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Much like the man himself, Dr. Bryce Taylor's book is thoughtful, comprehensive, wise, funny, straightforward and required reading for anyone working in complex organizations—medical or not.
Effective Medical Leadership is an easy-to-read primer on everything from structures of academic teaching hospitals to the importance of careful recruiting for effective, stable teams to risk and decision-making. Throughout, he presents a realistic version of what a leadership job entails: "the glow…and prestige of a title… endure all of about two days, when the stark realization of the responsibility and work ahead becomes clear."
With his characteristic emphasis on optimism, accountability and integrity, Dr. Taylor leads readers through the modern leader's constant balancing on a "barbed-wire fence" with clearly laid-out chapters, and multiple examples of compelling situations and the pithy lessons learned in bold print.
"This book provides some secrets and stories of Dr. Taylor's many successes and rare failures during a long and storied career as one of Canada's great physician leaders. He recognizes the fundamental importance of physician leadership in improving quality, safety and hospital morale," says Dr. Bob Bell, President and CEO, UHN. "There are many pearls of wisdom in this book, but having watched Bryce lead for the past twenty years, he has only used a small allocation from his pearl garden. I have a feeling there are several more books to come. We need them all."
Effective leaders must have a vision, understand the big picture, and care about details and, above all, people. He adds that leaders must be frank and forthcoming and live their values alongside the values of the organization. Any deviation from this gold standard and you might as well pack up and get off the bus.
He describes one such moment from early in his career, when he decided to override a decision made by the OR team to hold off on an emergency case. "It was a bad mistake," he admits, because it went against a proven process. He consequently had to suffer the wrath of Nurse Betty who told him to "grow up." Such clarity and honesty abound in the book, offering fascinating glimpses of difficult decisions.
In one example of walking the "barbed-wire fence," Dr. Taylor describes leading the surgical department during a time of intense cost-cutting mandated by the hospital Board. For surgical services, this meant decreased operating time and inpatient beds. However, Dr. Taylor continued to passionately argue the case against such reductions to the hospital CEO, until the CEO reminded Dr. Taylor that the debate was over, and that as a hospital leader, he must respect and support the Board decision.
"Bryce has always been fair and honest with both the clinical and administrative sides," says Dr. Lorne Rotstein, Head of General Surgery, UHN. "He is principled and fair-minded, and my colleagues and I have never been blind-sided by him. He is transparent, honest and has the ability to balance the needs and aspirations of his constituents with the requirements of hospital administration. A masterful juggling act."
One of the most intriguing chapters is devoted to the character of a leader, a compilation of hard-earned lessons from 30 years as a university, hospital and national medical leader. Written in a down-to-earth style, this section could be tacked on to every bulletin board as a blueprint on how best to behave in complex environments—be it a major research hospital or a family celebration with strong personalities voicing equally strong opinions. What comes through, time and time again, is Dr. Taylor's emphasis on cultivating "the way you are," including being appreciative, consistent, saying sorry when appropriate, and listening to people.
"When I meet other OR leaders, they're jealous that we have a champion of quality, respect and teamwork such as Bryce. It's a culture where teamwork trumps hierarchy," says Gillian Gravely, OR Nurse Manager, TGH and PMH.
Perhaps the most poignant and personal story exemplifying his leadership style is recalled by UHN surgeon Dr. Sean Cleary, who was a surgical resident and fellow of Dr. Taylor. "His patients love him, he remembers everyone's name, and loves to laugh at his own expense. He understands and practices both the art and science of medicine," says Dr. Cleary, recalling a telling incident at a time when the Eaton elevators were staffed.
"Upon entering the elevator, Bryce started to chat and joke with the elevator operator, much to the amazement of his surgical fellow who later wondered out loud why an eminent surgeon would know the name of the elevator operator (let alone talk with him). Dr. Taylor replied, 'Why wouldn't I? I see him every day.' I have never forgotten that, and, as his former student and now colleague, I will always try to emulate the way he treats all members of the hospital team with courtesy and dignity."