind to the risks and challenges they face every day.  They tend to acknowledge pain points and think through how they can be addressed quickly yet effectively.  This allows them to look forward to the next goal and the new trials that come with it.  Optimists address challenges.  They tend not to be threatened by them.

Interestingly, pessimism is rampant in doctors.  A survey conducted by the Physician Foundation in 2012 found that pessimism was firmly implanted in American physicians’ minds.  There, “over three quarters of physicians – 77.4 percent – were somewhat pessimistic or very pessimistic about the future of the medical profession.” Yet surprisingly, in a survey of 800 Americans in 2013 via Statista, half of them self report as being optimists, while only 4% describe themselves as pessimists, and 43% say they are somewhere in between.  And if my profession is much more pessimistic than the general population, is there room for optimism in its leadership?  I would suggest … absolutely yes!

“You’ll never find a rainbow if you’re looking down”
― Charles Chaplin

In business literature, optimism is seen as one of the most important traits of good leadership. In a recent Forbes magazine article on leadership, Carmine Gallow proposes five reasons why optimists make better leaders.

1. Optimists see opportunity where others see uncertainty and despair.  This is critical in a time when  radical health care transformation initiatives are the norm as we are experiencing in Ontario right now.
2. Optimists are inspiring and effective communicators.  They can get a message across effectively as they stand out among the white noise of negativity.
3. Optimists rally people to a better future.  They show others hope, which is key to surviving periods of hardship.
4. Optimists see the big picture.  They do not get caught up in the cycle of circular negative discussions or thinking.  They can see above and beyond today.
5. Optimists elicit super human effort.  They cause others to use their energy in ways that surprise them.  They attract many followers who are happy to work on their cause.

And in thinking how I most want to lead change, I am constantly comparing myself to others and asking who is it that I would climb a mountain to follow?  What do they look like?  What do they do or have that motivates me?  Whatever it is, I want to emulate them.  Great physician leaders are everywhere around us.  They are busy working away showing positivity in the face of adversity.  They seem fearless when others are withdrawing.  From them I derive strength.  I count these people among my closest friends, and that gives me inspiration.

Realistically, our time on this earth is short.  We have only a small window to create and enact positive change.  To do this well we must use the same energy that some put into pessimistic and negative thinking, and channel it to productivity and the advancement of new ideas.  Being optimistic is the single biggest advantage I have in the work I do, both in medicine and in healthcare leadership.  Every day I draw upon the energy of others who do the same, and the partnerships that are created  in this combined effort have the most amazing potential.

And the best thing is, with this optimism I am able to look forward to virtually every day and the challenges and opportunities that lie ahead in it.  To to be branded excessively cheerful and optimistic is, I suppose, a compliment.  It is a sign that I have succeeded.

Your thoughts are welcome!  And of course I just have to say it…. Keep smiling!

“For myself I am an optimist – it does not seem to be much use to be anything else.”
― Winston S. Churchill