Carpenters and Surgeons: Measure Twice

Surgeons are like carpenters says orthopedic surgeon Lauren Forese, speaking for the Princeton University’s Keller Center for Innovation in Engineering Education. Both surgeons and carpenters use a lot of the same equipment. and they make people and things better. Forese is senior vice president, COO, and chief medical officer of New York-Presbyterian Hospital/Weill Cornell Medical Center. She is responsible for 1,000 beds on two campuses. The daughter of an IBM corporate vice president she graduated summa cum laude from Princeton in 1983, went to Columbia Medical School, and has a degree in health services management from Columbia.

Forese had just given birth to twins when she finished her residency and was advised, to her consternation, to go back to school for additional skills that would help her get the right job down the road. Her husband was also an orthopedic surgeon, and her mentor predicted that, in the geographical politics of medicine they both might not be able to find jobs in the same place. With additional skills on her resume she would have more flexibility. She followed that advice and now she no longer enters the OR as a surgeon. “I miss the interaction with patients and families” she said “but now I run a hospital.”

With surgical illustrations she recommended the same principles for leading a two-person team as for leading 1,000 people.

Act like a leader. In an operating room, no matter how complicated the procedure, just one surgeon is in control. Set the tone. Leading is not the same as managing. At least by the end of the day, say your opinion.

Delegate praise to the team but shoulder personal responsibility for mistakes.

Snap out of analysis paralysis. Yes, measure twice and cut once. But perfect is the enemy of good. You never have all the information you want.

Communicate optimism. No surgeon enters the OR without the sense of “I’m going to make this better.”

Admit mistakes immediately. You have a very brief window to do that and teams can die from dishonesty.

Use precision to cut out the toxic. As a leader you may need to remove someone or some thing that does not allow things to go forward.. Use a scalpel not a machete. It’s about the health of the patient or the greater good of an organization.

A video record of this talk will be posted at the Keller Center. The photo on this blog was taken by Frank Wojciechowski.

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