Lessons learnt: healthcare leadership from many cultural backgrounds
I have been very fortunate to have worked in the international environment for the last 10 years. This has given me practical experience of different leadership practices around the world. I am often asked how are we in Australasia different in our leadership experience?
The best way to answer this is by outlining two stand out personal learnings.
Listening not just hearing.
I first realised I was not truly listening when working for the private company International SOS in London. My role was group head of international health strategy targeting the government sector. The role was wide ranging from working on service delivery for the Ebola outbreak In Sierra Leone to providing medical services in war zones.
I had a team that was global. Finance and IT were in Singapore, the hostile territory medical team was based in Dubai and special expertise was anywhere in the world including offshore on oil rigs. We formed project specific teams and International SOS was in 79 countries.
Diversity in languages and cultural backgrounds were immense. This is before considering core professional skillset.
Discussing a project on skype I sometimes barely understood the words spoken. I had to learn to listen. I realised my listening had a judgement on the type of answer I was expecting and I was ready to provide an answer before they finished the sentence. I also had a habit of multitasking at the very least tidying up my desk or getting ready for the next meeting when on a phone conference.
Learning to listen included staying 100% focused on the conversation. I also learnt to watch for body queues, tones in the voice, eye movements and used my intuition a lot.
Major advantages arose as my listening skills improved:
- It opened my mind. It was not uncommon for someone to completely misread what I was saying and put their own interpretation on the topic. Listening to their response I realised that how they interpret what I said was a very good way to analyse the issue and gave me a very different and enriching experience in how to analyse the problem from a new angle.
- Improved teamwork as well as team alignment. The opportunity cost of a team member truly not understanding what they have to achieve and how important their work outcome is to the overall project can be a major outcome stopper.
- Some cultures are very polite and are not use to a woman leader so I had to ensure they truly agreed with our direction moving forward and were not just nodding their head (in either direction) in agreement.
- Increased my empathy on how they truly felt. To be more aware how they felt individually and not just accept what they learnt to project to succeed at work. I learnt to focus my attention to each individual to see how they understood from their own cultural as well as professional background to identify how best to align their activity to an agreed direction,
The outcome was that diversity in looking at the same problem at different angles always resulted in a more robust solution. Building empathy through developing my listening skills leads to better staff engagement. The outcome of improved listening is priceless.
It does leave the question. Can we in Australia and New Zealand benefit from having a more culturally diverse health care executive team?
Best practices are from “third” world countries.
I’ve worked in a number of developing countries. There are three scenarios to share with you.
- The best disruptive thinking I have seen is in third world countries. They trend to vision the solution and then work backwoods to establish the process. They can introduce new technology with a mindset that is not limited by trend analysis and lamenting on evidenced based data. Crisis war, threat to individual safety opens your mind to new ways of thinking. Survival creates a mindset that can leapfrog traditional thinking. Consider how many parts of Africa has advanced in the use of smartphones to a cashless economy.
- I am currently working in Lviv Ukraine at the Ukrainian Catholic University. Developing a course in public health we were discussing the section on ‘health equity’. I was talking about equal access to health care regardless of socioeconomic group or distance to care. The Ukrainian academics translated “access” into “treating everyone with respect and dignity”, access was an ethical decision. The more I thought about it the more I realised that this is indeed the correct way to consider access.
- Traditional culture is a key strength in developing health care solutions in developing countries. Many of their solutions with very little resourcing come to deliver robust models of care that we in the west could learn from. I am very grateful for having Lord Nigel Crisp, retired Secretary of the NHS, as my mentor while working in London. His book Turning the World Upside Down identifies many of these health solutions driven by developing countries.
In conclusion, International best practice can be found in developing nations. It raises the question whether we need to expand our thinking to a wider range of solutions than traditionally a US and UK benchmark?