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Episode Transcript

Dr Rachel Morris: Do you know any leaders who are pretty charismatic but can have devastating effects on others in the room? Do you recognise your own strengths and the shadow sides that come with them? And how often are you really aware that other people may well see you as a leader, even if you don’t feel like one? As a professional, people often look to us for leadership and guidance, even if we’re not in an official leadership position. And we may forget to think about how our attitudes, personalities and behaviours can affect the people we work with. Yet an awareness of our impact on others is crucial to working with people. Being self-aware and emotionally intelligent is one of the key ingredients for success.

This week, Dr Joanna Bircher, GP partner, clinical director of the Greater Manchester GP Excellence Programme, and co-author of the book, The Leadership Hike, joins me on the podcast to discuss the impact of the side effects of our personalities, strengths and personal styles. We talk about how understanding yourself better can make such a difference in getting teams to thrive at work. So listen if you want to find out why you need to act like a leader, even if you don’t think you are one, how to find out what effects you might be unknowingly having on your team and how to find out what your strengths and blind spots might really be.

Welcome to You Are Not A Frog, the podcast for doctors and other busy professionals who want to beat burnout and work happier. I’m Dr Rachel Morris. I’m a GP, now working as a coach, speaker and specialist in teaching resilience. Even before the coronavirus crisis, we were facing unprecedented levels of burnout. We have been described as frogs in a pan of slowly boiling water. We hardly noticed the extra long days becoming the norm and have got used to feeling stressed and exhausted.

Let’s face it, frogs generally only have two options: stay in the pan and be boiled alive or jump out of the pan and leave. But you are not a frog. And that’s where this podcast comes in. It is possible to cross your working life so that you can thrive even in difficult circumstances. And if you’re happier at work, you will simply do a better job. In this podcast, I’ll be inviting you inside the minds of friends, colleagues and experts—all who have an interesting take on this. So that together, we can take back control and love what we do again.

We’ve had a fantastic response to the recent launch of our Resilient Team Academy membership for busy leaders in health and social care, which gives online tools and resources to get a happy and thriving team. Now, the doors to this close this week. But if you want to buy for your PCN or bulk subscriptions for your organisation, there’s still time. So just get in touch, and we can send you some more details.

A few episodes ago, we mentioned that we were thinking of running a thinking retreat for You Are Not A Frog listeners. And we’ve had an amazing response. So thank you, everyone who’s got in touch. Thank you for your wonderful feedback about the podcast. There’s masses of enthusiasm for a retreat, particularly in nature, particularly around a fire. So we’re going to look for something in spring, summer next year. So do get in touch if you’re interested and watch this space. We’ll let you know when we have organised a You Are Not A Frog retreat.

Now, I’ve been going around the country these last few weeks seeing people, speaking face to face and also online with various courses and conferences. I’m going to be speaking at the Leaders in Healthcare Conference for the Faculty of Medical Leadership and Management in November. I’m running a face-to-face workshop on how to lead without rescuing.

We’re also doing a live online You Are Not A Frog recording all about failure. So if you have any questions about failure, please email them in or if you’d like to attend the workshop or the live You Are Not A Frog recording as a participant, then do check out the Faculty of Medical Leadership and Management website.

Okay, so on with the podcast.

It’s really brilliant to have with me on the podcast today, Dr Joanna Bircher. Now, Jo is a GP partner. She’s one of the RCGP QI clinical champions. She’s the clinical director of the Greater Manchester GP Excellence Programme. Also, she’s the co-author of The Leadership Hike, a book about leadership in primary care. So you haven’t done much then, have you, Jo?

Dr Joanna Bircher: I suppose it’s when you accumulate these things, don’t you, the longer that you survived in the world. So it always… you clock it out. It’s more to do with longevity, I think, than the massive achievement.

Rachel: Rubbish, because this book is absolutely fantastic. It’s quite a weighty volume, but it’s just got so much in there. How did you find the time to write this along with being a partner and doing all the other stuff?

Joanna: Well, unfortunately, I’m a co-author, so I didn’t have to write the whole thing by myself. Well then, we did do a lot of editing of each other’s work, which was a real pleasure, actually. Amar was a fabulous person to work with. What I did was, I dropped a session, then just made sure it was timetabled in, and tried to. In QI, I presided project planning. I would create a Gantt chart, obviously, what am I going to do this week? What am I going to do next week? So trying to just be a bit disciplined with it.

But I did say, at the end of it, ‘That’s it. I’ll never do that again. Not. Painful.’ But, of course, it’s a little bit like having a baby, isn’t it? And now, we’re busy working on the companion volume.

Rachel: We’ve got you on the podcast because there’s so many ideas in this book. We could probably do about 20 different podcasts just from all the different ideas in the book. But I guess when I was thinking about, what would the listeners of You Are Not A Frog want to hear about in terms of leadership, I started thinking, ‘Will they be interested in leadership or not? Will they just sort of ignore this episode?’ because it’s about leadership, and thought, ‘Well, actually, no.’ Because I think when you are a professional, particularly working in health or social care or any other professions, such as law, accountancy, any of that, I think just the fact that you are a professional, automatically, other people will see you as a leader, even if you don’t see yourself as a leader. Would you agree with that?

Joanna: I would absolutely agree with that. I think the place where I particularly noticed it is if you’ve got any kind of training in your practice, is they see themselves as being quite junior. Sometimes, because of that, they don’t recognise the impact they might have in a room, or a space, or a meeting or in a reception where they’re asking about something, how they behave and have an impact on how the staff feel, and they don’t recognise that. That’s because they’re then looked upon as being in more of a leadership role. So yeah, I do think…

Rachel: You’re right. It’s when we’re not recognising that that the trouble starts is some people are expected to behave like a leader, we’re not seeing ourselves as the leader, and we maybe I don’t know, behave a little bit badly or don’t treat people the way that we would do as if we had considered ourselves to be leaders.

So I think what I wanted to talk about, and I know you’re really passionate about this as well, is that people are leaders for all sorts of reasons. Some people are sort of born leaders. They want to go off. They want to lead. They’re always at the forefront of things. They’re leading student societies from when they were about five years old, aren’t they?

And then, some people just wake up one day and find — they’re flipping out — ‘I’m in this position of leadership. I never set out to be there. It’s just where I am.’ What’s your leadership journey been like? Is it the first example or that was…?

Joanna: It probably was the first example. And it’s been a fantastic learning journey for me to recognise that actually the best leadership skills that you have, are not that kind of willingness to step forward and to have the best ideas and the best answers, which might be the 10-year-old me. Actually, the best leaders are those that listen to the ideas of others and collaborate. I think there still is quite a lot of mythology around leadership, this sense that it’s somebody who’s charismatic, who has great ideas, who could force forward.

While that kind of perpetuates the sense of what people’s image of what a leader is, it actually gets in the way of people really developing their own skills, because they either don’t see themselves like that person, or they don’t particularly want to be that person, that image of a leader. It kind of crushes their development. So that’s been an interesting learning thing for me. I hope that my style has changed quite a lot more than when I was 10.

Rachel: How did you get into your sort of current leadership position now? What was that journey for you?

Joanna: Okay, I was a partner in a practice for quite some time, and then took on some additional roles. So I became an appraiser and appraisal lead and started to work with the CCG because I always had an interest in back quality improvement. I didn’t really know it was quality improvement at the time. Also, I’m interested in audit and data and getting things right. The CCG took me on in that role, and it’s from the back of that that I got a place on the Generation Q program, which was a development program funded by Health Foundation.

Leaders across health and social care and on the voluntary sector to take them through a master’s program over about two and a half years in leadership for quality improvement in health care and got the role of college initially as a support to the quality improvement and clinical lead, and then we became general lead quality improvement, and then the GP Excellence Programme soon after that.

So once I’ve kind of hit that Health Foundation program, I could see all the opportunities that were out there, and it actually became less daunting when you realize that leadership isn’t all about knowing everything. It’s actually a bit of a relief to get out there and use different skills, exploring new ideas, what is bringing people along, and trying to think together rather than leading from the front. So yes it became a kind of nice wrong, really.

Rachel: Yeah, cuz that is quite — what’s the word — confronting that if you’re thinking that in order to be a good leader, you need to have all the answers, you need to know everything, then either no one’s going to become a leader, or the only people that become a leader are people that are completely deluded.

Joanna: Yeah, which is not a good place to be, is it?

Rachel: We’ve seen what happens!

Joanna: We have.

Rachel: To our people, haven’t we?

Joanna: Yeah, and also, if you feel so strongly that you do have the right answers, then you’re gonna miss so much. Aren’t you? So you’re going to miss so many opportunities to go in a direction you would never have thought of. Our own capacity for thinking is tiny compared to groups working together.

Rachel: Yeah, totally. In coaching, I soon realized when I was training to be a coach, that actually the less you know about the professional, the circumstances of the person that you’re coaching, the better. Because it stops you interfering in the process because all the ideas and the solutions are definitely coming from that person, not from yourself.

So one of the best coaches I know, she’s an ex-teacher, she coaches someone in the nuclear industry. She can’t give them any of the answers. They come up with the answers. Would you say that being a really good leader is almost a bit like that? If you don’t know all the answers, but you possess the skills to be able to listen, collaborate and then make good decisions, would that be much better than someone who definitely does know all the answers?

Joanna: I think it’s definitely better. But I don’t think there is a problem in leaders having some ideas too. But I do think that recognising your power as leader and when you’re presenting your ideas is really important. Because if you are perceived to be the most important person in the room by others, sometimes, once you’ve spoken, it crushes the ideas of others. So once you’ve said your idea, others in the room may feel that it’s now their role to implement that great idea. And actually, it may not be the best idea.

This is about having that awareness of power and what you bring to the room. A good leader can have great ideas but also have a massively, well-tuned awareness of the potential harm of coming in too soon with that idea or… Because actually, if that idea comes from somebody else and not from you, even if you were thinking it, it will have a greater, I think, a greater impact in the long term. Because you then get behind the idea. And if you’re able to really get behind someone else on your team, who perceive themselves having less power, it gives them a step up, boost their leadership development, their ability to work.

Rachel: Another phrase similar to coaching, actually. We know that if someone comes up with a solution, they’re much more likely to do it than if you come up with a solution. I think this self-awareness, this awareness of power is a really interesting thing. And it goes back to that thing we were talking about right at the beginning, professionals not realizing that they are seen as leaders by other people. And so that when they do speak, they think they might just be contributing.

But often, that does just shut everyone else up. Because they’re the doctor or they’re the lawyer, they must know everything when you might just be saying your opinion. And we know we’re quite good at giving our opinions really. It sucks as we don’t hold back. But other people might be holding back. They might actually have much better ideas than us.

Joanna: Yes. And I think it’s a fair assumption that they’re more likely to be holding back. I find it really interesting how different techniques will bring people’s ideas out. So depending on their own kind of style, they may feel much more comfortable writing a few notes down, and then somebody else doing the talking and finding a way of actually getting proper and contributing.

But in order to bother using those methods, the first step is to make sure you really fully recognise the value of that because I’ve seen some people kind of pay lip service to collaboration and contribution. But when you look at what the outcome is, it wasn’t that they were allowing themselves to be changed by that process. And the same is really coming to the table with a properly open mind, isn’t it, when you’re going to try and collaborate on something?

Rachel: Yeah, not just thinking, Well, I know what the answer is. Let’s help people collaborate. It’s not my decision. Let’s give them a chance to have their say. That’s what a lot of consultations feel like, isn’t it? ‘But consulting with you this week, our mind is made up anyway. But we want you to feel that that that you’ve had your say.’ And I think, having looked through the book and chatted to you for a bit, it does seem like, this whole area of knowing the answers and knowledge is just such a tiny part of being a leader. And actually, there’s a lot more in this book about self-awareness.

Joanna: Yeah, knowing your own strengths and what drives you, it’s important because that in terms of keeping your motivation for work, keeping your joy in work, making sure you stay connected with what drives you, and it’s going to keep you going, isn’t it, and help to prevent stress, help to prevent burnout. It’s making the most of that knowledge, your own self-awareness, but recognising the importance of things like drives for other people around you and recognising strengths.

Rachel: In my mind, there’s two barriers to self-awareness. Particularly, with people like doctors, the first barrier is that we are so busy and so stressed quite a lot of the time that it’s really hard to be self-aware when we’re often in that sympathetic zone. I call it being backed into the corner when we’re in our fight, flight or freeze zones. We’re just trying to get through the day. We’re not really thinking straight. We can’t really be creative. And then, self-awareness is pretty much the first thing to go. The second thing to go is awareness of anybody else and their motivations. So if we’re really busy, self-awareness flies out the window.

The second barrier, I think, and I’ve noticed this a lot in the doctors that I’ve coached and spoken to is that we’ve never been taught about self-awareness. Not in terms of like this is what self-awareness is, but actually, when I talked to my husband he said loads of personality profiles, skills, recognition, stuff, he knows what his strengths are, he knows what his colours are, his Myers-Briggs profile because he’s been through all that in leadership programs throughout his business.

We’ve never done a strength survey even, or we don’t know what our colleagues’ profiles or anything about that. Maybe it’s because we don’t have time or because it’s not particularly recognised or you only get that if you’re doing an official leadership program.

Joanna: I think what’s really positive about the new fellowships coming through, immediately post-CCTs, they’ve often got more of a focus on this. So people are having more a chance to look at their strengths, their personality, how that might impact on the job they do and how they feel about the job that they do. My slight theory is that becomes a kind of deficit model. Because we do this, don’t we? We focus on what we scored badly on.

We know this from patient feedback. You might have got like 98 lovely comments about how wonderful your practice is, and then two, which those are the grumpy. The only things you remember are things… So I feel slightly that sometimes if people focus too much on those profiles, like, ‘Oh god, I’m no good at that. I’m no good,’ and actually focus on the things that you are good at, and actually look for where those other strengths are in others and enjoy that, because you’ll build a much better team if that’s the case.

Rachel: When you were talking about your strengths earlier on, I was thinking, me and you would make a brilliant team because you love data and spreadsheets. I can’t bear it! Killed it! it’s the worst bit of my training, and you’re jumping up and down, going, ‘Yay!’

Joanna: Yeah, I’m a very useful person when it comes to data, and then get disappointed when people aren’t excited about data with me.

Rachel: Having heard you talk about data, I can see why are you excited. Because you look at it in a completely different way.

Joanna: My important thinking about the leader is the recognition that not everyone is as excited by the data as me. And that’s okay. So to find a new narrative, to find a way of telling the story, to some people that might mean looking at the data, and for others, it might mean more of their kind of narrative approach. So that’s been a bit of a thing about journey to self-awareness is that just give me the kind of benchmarking graphs weren’t made and suddenly wants to do something different. That’s that.

Rachel: Also, understanding your strengths come easily to you. So I’ve had a few conversations with some friends. I’ve obviously started a podcast, started an organisation, have done stuff, and the stuff that I really enjoy doing like presenting and stuff like that. And then, someone else I was talking to was trying to do very similar, so I’d like… ‘How about doing some webinars or this and that?’ And just said, ‘All you need to do is get a Zoom account and do this and that.’ And I could just see the blood draining. It was like ‘Hah! Mmm.’

I had exactly the same experience but in reverse. The other week, I was talking to someone who’s really good at improving usability on websites and stuff. And he was saying, ‘All you need to do is just have a look at x, y and z.’ And I was like, ‘Ohhh.’ Then, it was like, really easy and really obvious. And for me, I was like, that I don’t… I couldn’t even… I just could feel my anxiety. Because after all, maybe that’s what it feels like when I tell someone just to jump on a webinar and do a webinar.

Joanna: That’s really easy, except like, when we’re confronted with our deficits, with the things we’re less good at, they can generate a real kind of a horrible feeling and our concerns, ‘I need to learn that thing. I must learn that thing.’ If you can kind of stay close to your own strengths and what drives you, you can actually take a step back and think, ‘Do I want to learn this thing? Do I want to do that thing or other things that my strengths are better used to doing?’ It might be that you do, that you think, ‘Actually this’d be the thing that will take me to the next step, and I’ll learn it.’ But you don’t have to do it. There are people out there that can do that stuff.

Rachel: Also, this person I was talking to, I was like, ‘That sounds like it’s about two weeks work.’ He said, ‘I’ll do it for you.’ I said, ‘Oh, no, I couldn’t take advantage of you.’ He said, ‘It will take half an hour.’ I was like, ‘Really?’ If someone’s good at something, it will take them a lot less time. And I really liked what you were saying earlier in the focus on developing your strengths rather than developing your weaknesses. I think you’re absolutely right.

We have focused in medicine on developing our weaknesses, partly because if you’re not good at communication, and you’re a doctor, you probably do need to learn to communicate. There is a basic level you need to be at, right? But actually, we know that you’re going to be much more successful. It’s more economical. You get more bang for your buck by developing your strengths than developing your weaknesses. And you’re not going to enjoy it as much. So you’ll never be brilliant at it. But we’re not really in that mindset, are we?

Joanna: No, and you’re right since a lot of the models that we have to. We have to achieve certain competencies definitely not fixed that one set. But there’s a greater advantage in being aware of the things that you’re less good at in that this is your great opportunity as a leader to bring on those skills that springs on your team that supports you and that you really need, that builds a better team.

Rachel: So how would you go about actually finding out what your strengths are?

Joanna: Some of the profiles that you mentioned, strengths and inventory and doing a Myers-Briggs, they’re all useful to a certain extent. Sometimes, conversations with people who you trust and who understand the dynamics of where you work can be really useful. We’ve certainly done this as a partnership and at various points. I actually work with my husband, so you’re much more honest with your spouse, aren’t you, than I think I probably would be in the work I do. Obviously, everyone doesn’t have that advantage.

But in terms of the impact of me being me on a dynamic in a room and on the patterns within the practice, he would be my most honest critic, which actually, it’s been really helpful over the years. It’s not always been feedback that I’ve wanted to hear. But in the end, it’s usually been really useful feedback.

Again, we go by self-awareness. It’s that recognition that you being you will have great things that what happened as a result, but also side effects that we bring. We bring something positive to a room. But there is also, like any intervention, improvement intervention, drug intervention, it can have side effects. It’s kind of having that those, ‘What are some side effects of me? And how do I mitigate for those things without beating myself up?’ Because everything comes with good and bad.

Rachel: Yeah, I really like that idea of looking at it as side effects rather than but on my weaknesses. Actually, what are the side effects of my strength? I know. I have lots of ideas. I know I can just overwhelm people with too many ideas at once, and then no one knows quite what they’re supposed to be doing. That is a side effect of having lots of ideas, rather than framing it as a weakness of I’m a bit scattered and not particularly focused. I like that. I’m gonna use that. What are the side effects of your strengths? And you can see that people that are really good at detail, really good at detail and spotting problems and holes in it, the side effects of that are, in a team meeting, if they go into the detail too quickly, or they start to critique something too quickly. They can actually quash an idea, can’t they?

Joanna: Yeah, and suck the energy out the room. But if they knew that that was a strength, that was actually really, really important, but it just needed to be placed at the right time. So it’s about recognising that that person’s strength is great. And we find this in QI, so when you’re implementing an intervention, and you’re measuring what the positive outcomes are, we always have a balance measure. We try to get some kind of balance measure, and that balance measure will be ‘bout the things that could go wrong, what do we need to make, or what are the side effects.

Those details, people are brilliant at that. They’ll be thinking about things that might go wrong and recognising that that’s actually an important role. And you need it. But actually, it would be really great if we could have it at this stage. Let’s say at the moment, we’re just throwing ideas out. We’re at this stage, and that person knows what their role is, and when it’s best situated, and they can even write down the things that are worrying them at the moment. So you’d have to verbalise, not just yet, but scribble them down. Because it’s really difficult holding it all in your head. If you’re finding things that are worrying you about the concept you’re having, when we get to that stage, we’ll table them, and we’ll look at them together.

I think another way of thinking about the side effect is that, sometimes, the brighter people shine, the more shadow they can cast. So we struggle, and everyone has different levels of kind of self-confidence, don’t they, often based on their own background and personality type, parenting, all sorts of things built. And things can either can crush people’s confidence.

In situations where the more confident somebody is in a room, the less confident others can sometimes feel, which is why I see it’s a kind of the shadow side. I wouldn’t think that anyone should ever crush their own confidence or make themselves smaller because I don’t think that’s helpful. But I think a recognition of the power of the personality on people who are less confident is useful in terms of how you capture something, how you vocalise something.

Rachel: Yeah. Also, I think it’s power of hierarchy as well. I think that the higher up the tree you are, the less you see the hierarchy. I used to run the doctors professional program. We had a talk from a very senior doctor in the trust. And he said, ’There’s no hierarchy here at all,’ to a load of third-year medical students. And I just thought, that’s really interesting because I’m sure the medical students feel the hierarchy. And I’m sure the junior doctors feel the hierarchy.

Even if the leaders genuinely don’t want there to be one, it’s always going on. No matter how kind and compassionate and non-hierarchical you are as a leader, if you’ve got people that are more junior than you, or maybe a different type of profession, then it’s their own assumptions, no matter how much you don’t assume that. People always just feel that. Particularly, if you feel that you’re at the bottom of the heap, you will massively see that hierarchy. And you ignore that as a leader at your peril, don’t you?

Joanna: Completely. In general practice, we’ve got an employee-employer relationship, haven’t we, which has obviously got hierarchy inbuilt to it because you’re paying someone’s wages. I think if you denied any hierarchy, what you will then do is fail to mitigate for it because you’re basically in denial, I think. Know that these power imbalances are always going to be there, and then work on how you mitigate them.

It’s the same with the doctor-patient relationship, isn’t it, a clinician-patient relationship. There’s an inbuilt power imbalance that will be really helpful if we mitigate.

Rachel: Yeah, yeah. And you always could get that no matter how, it can’t be overcome just by saying there’s no hierarchy. You have to do it. You have to act it, don’t you? okay? ‘Yeah, I really want to hear your ideas. That’s great.’ That’s really important, holding back maybe your stuff until the less confident or the people who see themselves as lower in the hierarchy have really had a chance to say their piece. And again, that’s about awareness of what’s going on not just self-awareness, but awareness of what’s going on in the room.

Joanna: Yes, and the natural tendency is for people to hide their thoughts if they’re not confident in their brilliant ideas and how do you get those out using more collaborative techniques. If you deny this apparent problem, you’ll do nothing to help it.

Rachel: No, no, and you can’t wish it away either. And you can’t get it away just by being nice as well.

Joanna: And you can’t moan about it. So you see, sometimes, where people are like there are meetings and don’t have any thoughts on this, and there’s just silence in the room, and then later, the person leading will say, ‘Well, nobody ever contributes. Nobody ever does this.’

It’s such a missed opportunity because it’s not recognising that if people haven’t spoken, that definitely does not mean that they’re not thinking or that they don’t have ideas. It means you haven’t yet found a way of bringing those ideas out. So the problem is with the method that you’ve used, not with the people in the room. But yeah, it’s sometimes easier to blame them, the other people in the room.

Rachel: I like that. I like that. So always assume that the people in the room have got stuff to say, and it’s your job to get them to say it.

Joanna: Yeah, they do, don’t they? Because they will chatter away quite happily when you’re not there and ideas will come up that way.

Rachel: Yeah. And if they really haven’t got anything to say about it, it may be because they really hacked off what’s happening and they’re sulking, and they just go.

Joanna: Yeah. And you did that as well.

Rachel: Yeah, well, exactly, exactly. How do we get more self-awareness? What would you suggest people do?

Joanna: I think, as I mentioned before, sometimes a formal tool is useful. But I do actually think that genuinely going with an open mind to asking others is helpful. As long as it’s somebody that you know you can trust to be kind to you.

Rachel: I was just thinking what a gift that is to… Well, I guess a double-edged sword to be working with your husband because I think your partner is the one person who just gives you the… It’s the best method of giving feedback because the relationship is there, and you’re not going to be worried too much about really upsetting them, whatever.

You can just give it how it is, and you’ve got hopefully the best intentions behind it to really help that person, and you’re not going to mince your words. I just think that’s great. How can you get that feedback relationship with people that you’re not actually living with or whatever?

Joanna: It’s sometimes about giving them permission to isn’t it? Having somebody that you trust in the practice, who knows that you are really interested in your impact on the room, both positive and negative, and whether it’s always productive and useful, or whether it might be worth testing out new ways of being.

It’s a little bit like when we do quality improvement. We don’t suddenly have a massive revolution, change everything. We test out a new way. ‘I wonder what would happen if I do blah.’ Having someone that knows that you’re doing that and can be your partner alongside, your pal that you can have a chat afterwards.

‘I could try this out. What do you think? Did that work any better? Or I’m wondering about whether if I use more techniques. Are we writing stuff down? Or whether I speak less, or whether I…’ And get them to kind of give me some feedback that way. I would think that would be a pretty good way. I’ve not tried that out myself because I’ve got my husband. And that’s easy. But actually, there can be a lot of workplaces where that will work.

Rachel: We did an exercise actually with our Red Whale Lead Manage Thrive team. Also, I’ve done this in a team coaching session with a team where it’s like speed dating, but speed feedback. You sit down, and you’ve got five minutes. You say to the person, ‘What do you do that’s particularly effective? What do I particularly appreciate about you and what you’re doing?’ And then the next question is, ‘And you would be even better if… Or your work would be even better if…’ That ‘even better if,’ it’s a really, really helpful way of raising… ‘Even better if, what if maybe, you took a couple of minutes to pause before you spoke. Or you focus on this more, which would make it even more effective.’ I got very good feedback.

Joanna: That’s interesting. Another way of doing that could be, rather than the kind of deficit model, you look at the impact model as a side effect thing. So ‘I love your great ideas, and sometimes because you have great ideas and you think really quickly, that can have the side effect of stopping other people from thinking or making them… They don’t think as quickly as you, and so you’ve come up with the ideas and that questions any contribution not because they don’t have it, but because your contribution’s actually great. But see, more things don’t come out.’ So you look at how you mitigate the side effect rather than you having to check. Look at how you mitigate it rather than ‘You’re wrong or bad.’

Rachel: That’s that really helpful thing of side effects. I really like it. But I personally have found strengths inventories really, really helpful. For listeners who have never done one they often involve a really long list of questions, then we’ll take half an hour or an hour to just answer these questions. But then, what comes out the other end is a list of strengths. It might be 30 strengths. You’ve got this list of all your strengths, which is great. ‘It’s brilliant. I’ve got all 50 strengths but in order.’

Basically, the top five are your key strengths and the stuff at the bottom is, ‘You’re really crap at this.’ That’s the way I take it anyway. But that has been really helpful. There’s several you can do on there. There’s one by Gallup. There’s a CliftonStrengths Finder. There is a free version that people can go to. It’s called the VIA survey of character strengths. Martin Seligman’s organisation do that. I’ve just found that really interesting and really helpful.

Because actually you sort of think, ‘All my strengths are being compassionate.’ But actually, the sort of strength they come out with is… One of them was like, winning others over. That’s interesting. So actually, quite good at being persuasive about things or communicating. The strength that came up with me. Well, when I read that was like, ‘Yeah, that makes sense.’ But I haven’t ever really identified that. And it really did change then what I focused on in my work and the stuff I went after. I don’t know if you found that happened when you did one.

Joanna: I think the fear is that we focus on the bottom five and go up feeling rubbish. And that’s what we need to make sure when we move away from. You use your strengths in your role as leader, isn’t it, and in your, in your general and working life.

Rachel: How helpful is it as a leader to be aware of either the personality profile or the strength or the motivations of other people in your team?

Joanna: Particularly, the motivations, we forget how important that is for things like job satisfaction and joy in work. People, no matter what part of the art team they are, whatever role they’re working in, from the person that comes and cleans the practice to sometimes reception staff or practice nurses, they have gone into that role because of some motivating factor. It’s very rarely just about the money.

In terms of their strengths, as leaders, it’s one of the things that we do do, is we keep an eye on what they’re doing. We know what they’re good at naturally. So yeah, I think really important. And either formally or just kind of observationally just from what we see, I think how comfortable people are being what that, what education level they’ve gone through, that’s a different degree of comfort with formal psychological profiling and things.

Rachel: I have seen some emails from people in some corporate jobs, which literally have their personality profiles on the bottom, or they have like, ‘I score three yellow, and pen red, and five blue’ or something like that, which could be really helpful if all the team had done exactly those four colours, their goals, or something like that. It’s always… That’s pretty interesting that that’s in their signature. It’s pretty helpful.

Joanna: I’m the go-to person for a hug when you’re feeling down. Or I’m the go-to person for the answer when you need a bit of… you need to detail that sort of a… please look for me, yeah.

Rachel: ‘Yeah, don’t mind me when I just tell you what to do because I’m extremely red’ You’d only read it in that category or whatever. But it does just help you make allowances for people, doesn’t it? Yeah. So we talked a bit about self-awareness and the importance of it.

I would say I think the thing that’s helped me the most for self-awareness is actually coaching, is getting a coach and talking, talking things through. If anyone can get hold of a coach, there’s quite a lot of free coaching available in the NHS. I know there’s quite a lot of free coaching available through the various leadership academies as well.

Joanna: Yeah, I think the NHS one is the LookingAfterYou program, isn’t it? So if you go online and put in ‘looking after you, NHS’…

Rachel: Really worth it. I think, sometimes, in medicine, we have this thing of you only get a coach if something’s wrong, you’ve got to solve a problem. Actually, no, in business, if you’re a senior leader, you have a coach. You’ll have a leadership coach to help you. Decisions are hard. They’re complex. So get some self-awareness. It’s really important.

Just before we finish, what other attributes would you think it would be really important to really work on if you want to really improve as a leader, even if, even if you don’t really want to be a leader, but you’re just there anyway.

Joanna: Okay. Listening, active listening. That would be my number one. I think the number one most important leadership skill is about properly trying to understand what somebody’s saying. It sounds really obvious, doesn’t it? But it does really mean stopping your own brain almost. I can’t remember where the quote came from, but real listening isn’t just waiting for your turn to talk. So naturally, we get fed a cue and our brain starts thinking of our contribution to that thing. And immediately, from that moment that happens, we stop, and we stop listening.

I also didn’t coin the term to this either, but autobiographical thinking, so somebody started to say something, and immediately, we put in our own slant on it, depending on our own story. So what, when we experienced that, that’s when we and all those things get in the way of proper active listening. Obviously, coaches are really properly trained in active listening. They’re there just to do that.

But if we all did a little bit more of that, leaders do that probably when a team member mentioned something, how do you stop yourself making an assumption about what they mean? How do you take those questions just to the next level about, or ‘Tell me exactly what happened, and how did that feel?’ Because you can really crush somebody’s feedback on something that they’re trying to tell you by making those assumptions. Yeah, listening, number one skill. And I’m still working on it.

Rachel: It’s hard. The problem is, as GPs, we think we’re trained how to listen. We’re not, really. We’re trained how to listen in order to diagnose, not listen in order to just really, really understand. And the quote I’ve heard is, ‘People around here, don’t listen. They just reload.’ As a leader, I think if people come to you, even just expressing displeasure about something, you can often feel it as direct criticism, even when it’s not. They’re just saying something that got on their nerves. And then, your initial reaction is defensiveness, isn’t it? Your metre flares up. Your defensive. Then, you stop listening. Whereas, if we could just get ourselves go, ‘Tell me more about…’

Joanna: ‘Tell me more.’ Yeah. And actually, you mentioned about, although it’s mostly the diagnosis, but we also kind of probe what patients are thinking and what they were hoping for. But we forget to do that outside the consultation room. And somebody comes to us with an issue or a problem. And in a practice, when we’re in our leadership capacity, or whatever level we’re working as a leader, and we think that they’re coming to us because they want our answer. They want our solution.

When patients consult with a problem, we try to not assume that what they want is a diagnosis and a management plan. Actually, they might want a completely different question answered or something else is on their mind. We’re trained to be really genuinely curious about that. If you could translate a bit more of that genuine curiosity, which you’re right, sometimes, means question your gut reaction if it’s negative.

But also, question your gut reaction of assuming that they’d come to you for a solution, when actually they want to talk something through. If you have to be the person with the answers, that’s not a great place to be. But if you’re the person that then will listen and help that person, I think a bit coaching skills for every leader is good and to help that business come to you with their issue to come up with their own answer, that will be a better answer, definitely.

Rachel: We use ideas, concerns and expectations, don’t we, in a consultation. Just use that with people. And even if you don’t see yourself as a leader, someone can see you moaning about something. Just try it. Any other top tips before we go Joanna? What would your three top tips be for being a good leader, even if you don’t feel like it?

Joanna: Okay, so number one, genuinely believe that you’re not the person with the best ideas. Second one would be learn how to listen and continue to practice it because you will slip back into old habits frequently with them, probably had decades of not proper listening. So definitely do that. I quite like what you summarized before after we were talking about in the room that remember that everybody in the room with you will also be having thoughts. And if you haven’t heard them, then you haven’t come up with a great idea to help them to express them.

Rachel: Great, those are three fantastic top tips. So Joanna, we are out. We’re out of time. But will come back on the podcast at some point to talk more about…

Joanna: It’s been really nice to talk to you, and you might get me just talking about data and quality improvement. That will be my next… I have my mind, most papers, objects of…

Rachel: So, Jo if people wanted to contact you, get ahold of you, how could they do that?

Joanna: I’d be happy for them to use my NHS net email address, which is joanna.bircher@nhs.net.

Rachel: Great. And they can find the book, which is called the Leadership Hike. How can they get ahold of that? If they want to read it, and I’d recommend it it’s really good.

Joanna: It’s available from all booksellers. You can order it from normal book shops, which is obviously what we like to encourage. It’s also available from the big online sellers.

Rachel: Great, thank you for sparing the time to go in here. And best of luck with the book and the second book as well, and we’ll speak to you soon.

Joanna: Lovely thanks, Rachel.

Rachel: Bye.

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