By Linda Lawrence, MD, FACEP, CPE; USACS Regional President

As I look back through what has now been 25 plus year career, I sometimes reflect on what I would have liked to have known as I began. As a past president of ACEP, a regional president at US Acute Care Solutions, and a colonel in the U.S. Air Force, what about my leadership style has most aided my progress? I think it has been trusting myself, and trusting in the kind of collaborative leadership qualities I bring as a woman.

Collaboration combined with a strong inclination towards listening before acting is the cornerstone of my leadership style. It took a lot of self-knowledge and growth to understand this but eventually I learned to lean on my strengths and trust myself. The combination has made me a versatile leader, as it has also distinguished me from my male colleagues in the many male-dominated environments I’ve thrived in.

Many people think of the military as a very top-down, give orders, take orders, fall-in-line kind of place. But the truth is those kinds of leaders don’t do well in the military. It is a gigantic bureaucracy, to be sure, with a thousand little problems, and no easy solutions. Not entirely unlike healthcare. Both kinds of environments necessitate a collaborative approach that relies on front line decision makers to come up with solutions and take ownership of the follow through. Both environments also require leaders who will listen to and support those front-line decision makers.  This has been my approach at US Acute Care Solutions. As I ended my military career I wanted to make my mark on a new and exciting endeavor and I have been able to do that at USACS.  I am currently the Regional President of the Southeast Division of USACS and as a Regional President, I oversee emergency departments that treat more than a million patients a year. I view my job as one that makes a large impact by listening and supporting while using my experience and unique leadership style to guide policy and encourage forward movement at the company. I also am fortunate to be able to make an impact through our Diversity and Inclusion Council that has set the tone to make our organization the destination of choice for women.

The Air Force taught me to live by the core value of “Service before self” and appreciate the privilege of leadership is to selflessly serve those you lead.  I learned that a leader is not at the top of the pyramid but to instead think of an inverted pyramid where the leader is holding up those below them.  In my current role the inverted pyramid has the clinicians on the top, and below them the Directors, below them the VPs, below them myself and the other regional presidents, and at the bottom supporting all of us our CEO.  Our jobs at the various levels of leadership is to support the people who are working every day to achieve our mission, caring for patients.

During my Air Force career, but particularly in the last ten years, I frequently worked with new leadership. I constantly moved between senior leadership roles, as did my commanding officers, and between their moves and my own I was in a period of continuous adjustment. What I learned during that time, and what I think it teaches you, is that no matter where you are, or who your leader is, you need to continue to exercise your own, personal style of leadership in order to be successful. You need to trust yourself.  Particularly as a woman, our experiences, unique points of view and communication styles add value to any team. Our value-add is not that we can mimic or be like men it is precisely because we are not men that our value is of great impact. Harvard Business Review as well as other studies bear this out objectively.

I can think of many instances throughout my career where my collaborative approach has been like gold for managing successful change. When I was CEO of the 31st Medical Group at Aviano Air Base in Italy I remember walking into the hospital for the first time, and seeing its very long outpatient hallway. As I walked down the hallway there was a series of check-in desks within yards of each other, each staffed with separate check-in personnel. When I got back to the office I looked up the number of admin support allotted for a hospital of our size, and it didn’t even come close to the number that was staffing the hallway. What we had, were medical technicians sitting out in the halls doing check-in. And because the technicians weren’t doing the work of supporting our physicians, our physicians were busy filling in the job of medical technician. It was very inefficient and I knew how to fix it.  But rather than dictate change I held meetings with my leadership team and more importantly with my clinicians, listened to their issues and coached them so they took ownership over holding a LEAN event, bringing together all the stakeholders, and finding a solution. In the end, they came up with a plan for the centralized check in desk allowing the technicians to go back to the clinic and support the clinicians letting everyone to get back to the jobs for which they were trained.  Their solution was the same one I had few months earlier but because it was their idea and their plan they had ownership that wouldn’t have happened if I had told them the solution.

This same, collaborative approach worked in almost every challenging incident in which I was a leader and over time I learned to trust that this was a key part of my strength—collaboration and coaching others to find solutions. Leaders in both the military and in healthcare have to learn that the leader is usually not the problem solver. The problems need to be solved at the front line. Our job is to encourage and support input while letting those that are our core work staff take the lead. As emergency physicians, we make quick decisions that save lives while giving clear and concise directions to the teams that support us, but to truly improve the lives of our patients, and to fix the thousands of little and big problems in healthcare, we have to learn to be collaborative. As women in leadership or those that aspire to grow into leadership, our inherent strengths in language and communication are often greater than our counterparts and gives us an advantage. The trick is to own that style regardless of the surrounding circumstances. The trick is to trust ourselves.

The culture at US Acute Care Solutions relies on collaboration to be successful. We are a fast-growing company that has brought together the best groups from around the country. I joined USACS because I knew it could play a pivotal role in creating opportunity for emergency physicians to own their practices. When I say own, I’m not referring to the financial equity that we give, I’m referring to taking ownership over our practice, and most importantly taking ownership over our decisions. I knew the job would be exciting and challenging because to some extent we are building the plane as we’re flying it. Sometimes that feels a little chaotic, but at the same time our culture of owning it gives us the opportunity to build a truly great company.