 Hello, very good morning. Good afternoon and good evening, depending on from where you are joining us today. Thank you all for joining us for yet another awesome session. I'm Kilei, your host for today's session. I'm the first homegrown GP and a fellow in medicine medicine from Bhutan. I'm also the fire lesson for South Asia one person 2021. I begin with this quote, I quote, become a type of leader that people would follow voluntarily, even if you have no title or position. Welcome to the second position leadership webinar. The topic for today is effective leadership practices brought to you by aspire global project started by the wonka young doctors movement. We have young doctors movement lead Dr. Sankar and the global aspire lead Dr. Uma and also aspire listen for Europe, Dr. Maria in the steering team. I'm so delighted to have all the health professionals gathered here to begin with. Let me share a very small story about myself some seven to eight years ago when I was sent to a hospital in Bhutan right after my MBA degree I was barely 25 years old just out of my medical school. But by default I was to hit this hospital to manage about 20 bedded hospital with some hundred hospital staff. Some were there when serving this hospital, more than my age, and there was so much on my plate, which I, which I was never thought at my medical school, the administration managing staff taking these going for training workshop. So many, apart from a patient management, however, I somehow made it today, but I wish I had some skills to manage those times. Well, physician leadership is a crucial aspect of a doctor's career, but we all recognize that it is not typically emphasize formally taught in our medical school. But as the physicians progress in their career, the often find themselves in the leadership roles, whether as a department head, team leaders or administrators, effective leadership becomes essential after driving positive change improving patient outcomes and fostering a collaborative healthcare environment. Physicians often learn leadership skills to on job experiences, mentorship, self directed learning or real life challenges and experiences that provide valuable opportunities for them to develop leadership quality, such as communication decision making and ability to inspire and motivate teams. The significance of a strong leadership cannot be stressed in this constantly changing world of health care and determining the future of medicine doctors who are the foundation of health care will be crucial. We are here today to discuss and celebrate the art and the science of the physician leadership, a path that comes with its own set of difficulties and immeasurable benefits with our topic for today is effective leadership practice. Our goal is to create a network of leaders devoted to enhancing patient care, encouraging innovation and bringing about good change in the healthcare sector. In the, in the upcoming hour, we will hear from expertise and speakers, the insightful discussion and knowledge sharing that will help each one of us enhance in our leadership development. This webinar will not only cover theory, but we'll also have a useful advisor from our leaders, which you may find it useful in our day to day work. As I mentioned earlier, physician leadership is not without its challenges, as so, Winston Churchill amply put it, I quote, courage is what it takes to stand up and speak. Courage is also what it takes to sit down and listen, unquote, effective leaders must have a courage to embrace change and to learn from the peers and patients and collaborate with diverse teams and all while keeping the patient's best interest at the forefront. But also keep in mind that leadership is a never ending journey, not a destination. There are always opportunities to grow as a leader, whether you have experienced or you're just starting to explore your potential. I quote, leadership in medicine is not a title is a commitment to inspire, influence and instill hope in the lives of the people we serve, unquote. So let's embark on this journey together. Let's harness the collaborative wisdom in this virtual room to inspire and support each other in becoming the physician leader our health care system desperately need. With this, let me introduce you our distinguished speakers today. First speaker for today is Miss Israel Khan. Miss Israel Khan is a professional coach and organizational development leader who partners with leaders, teams and companies to make the right thing easier to do. She is a natural connector and she's about, and you are about to witness that she has a gift of helping uncover our true vibrancy. Israel has experienced a 15 years guiding leaders to drive high performance and transformational change. She spent seven years in more fit cancer center, developing leaders at all levels, and especially passionate about creating programs that develop critical leaders. Israel currently serves as the director of organizational development at Yuma Regional Health Medical Center in Yuma, Arizona, USA. Her board fellow has expanded to include coaching and facilitation for the family medicine resident program, as well as medical directors across the hospital. Israel holds bachelor's degree in psychology and business from the University of Minnesota Twin City and a master's degree in industrial organizational psychology from Kitago School of Professional Psychology. Thank you so much for Miss Israel Khan. Our second speaker for today's session is Dr. Beesan Eiraka. She's a young family physician with an interesting public health and epidemiology, master's degree in epidemiology and public health. She holds certification in family medicine from Ballistan Medical Council and family medicine from M. Media Medical University in 2020. Recently she received a diploma in safety quality informatics and leadership from Harvard University in the United States. She is also a member of World Organization for Family Medicine, Wonka, and I, Zary, YG, and Lesan from Ballistan. Dr. Mareeka has a special interest in research, and she has published over more than 23 research papers with a high quotation, citation score, and a peer review. Research on COVID earned her a number of research honors, including the best Ballistan Research Award for the two consecutive years, 2022 and 2023, and the best oral presentation for Wonka based on early health care research. Now, just to introduce our third speaker for the session, Dr. Natalia Galariza was born in Durango, Mexico and grew up near Yuma, Arizona. Inspiring her interest in becoming a doctor was her mother, who was also a family physician in Mexico and has practiced family medicine for over 25 years now. Dr. Galariza attended medical school at the University of Otonoma at Badger, California, located in Mexicali, Badger, California. She graduated with honors. She completed her family medicine at Yuma Regional Medical Center, where she's also a part of the first graduating class. Dr. Galariza had worked on both sides of international borders as a physician, which gives her the first-hand understanding of a region's unique health care challenges, her passion for global health, medicine, advocacy, and medicinal education. She finished two academic fellowships, one with the University of Arizona College of Medicine and finished for faculty development and emergent leaders fellowship with the Society of Teachers for Family Medicine. This year, she's a part of the new scholars for the Society of Teaching Family Medicine. Dr. Galariza started a mentorship program for underserved students in Yuma Country two years ago. She believes in family medicine as a whole and loves the bones that specialty allows physicians to have their patients. She is now the core faculty at the Yuma Regional Medical Center Family Medicine Program for the last six years. Earlier this year, she further evolved her proposal in improving the health of the community and advancing health family medicine outreach for accepting a new position to become the program director for the new residency program in the south of Yuma Country. Other professional memberships is that she's a member of the American Academy for Family Medicine, Arizona Academy for Family Medicine, and National Hispanic Medical Association. That's for Dr. Galariza. And we also have a special guest for tonight's station, Dr. Ramon Kumar, the national president for Academy of Family Physicians of India, and the past president of Wonka South Asia, 2018 to 2021. Dr. Ramon was also the first young doctor elect for South Asia. Dr. Ramon was recently featured on the cover of the Lancet as a global primary healthcare leader, one of the first generation residents trained both qualified family physicians. He holds a long standing interest in making contributions to primary care. He is the founding of the president for Academy of Family Physicians for India, and organization that is she's heading the movement of the return of trusted family doctors tradition in India. Dr. Ramon is also editor in chief of family medicine and primary care, a peer reviewed top med index journal. He had been conferred several rewards and recognition. To name few healthcare leadership award 2012 India Montego to global scholar award 2023 and Delhi healthcare award in Dhaka 2020. He also successfully conducted the 15th World Rural Health Conference in New Delhi. This conference successfully accumulated the adoption of a Delhi declaration 2018, which calls for people living in the rural and isolated part of the world to given special priority if nation is to achieve universal health coverage. The health declaration, and also the WHO, we visited the alma mater declaration with the aim to achieve the highest possible level of health for communities with self with the global goal of health for all rural people. Dr. Ramon is a true leader, inspiring many young doctors worldwide. Thank you so much for your presence tonight. And before I hand over to Etra, some housekeeping notes kindly fill out our questions if you haven't. Over to you, Etra. Thank you so much, Kinley for the kind introductions and for those beautiful quotes. I, I'm a fan of that Winston Churchill quote quite a bit on courage and leadership leadership is what it takes to to stand up and leadership is also what it takes to sit down and listen. So, with that, I want to welcome everybody to part two of this leadership development webinar series. Excuse me. And today we're going to be talking about effective leadership practices. So if you had joined us for last month, or part one, which was introduction to the position leadership. I hope that you remember some of the, some of the cornerstones of leadership that we discussed but if you don't and that's okay and if you're joining us for the first time. Welcome. Very, very heartfelt welcome to everybody that's that's here with us whether for the first time or coming back. A quick recap of part one, and this is going to help us sort of set the stage for this webinar as we move along. So the recap is this visual. Emotional intelligence is the cornerstone of leadership leadership as Kinley mentioned earlier is really begins early in a physician's career. This is before we even notice it. And emotional intelligence and its components are the cornerstone of effective leadership. So we talked about emotional intelligence being, being aware of yourself, right paying attention to where you are. So that's social awareness picking up on cues from your team, from your patients, etc. Managing yourself so when things aren't going according to plan or if you rushed or if you're stressed you have to be able to understand that number one and then also manage that so that your, your sense of calm and your sense of focus remains intact. And that is relationship management. So how do you manage relationships. Well, instead of assuming that everything is just going to work out right if you avoid an issue maybe it's not there. So this is the some of the things that we talked about last time, as it relates to the fundamentals of leadership development so today we're going to be talking about this movement so emotional intelligence is really the foundation. And now as a physician leader, how do you kind of translate your practicing of emotional intelligence into effective leadership practices. So that's kind of what our time is like for today. So we're going to be talking about a few different things as it relates to the relationships of your team. You're communicating effectively collaborating effectively and decision making skills how do you make effective decisions. Not only for your patients but also for the teams to which you belong and for the teams to that that you lead. So I want to start it up start us off with a very quick interactive exercise. So I would like for every one of you. To please find a blank piece of paper and something to write with with the pen pencil doesn't matter. So if you didn't indulge me just a really quick exercise. So if everyone has access to a blank piece of paper doesn't have to be large. And I'm going to ask you to think about two things. Okay, so this exercise. I would like for you not to use words. I would like for you to use imagery and visual. I would like for you on the first side of your paper to draw yourself depicted in your own. What do you think is your own leadership style. How do you see yourself as a leader. How do you come across as a leader and draw that out. No words. Don't write words. Just draw a picture really quickly. And then the second part is turn the paper over. I could could we have everyone just muted please if we're not speaking that would be great thank you. The second part of the of this exercise is you turn the paper over and you think about a leader in your career it doesn't matter when draw the depiction of a leader that you least enjoyed working with. So just to recap the first side is yourself dominant your default leadership style. The other side is a leader that you least enjoyed working with. What was that like. So I'm going to give you really quickly maybe like a minute to kind of be creative. You are welcome to share your picture although it's not required I will be asking you to share what is on your picture. Just be creative. This is a very creative exercise and we will debrief in one minute. Okay. So I am curious. Would anybody like to share just feel free to unmute yourself if you're on video that's great. Any brave souls want to share what they drew out as their dominant leadership style. What is on your picture. Yes. Thank you. Yeah so I just grabbed my cell phone and I'm just going to show you the picture what I do on my notes. Okay sure. Can you see that. Yes okay so tell me what's going on what what is this. So this as a leader myself. So you asked two questions right one is how you depict yourself as a leader and how you least enjoyed working with. Yes. First one my leadership style is a mixed style depending on what kind of situation I encounter but it's one style it doesn't suit all so it's definitely a mixed style and I least enjoyed working with most of them because I think the pride is in the title and not the work or how they help others. Thank you so much for sharing that I love that you shared that leadership is not a one size fits all that is exactly what we're going to be talking about is how do you flex your style. So that you can adapt to the situation that very good. Okay I want to hear from one more and please members of the project team. Please also share you did this before when we were preparing so you're welcome to share as well. Anyone anyone. And Rumi Dorsett. Please unmute yourself. Hi everybody. So for my drawing that depicts myself in my favorite leadership style I have here. Let's see. If I could focus it. No it's going to work. But anyway it's supposed to show. Right it's supposed to really be depicting. And by the way one minute is not enough time to. But yeah supposed to be depicting me. Basically this is supposed to say I'm like basically glitter sparkles stars hearts coming out of my mouth as I speak to a very unmotivated team member. So my favorite style would probably be one of motivation as well as transformation. And then it's a little hour to show that after my little. You know, my inspiration and motivation and transformation on them they are transformed to being on some sort of highest peak of platform for whatever. And so I think it's just that they were working on and they're saying you know that I could do it so not necessarily trying to put the focus on myself but just empowering my team to be transformed. I did not have enough time for the second part. So right now I just have a start of a stick figure with some irritated little squiggles. So that would be probably a manager more than I would say a leader who is more dictator telling me what to do there's no room for creativity. It's more of a fair based way of running things sort of things. Excellent. Thank you so much for sharing that you know I I've done this for a while with different teams and almost always right the leadership style that we say that we are, you know that that we pride ourselves in are like you know the aesthetic that helping people I you know members of our project team when we did this exercise together they said, we're all having a meal together we are all breaking break together we're collaborative we're not isolated you know things of that nature and then the flip side is micromanager right someone drew a dinosaur I think you know someone drew a dragon. So, so I want you to really pay attention. This exercise is really to help you understand that you do have a default leadership style, whether you know it or not. Okay, and you do pay attention and you have an idea of what a leadership style is that you don't enjoy. You already know that as depicted in in your artwork, essentially. So we're going to come back to that but what I want to quickly say is our objectives for this webinar is to understand how to flex your style, depending on the situation, increase your awareness of the team dynamics that are going on. Remember this is part of emotional intelligence right the social awareness. And number three, we are really going to just barely scratch the surface on the basics of conflict resolution. Because no matter our intention, there is going to be times where we don't see eye to eye and we have to resolve conflict very quickly, or else it is going to impact our clinical outcomes. So in order to set the stage for that and how you know teamwork impacts clinical outcomes. I'm actually going to turn it over to the queen of research herself. Bisa is going to walk us through a summary of some of the literature that she's found. So Bisa I'm going to turn it over to you. If you are. Yeah, I'm here. Lovely. Here you go. So according to the general medical council being a good doctor means more than simply being a good clinician. And according to the general medical council doctors in their day to day role can provide leadership to their colleagues and vision for the organization for which they work, and for the production as a whole. On a quick review of literature we found an editorial entitled teamwork in family medicine, another myth to expose. In the paper they describe teamwork in family medicine as a care term. They argue that even though there is evidence of improved health outcomes and higher patient satisfaction associated with team based care, and that there appears to be a relationship between teamwork in family medicine and patient safety. The teamwork may also be one of the solutions to prevent the diagnose and treat professional burnout. In addition, an external evaluation of primary health care reform in Portugal identified teamwork as a key of success of the reform. However, some evidence project that teamwork is the enemy of continuity of care. Since bigger teams have lower continuity and when everyone is responsible, there is no one is responsible. So also there is also evidence of that medical errors of concrete enduring handovers of patients from one team member to another. Another challenge to teamwork comes from care force battles between professionals groups for the on the ownership of the teacher, the type of patient, body of knowledge. All of these tend to work against the goal of teamwork and against the interest of the patient, of course, back to you as well. Sorry, I had to find the unmute button. Thank you so much. So this really is the cornerstone here because we looked at the literature and this is important to share because, you know, the literature all share is fairly supportive with the fact of, you know, effective clinical teams yield better outcomes. You know, there's a lot of literature and not, but what Beeson is also saying and what she's found as well is we need to also understand that teamwork also has as its limits, because there's certain things that, you know, teamwork is probably not a good idea, for example, in terms of crisis acute situations, critical care moments, things of that nature. That's where a leader needs to discern when when teamwork is the most critical. Okay, because when we rely heavily on teamwork as the solution to all of our problems, it will impact continuity of care. It will create team divisions or what we call silos, right? All different teams are trying to work together, but they're too caught up in their own priorities to really pull up and look outwards. And there's also this whole piece of territory, right? Don't don't encroach on my turf. This is my expertise. You stay there, right? So it gets it gets prickly. So we wanted to be realistic with with how we're looking at teamwork and really acknowledge the fact that teamwork has it limits and it also has its place. But that doesn't mean that we should not have it as a absolutely laser focused outcome, because for the most part, clinical teams that have very good teamwork yield better outcomes. They are willing to speak up more when there's an issue, but you have to understand when teamwork is critical. And that is when we're going to go into our situational leadership model. So I'm going to be really running through some very, very important models and concepts that quite frankly within themselves will take a whole day to do a workshop. So I'm doing this really quickly. And just to give you an exposure to this and to kind of get your mind jogging so that you can in your own time, look at this further, right? You know, talk to your mentors, talk to your guides, read things, sort of start developing yourself as a leader, using this as sort of like a starting point. Okay, so when we talk about situational leadership, this goes back to the earlier point that was just made where the different situation will demand a different leadership, leadership style for you. Now, how do you do that? The first thing you have to understand is that you can have more than one style. In fact, you should have more than one style of leadership. And that all depends on the development stage of the team or the each person on your team that should correspond with your style. So this is an actual model that has been validated by empirical research and psychology. So situational leadership is comprised of two different models. The first sort of half is to look at where is your is your team at, right? Who are the members on your team? Number one, who is really on your team? Number two, what is the development level of them? So we started D1 right here. Okay, so this is D1 where they're not fully developed yet, they're still developing. D1 means that they don't have a lot of the skills yet. They're probably new, but they have a very high level of commitment. So a lot of potential, a lot of speed of learning. So I would call D1 as enthusiastic beginners. They're very enthusiastic, but they're still in the beginning stages. So they're going to require a different level of support from you as a leader compared to, let's say, someone in D4. D4 are individuals that have a lot of expertise, very high commitment and very high confidence. These are the people that have a lot of expertise. So you want to lead them differently than how you would lead someone, let's say in a D1 category. Now D2 and D3 are also in the middle and those are going to correspond to your leadership style as well. So let's go into the actual leadership style model. So based off of the development stages of your team, you're going to look at it in this way. Now feel free to take a snapshot of this, a screenshot of this. This is really important. You can also Google situational leadership and this will pop up for you. So for example, your leadership style is going to need to be a delicate balance between how much you direct behavior, so you're more directive, versus how much you support people. So it's supportive behavior. Directive behavior is telling people what to do. Supportive behavior is partnering with them and dialoguing with them and asking them, what do you think you should do? Okay. So based off of that, someone in a D1 development zone will require you to have an S1 leadership style. That means you are more directive. Okay. So you need to provide some direction to people in the D1 category. Now someone in D4, they don't require a lot of direction, right? So using an S1, right, on this bottom right hand corner here, using an S1 style, is not going to work for your D4. They're going to feel micromanaged. They're going to feel like, you know, the picture that you drew on the other side of your paper. So instead of S1, you're probably going to need more delegating, right? So someone in D4, high competence, high commitment, they're going to need you to help them grow, right? So don't really direct them, delegate to them and tell them, I'm here if you need me. Okay. So those are the two sides. So let's say you are in the directing category and you start noticing that someone that is new, your enthusiastic beginner is about to, is improving. So they don't need too much direction anymore, but they're not ready for delegating yet. So this is where you need to provide a mix of coaching and supportive behavior. Coaching is basically helping your team member to understand solutions to their own problems. So you're not directing them with, here is what you need to do. Coaching is to help them understand what they need to do by helping them problem solve on their own. What do you think you should do, what's the plan, what are the possibilities, etc. So I'm going to pause right now because this is a large chunk of the webinar. I wanted to ask if anyone has any questions, any one in the chat or from the project team. Okay. It's like, excellent. Looks like this. So that means I'm doing a good job. Okay, excellent. All right, I will assume that. Lovely. Okay. If anything comes up in the middle, please feel free to write it down in the chat. We'll try and come to it afterwards. So this is situational leadership. How do you adjust your style based off of the development needs of your team? Okay, so this is how you can move forward with that. Okay. So next thing is the team stuff. Okay, so this is leading a team. Now you have to be aware of how do you lead and belong to a team. So when we go into this, I want to kind of really draw a picture for you. Okay, so forgive my mouse. If it's a little wonky, I'm not going to draw straight lines. But we have to accept that the quality of our relationships, right, as physicians directly impact our outcomes. So for example, I'm going to draw a really, really quick graph here. So on the x-axis is the quality of your relationships, right? So are they good? Are they medium? Are they not so good? And the y-axis is the degree to which you meet your performance goals. So that is patient experience, clinical indicators, patient outcomes, what have you. So you need to understand that if you have a low, right, a low quality of relationship or a bad interaction with a team member, that is automatically going to impact the clinical outcome. Okay, and that is known as contention, right? If you're in a contentious relationship, you're automatically not going to really yield a good clinical outcome. Okay. Now let's just say that you put some work in to your relationships. You're practicing emotional intelligence, and you're trying really hard to sort of smooth out a relationship between a colleague or a team member. And so you get to another mode on this graph. So you make some changes, right? So you're improving here. So you get to this different mode, and you're not no longer in contention, but now you're just coexisting. Okay. You're not in contention, but you're just coexisting. Okay, so your clinical outcomes will increase, but you're just coexisting. Okay. Now, if you put in more effort, right, into your quality of relationships, then your clinical outcomes will increase a little bit, but not by that much. Okay. This is where you'll reach a stage of cooperation. So contention, coexistence, cooperation. If you put just a little bit more effort into your quality of relationships, you'll jump up exponentially and you'll reach a phase called collaboration. Okay. So one thing to just keep in mind is you will travel up and down this curve every single day, every single hour. Okay. It depends on if you've had your coffee, it depends on the traffic, it depends on your patient load, it depends on a lot of things. But just remember that no one wants to be in contention. Okay. It feels better to be in coexistence, but really what the goal is, is to get into cooperation or collaboration. And that means that we need to put some effort into our quality of our relationships so that we can yield the highest level of outcome for our patients and the communities that we serve. So to highlight an example of this, I want to ask Dr. Natalia Galarza to share a quick example of how this sort of plays out in the real world with an example that she'd like to share. Natalia, please go ahead. Hi, you're muted. Hi, everyone. Good morning. So I actually have two examples. One is already knows, but as she was actually talking, it just, you know, a light bulb hit me. And the first one is, you know, early in my career, I have a, I had a very contagious relationship with a senior attending. I would say that we were just, and we would knew we were give ourselves the good morning. But then that was about it. And one time, one of her patients came to clinic with me, since she was out of town. And there was a critical diagnosis. The patient had become a diabetic. I'm very uncontrolled diabetic suddenly. And I remember that I really struggled with myself to communicate with the other attending with the other doctor. I knew that just as professional courtesy and, you know, as colleagues in the same clinic, I needed to talk to her like, you know, normally I would have been like, Hey, one of your patients swing by my clinic last week. I'm not here. She actually debuted as diabetic. She's in bad shape. I started her on medication and she's coming to see you next week or in a few weeks to see how the treatment's going. That's what I would normally done if I would have had a good relationship with that physician, but I debated a lot to actually do that. I even really thought about keeping the patient to myself. Just because I didn't even want to come. I didn't even want to talk to this other person. And, you know, after talking about this, I came to understand that, yes, it was just because of the animosity that we had. But also of the, I didn't even want her to question me, like why I had decided to put her on a certain medication instead of something else. It came from insecurity, but also from just a lot of mixed feelings. But at the end, you know, I put my big girl pants on and I went to her office and I'm like, Hey, just for you to know, one of your patients came. I saw her ex date. She's coming to see you again. And I started her on the medication. If you want details, there's my note. I actually made a purpose of writing a very detailed note. And that's, you know, you will find it if you need anything. Let me know. And that's it. But I think it would have impacted. She had been the piece, the primary physician for that patient for more than 10 years. So the relationship would have obviously been impacted. And at the end, I think she, she appreciated it. I know that she appreciated the gesture in some way. And I think it was more civilized after that, the relationship or at least more courteous. That was one. And then the other one that I was thinking of, it was actually when we have new residents or senior residents, you know, that end of the spectrum when we have interns. And depending on the relationship that you have, or even with any resident, any stage, I often tell the residents, like, you guys just have to adapt to four or five of us as your preceptors. When we have to adapt, like 18 of you, and the residents will peek and choose who to, you know, precept their patients with. And unfortunately, that can have deep impact for the, for the patient. If they choose to precept that patient with a preceptor that, you know, pays less attention to details or is doing something else. What is precepting? Sometimes the bulk, sometimes the patient can fall to the cracks, unfortunately. And that, that actually is one of the best examples that I have of how certain relationships and quality of the relationship impacts the clinical outcomes, especially in medical education. Or if they have no option than to come with you, but you don't have a good empathetic mentorship coaching relationship with our resident, the resident will try to spend the least amount of time with you. Telling you less details. So you don't question him or her. And then the one that might be paying the price will be the patient. So, you know, that's another example that I can, that I can come with. Isra, you are muted. Like on the bottom of the screen on the left side corner, you will see the video and audio but sorry, this is, this is getting a little, okay, thank you. Amazing. Thank you so much for those examples, Natalia. So that really, really kind of highlights, you know, just don't fall into contention. I try to get up to coexistence, even if it's, even if it's, you know, feels a little awkward contention is where you don't want to talk to them coexistence is where you agree to disagree for the sake of your patient and the communities that you serve. But try not to fall into contention. And so I want to kind of quickly kind of move into the second piece here of leading and belonging to a team. This pyramid is the basis of a very well known book called the five dysfunctions of a team. I'd recommend that you all read it. It's a very short book. But this is essentially five dysfunctions that happen on a team that cause issues. Okay, dysfunctions. The very first thing for a team that dysfunctional is dysfunctional is the absence of trust. What that basically means is that we're not willing to show that we've made a mistake. Okay, we're not willing to show that we're vulnerable to our mistakes. Right. So last, last webinar we talked about admitting that we don't know something. We have a hard time doing that in front of a team. That means that there's not a lot of trust. Okay. The other piece is fear of conflict. Okay, so there's artificial harmony and there's a lot of tension that can also be a quick derailer in terms of a team lack of commitment so people are not really understanding what they're responsible for. Especially if you're in a practice that has multiple roles. So a physician and attending interns, residents, medical assistants, registration, right. I'm working with a team right now at this very moment that has a lot of ambiguity and no one really knows what they're doing. So it's causing a lot of fracture. So standards, status and ego, these are all pieces here that contribute to the dysfunctions of a team. So I definitely recommend that you take a look at that book because this is sort of like the cornerstone of team development. Let me go into my last tool that I'd like to share with you. And this is basically how do you resolve conflict when you are in a conflict zone when you have a potentially contagious, contagious, contentious interaction with someone. How do you resolve it? Okay, and I've done this for many years and I've done this with, you know, with people all over a hospital system regardless of roles, nursing, leadership, you know, surgeons, family physicians. It all works if they practice these four steps, it will work. Okay, conflict will be easier. And you'll notice these are the four steps to conflict resolution. And again, these are absolute basics. We have a list of further reading that we'd encourage you to take as we move forward. So the first thing you have to do, right, is to get your head right before you open your mouth in a conflict. And basically means is going back to last webinar. Okay, the last webinar was social awareness and self awareness. What are your cortisol levels, what are your adrenaline levels, what's going on, you know, kind of get the stress response under control and clarify your motives for feeling hurt or feeling angry or feeling like there's a conflict. What do you really want? Do you want what's right for the patient? Do you want to win an argument? Do you want to show that you're right? Right, clarify what it is that you really want, really get your head right. Take some time, talk to people that you trust, talk to your mentors to how to see clearly in this contentious situation. Number two is master the stories that you're telling yourself about someone that basically means really check your own assumptions. We start assuming things about people. And they become stories in our head and they're not really based on fact anymore. So if someone acts a certain way, right, it's, it's we automatically assign meaning to that where we don't know the entire story. Just the other day I had someone tell me, Oh, Dr. So-and-so was rude to me. Okay, what did he do that made it that he was rude? Right. So that's a story separated from what exactly happened. What's the fact. And you have to do that on your own as a leader, separate the stories, the meaning, the interpretation from the actual facts. It's very difficult to do. So that needs a lot of practice. When you approach someone in a conflict situation, you must clarify your intention. You absolutely have to clarify your intention so that you're starting off with mutual purpose. What that may sound like is my intention for this conversation is to check, you know, to make sure that we're on the same page for this particular patient, right, or for this particular issue. I, you know, I'm assuming one thing I just want to check for understanding. This is my intention, right, just like that. No high voices, no, you know, no stress, nothing like that because you have to get stuff one done right. Okay. And then the last piece here, and it is so often overlooked is gaining commitment at the end of a conversation to really understand what are we going to do differently this time around together. In order to not encounter this misstep, miscommunication, misunderstanding again. Commitment is so important. Don't just be satisfied with a good conversation. You must end every conflict resolution conversation with a commitment. Okay, moving forward, I will do this differently. What are you going to do? Okay, I will do this differently. Doing step four is so important because it prevents us from getting into the spiral, right, the spiral of I talked to them and it's still happening. I talked to them. The problem is still happening. You're able to cut through this pattern by doing stuff for gaining commitment. Okay. So as we move forward, I want to give you some tips for practice. So number one is, like we said, observe the development levels on your team. Are they developed or are they developing? Are they in D1, D2, D3, D4, right? Are they new? Are they enthusiastic? Can they do this on their own? Really understand that. Number two, I would recommend that you pay attention to what triggers the story that you tell yourself. What are your own assumptions that are not based on facts? Just start paying attention to that. Okay. And start getting into the habit of asking, what do I really want? Because this goes back to you getting your head right into these four steps of conflict resolution. And I've also included some bits of further reading here. But at this point, I've really shared all the tools and the high level kind of critical pieces that I'd like for you to learn. But I'd really like to invite Dr. Rahman to share some of his expertise, his journey and his mentorship and guidance as it relates to this topic. Maybe I'll just reintroduce Dr. Rahman. Yes, Kinley, please do so. Yeah, Dr. Rahman, just give me one minute. Yeah. Dr. Rahman Kumar is a past president for Wonka South Asia, 2018 to 2021. And he was the first chair for the YDM, that is the Young Doctors Movement chair in the South Asia. And he's also the founding president for the Academy of Family Physician India, and chief and editor for Journal of Family Medicine and Primary Care. He has published more than 100 research papers. He continues to inspire and motivate young doctors in India and worldwide. Welcome, Dr. Rahman Kumar. The floor is yours. Thank you. Thank you, everyone. Thank you, Dr. Kinley. Isra, I'm grateful for inviting me here. Dr. Oma, everyone, part of this workshop. I was very carefully listening to the workshop, to the technical points that Isra was discussing and all of us, all of you have contributed. As leader, we have various, you know, roles or expectations, or we have various perceptions about leadership, leadership roles. So from my experience, I would like to share some of, you know, my own experiences on how I see leadership, managerial roles and other such positions and how do we, you know, get best out of it. Can I share my slides, please? Because there is some slide there. I cannot share my own. Yes, no problem. Thank you. So you can see my slides now. Right. Thank you very much. So I, as I was introduced, I wear many hats, like many of us do in our positions. I'm part of the National Board of Examinations, where I am a convener of the Family Medicine Specialist. I'm the National President of the Academy of Family Physicians for India. I'm part of a journal. I've been through the journey of spice route, young doctors movements, from South Asia. Also, I do my independent practice. So while I talk to all of you, I have my patients waiting appointments there after this talk. I'm also a full-time practicing physician. I'm a private practitioner. I'm a private family physician practicing full-time and community on my own. So I have some experience to share and from that background, I'm coming to this workshop, what I've understood about leadership. So this is our group photograph of Wonka, because I'll be talking mostly angrily, you know, this entire discussion about our own organization, World Organization of Family Doctors Wonka. And at the time, I was the first chair of the Young Doctors movement. And you can see people representing leaders, representing various regions of our world. We all, you know, belong to different cultures, different continents, you know, different age groups. And what we're all together for in Istanbul 2016 was the common purpose of Wonka. So commonality of purpose is one of the most important driving force of any organization or leadership, you know, position, or the purpose of leadership, I would say. So all people from different walks of life, different age groups, different genders, different, you know, you know, academic backgrounds, experiences all come together for a purpose. And among these people, all of them are leaders, you know, we did have Professor Michael Kitt as our world president. But if you look around from the world, all of the people who are, you know, present in this photographs, our leaders still, you know, contribute to various organizations in different parts of the world in their own different capacities. So leadership is not about one person, you know, it is about the purpose, it is about the organization that you are working for, working with or working to build around. And as we all know this, you know, concept of cabinet medical expert, and we are supposed to be as medical experts, scholars, advocates, managers, collaborators, professionals. And if you replace the word expert, it is actually you should be reading medical leaders or leaders, because these are all folks of a leader in any organization, any system, any position, any time, whatever you do, we are supposed to be leaders. And this is, you know, also academically, you know, given upon us to be leaders, so it is not just a choice everybody every medical professional has to be leader, right. And when we are leaders, and when we talk about the medical systems, we have to understand that we are not not the only one in the galaxy. There are others stakeholders in this is in terms of business but you know there are suppliers, employees, local communities, governments, non-government organizations, you know, everything is part of what we are. So we have to be aware of where we are, who we are, where we belong to, and what the purpose of our vision, how do we fit in our, you know, moment of our, you know, our efforts in a direction that is not, you know, which is best in the momentum of the overall scheme of the things. So this is very, very important for the purpose. And from the perspective of family doctors, family medicine, something which we do is, you know, not very common, which is full person care. And because everybody as community, as people, as systems, majority of the time understand is in terms of the organs, organ systems, specialties, you know, service specialties, not in terms of the whole person care. So this is something very unique that we are always, you know, challenged with which we are promoting, which we are trying to advocate for person care. So the purpose of what we do is, you know, also about the philosophy, what we are trying to advance in our day-to-day practice, whether I'm practicing in my own clinic or when I'm speaking on the Bunker Forum. It is same, full person care. And also about the communities because, you know, one part is, you know, addressing our own, you know, colleagues, our own peers, health system, and also the communities that we serve to, you know, what is their issues, what are their challenges. Why they are confused, you know, what are the barriers they are facing and understanding ourselves and also outwardly, you know, the inner stakeholders and externally, we have to communicate and understand, especially in relation to health care, our patients, communities and the population that we serve is very, very important. And, you know, I'm bringing the symbols because, you know, this is how our medical education system looks at human health. And this is very important because, you know, we all have heard about this story, wise men and the elephant. So doctors, physicians are supposed to be the wisest men, women. And still, you know, we have, you know, differences of how we look at the human health. And this creates lots of conflicts within the health systems, problems and challenges, in spite of being very advanced, very complicated, but still we have this problem of, you know, having a fragmented overlook of the health system. And it is, it originates from our medical schools, colleges, how, you know, we are taught in our test books, how conventionally we are given the idea of health care. And the thing of generalism is something that is not very valued in medical systems, especially generalists are very, very important in running governments, bureaucrats, politicians, you know, special leaders, journalists in judiciary or every year I see a journalist, you know, at the top notch of everything, but in the medical field, it in the specialist specialties, you know, the more narrow, the more specialized, you are the more valued person, you know, you know, those are financials, you are rewarded. So the second thing that we want to emphasize to ourselves and to outward also to the community society, the importance of generalism. This is very, very important for the purpose of it, and the range of it, you know, depth we all know, range is also very important. So whatever literature, one book I would recommend for all of you range. You know, this triumph in the specialized work on specialist and generalists both are required and this, you know, symbolism books, literature, philosophies have to be imbibed understood, and to be communicated, wherever, you know, because this are the things which will bog you down many times, you know, which will inhibit you, which will make your smaller inferior many times feel even if it if you're not. So you have to build up your argument from you know this background of the scholar stick work. And of course common sense of being Swiss knife, you know, medical specialist is multi skill. So we have to be using our common sense also is apart from the scholar stick, you know, academic work, and also communication is very, very important to show how specialist work in a system any system and this graphic is true for anyone, you know, any system not just for health system, but it business politics governance, you know, everywhere this works. And you cannot compare generalists with the specialist. Normally what we tend to see you know who is better with inferior superior in that sense, but this is not so. Every system needs specialist very, very specialized people, people who know rocket science. Also, people who manage those office scientists. So this is very important that we understand and communicate in easy way, so that everybody understands the importance of family medicine, family practice, family physicians, and also another myth that specialists are more knowledgeable, intelligent. This is not true. A genius can only be a journalist, you know, true history if you look at Mahatma Gandhi, Laila Da Vinci, Rabindranath Tagore, all have you know to say that you know must check off all master of none. It's not, you know, something. But this is the whole idea for philosophy of family practice, general practice, generalism. And, you know, this is the level you can reach and reach and this is the level of stimulation, intellectual stimulation that you can, you know, feel when you work in this field and not feel low about what you do. And like you see in this example, painter, sculpture, architect, musician, mathematician, engineer, inventor, you know, whatnot, everything. We designed the parachutes, tanks, airplanes, at least times, 15, 16th century, five centuries back. So you can just imagine, you know, the purpose or, you know, dynamics of being a genius and only a journalist can be a genius, especially can only perform good procedures, specialized procedures. And we often talk about leadership and management, you know, we look at leaders as, you know, someone superiors or managers who are, you know, often toxic in that term. And this is the discussion in the corporate world. Normally, you know, and what are the, you know, difference between a leader and a manager and manager is often looked down as in someone who is, you know, hard task master, you know, who is something not to be with around who is, you know, very bad to be, you know, with something like that, but Lisa is something, you know, who is, you know, you know, like a deity, we all pray and, you know, look up to and, you know, so nice and so big people. But if you carefully look at this graphic, leaders are very big as compared to their followers. And management, you know, it's kind of, you know, so in this context, it's important that, you know, when whatever you are, you know, leader or manager, you have to perform as well as flexible because one of the purpose of, you know, the two types of, you know, activities one is running the organization for which you have to be firm. You know, you cannot be just flexible and you know, make happy everyone kind of person when we are in a leadership position. So you have to be firm. And you also have to be flexible as a leader, because, you know, we have to listen to the other people requirement needs aspiration objectives as intelligent beings. Human beings are supposed to be intelligent, most important intelligent among the, you know, all planetary animals or, you know, living beings. But as AI is taking over we have to be intelligent ever evolving by training experience network here, whatever, you know, intelligent is one. Keeps on learning. So this is very, very important. It is not about your qualification and we are from Howard, or we know very high position. If you stop learning, you become, you know, less intelligent out of, you know, context and mentorship is very, very important, whether you're a leader, manager, and one who aspires to be leader has to be ready to be, you know, mented, you know, mental. You cannot be a leader without being a mentee. Because we have to, you know, learn from people. If you are ego centric, you do not want to take ideas from others. Then it will be a leader. And in terms of running organizations, like for example, Wonka, you need continuity. We want productivity. We have to have outcomes. We also need to have growth and transformation. So many times both the roles of leaders and managers are combined. They are not separate. Any leader and this you would find interesting that leader minus manager is a poet. So, you can do poetry, say good things, you know, very popular, you can be taught in textbook, but you cannot be a transformative leader without being a good manager. So you have to be both. So always remember this mind and leadership is not about doing big, big things. It is not about being Martin Luther King or John F Kennedy. It is also about being your day to day work in your family, in your office, in your neighborhood. And simultaneously it is also managers role or any workers role, because you are also a citizen of your country of this planet. And this is the best part of any leadership process where you cannot identify the leader because it is a commonality, as I said in the beginning of the goal of the purpose, which brings the purpose of leadership is very, very important. You cannot identify a leader in a leadership process. This is the best ideal situation. I would not go into details, but you know, for transformative leaders, you know, this is a very good book for entrepreneurs. This is also very good for leadership, because there are things that we do conventionally we move on for me and we finish our life span. This is the concept from this book, zero to one, but for leadership, for entrepreneurship, you have to do unconventional things like in today's specialized world being a family physician, generalist, general practitioner, it is an unconventional thing. And here lies your, you know, opportunity to create, you know, something new, something big, something bigger than what it was, it is not a conventional life that you've chosen, and you have the courage to do to pursue to create the leverage of you know, a person, an unconventional person would do. And this is what most leaders have this quality to do something unconventional, and it is zero to one, it is not zero to 10, zero to 100. You just have to be slightly, you know, lift off from your conventional thinking lifestyle. So for leadership to summarize, you know, you have to have a vision. And any person who aspires to be leader, there are two most important things. Number one, to my experience is initiative, taking initiatives and taking responsibility. So many times, as I said, poets may have reason, but leader is one who takes initiative and responsibility. Then comes the goals. Then you need to have a program for your team. Then the teams come in because they buy in this vision. And then the, you know, in this hierarchy, skills, competencies, resources, capacity support network, and organization leadership, all this kind of initiative and responsibility are the most important part of it. You know, team comes next. I have a few more slides. Just so these are the common things that bring people together, you know, common threats, common incentives, higher order of societal objectives, employment of, you know, occupation. You know, this is one of the reasons ideologies, political ideologies, you know, common ideologies, ideologies, and common purpose should be communicated, written and oral, both. And then it comes to the building of the team and also organization. Often there is conflict, but then again, I come back to the same. You know, the commonality of the purpose, and in our case, it is the power of purpose, which is, you know, wonka and wonka defines in terms of you look at the vision mission objectives of wonka. And that is why we are here. So once you're for that, you bring our best best of our skills. We have our competencies for the benefit of our common objective on this platform. So power of purpose is very, very important for, you know, for any kind of, you know, conflict resolution. This is how people from different backgrounds, different countries, different nationalities, different languages come together, work together for the success of purpose, not for a leader. It is about the purpose and the goal. So these are my thoughts and experiences. I would like to hear more from all of you. Thank you very much. Thank you very much, Dr. Roman for sharing your insightful of all your experiences of leadership from a very young age until now. I'm sure that every one of us have something to take from such an insightful presentation you made it up there. Anything you want to say, Dra. Yeah, so I know I just have such such respect and such admiration for what was shared. So I want to open it up to anyone does have any questions or anything that they would like to share in the chat specifically for Dr. Roman or anything that we've shared so far. Natalia. Yes. Yes. Hi. That was amazing. Thank you. It was so inspiring. And I just want to touch base on something that was say last about that, that when you're a leader is about the success of the purpose, not about the success of the leader. I think that's so inspiring and such a way to lead. And that's actually how you, that's how you keep your team inspire, right? That's how you keep them going. That's why you have to have a clear vision and mission of your purpose of your organization because that's how you're going to get people to buy in. If they, if they don't believe in the mission, if they don't believe in the vision, they're not going to manage up. They're not going to follow that. They're just not going to engage. So I think that was so important. Thank you. It was, it was really good. Do we have any questions for our leaders here. Anyone from the audience. Okay, I think I don't see any other hands raised. So I'll go. Oh, did I see something in chat? No. Okay, so I'll just go ahead and begin to wrap up here. I would like to thank everyone, especially Dr. Roman for such an inspiring and such a really holistic view of leadership as it relates to your experience and your journey so far. So we continue to be very, very thankful and grateful for your presence here and what you've shared. And so I just want to give everyone just an overview of our next session, session three is going to be at the end of September and we're going to be really shifting gears and talking about self care and how to maintain your effective leadership practices. And then we're going to be talking about recovery and preventing burnout tools for prevention recovering from burnout, as well as resilience so that is an overview of what we will be talking about next time. So please take things over to wrap us up and for next steps. Thank you very much everyone all the audience for joining us today and my speakers and Dr. Roman for for your insightful presentation. Yes, as Israel mentioned kindly join join us on the same time on 30th of September. So the topic we are going to present that time is maintenance make easier. Yeah, details. So, yeah. Anyone sharing my phone just. Okay, so, yeah. So we do feel free to drop any questions anything if you have otherwise we're going to wrap up wrap up now. We have a question that we will email to you kindly fill that up and see you all in the next session. Thank you all very much. Good. Have a good day and a good night.