IDSA Leadership Institute Leadership Bolus

Dr. Hartzell is a member of the faculty for the IDSA Leadership Institute. He is a board-certified internist and infectious diseases physician. He served 25 years in the United States Army, including a deployment to Afghanistan as a battalion surgeon with the 82nd Airborne Division, before retiring in 2023. He has held multiple academic roles including assistant dean for faculty development at the Uniformed Services University and program director for the National Capital Consortium Internal Medicine Residency. He completed a Master of Science in Health Professions Education at the MGH Institute of Health Professions, where he continues to teach leadership development. Dr. Hartzell’s current academic interests include leader and faculty development to empower leaders to create positive change in their spheres of influence at work, home and communities. 

Happy holidays!

December is a time for many to take a pause, get some rest and spend time with family and friends. Wishing you all time to recharge and create some memories. 

The courage to lead

I came across this interesting article, “Now Is the Time for Courage” by Ranjay Gulati, PhD. The article talked about how, given all the challenges we are facing in our world today, we need to have the courage to lead and make change. We similarly face numerous challenges in medicine. It reminds me of one of my favorite President Theodore Roosevelt quotes from his “The Man in the Arena” speech”:   

“It is not the critic who counts: not the man who points out how the strong man stumbles or where the doer of deeds could have done better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood, who strives valiantly, who errs and comes up short again and again, because there is no effort without error or shortcoming, but who knows the great enthusiasms, the great devotions, who spends himself in a worthy cause; who, at the best, knows, in the end, the triumph of high achievement, and who, at the worst, if he fails, at least he fails while daring greatly, so that his place shall never be with those cold and timid souls who knew neither victory nor defeat.” 

Dr. Gulati, in his article, outlines steps to cultivate courage and to lead: 

• Create a positive narrative 
• Cultivate confidence 
• Take small steps 
• Find connection  
• Stay calm  

Thank you all for leading and being in the arena! 

Evidence-based leadership corner 

 More on gratitude … 

A recent Harris Poll of 1,504 health care employees reported that 84% “felt underappreciated at their current employer,” and 55% are looking for a new job. A report from Achievers Workforce Institute stated that only 19% of employees say they are recognized weekly. My experience in health care is that this percentage is even lower. 

This leads me to this excellent article, “How Does Gratitude Relate to Nurses’ Job Satisfaction: The Mediating Role of Resilience and Stress” by Bai et al. The authors reported that gratitude improved resilience and decreased stress.  

The data continue to mount indicating the importance of demonstrating gratitude at work. As we approach the end of the year, make it a point to show gratitude for the people you work with. Give a heartfelt “thank you” for something they do. My challenge is for you to write a personal, handwritten thank-you card for at least five people. One of these five needs to be someone outside of work for whom you are grateful. 

Steps to success 

One last wellness tip: How many steps are you getting per day? We often quote 10,000 as a goal, but new data suggest 7,000 is a good number. I am not advocating for you to walk less as I would encourage you to get 10,000 or more steps daily. That said, if you can’t find the time to get to 10K, then get to 7K.  

Another thing I have seen recently are step competitions at work. It reminds me of when our internal medicine residency used to do fitness competitions. Get creative about how you can foster healthy habits for yourself and those you work with. 

Lead well, my friends! 

Josh 

Julie is a board-certified infectious diseases physician, mom of two girls and a certified professional Co-Active Coach. She is actively involved with the Society for Healthcare Epidemiology of America and is currently serving as the chair of the DEI Committee. She has completed the Co-Active Training Institute Leadership Experience, was part of the IDSA Leadership Institute Community of Leaders program in 2022 and coordinates the Leadership Lecture Series for the Department of Medicine at UT Southwestern Medical Center in Dallas, Texas. She has trained as a professional coach through the Co-Active Training Institute. She actively coaches physicians and other health care professionals in medicine to find their voice and create an aligned future with full intentionality. Dr. Trivedi’s interests include faculty and leader development through mentorship and professional coaching. 

Permission to pause 

By Julie Trivedi, MD 

I hereby give you permission to pause, permission to rest, permission to say no, permission to take a break, permission to unplug, permission to do it messy, permission to walk away — all so you can just be.  

The holiday seasons are upon us and with them come a flurry of activities — travel, gatherings, cooking, parties, shopping, more travel, more gatherings — while you somehow, somewhere try to find a moment of peace for yourself.  

Did you notice your heart rate pick up as you read the last paragraph? That’s your body clueing you in to the stress it experiences when it runs nonstop in service of others or in service of “getting things done.” 

The last few months have been a time of reflection and, most importantly, a time of giving myself permission to pause and heal.  

My story is this:  

Throughout August, September and October, I had multiple weeks of service with record high patient volumes. With the personal and professional stressors, my usual state of resilience was not at baseline. I developed viral keratitis, and the Friday before I was scheduled to go back on service, I was literally in a shambles experiencing a sense of dread and overwhelm. The irony in the story is that the day prior, I was facilitating a group session on well-being for APPs starting their hematology/oncology fellowship. As I included a slide on the stages of burnout, I recognized what I was experiencing. I knew I needed to advocate for myself and, even then, the hardest part was realizing that in doing so, my colleagues would end up working extra shifts.  

I needed to honor my body and take some time off. Two weeks and a day of Family and Medical Leave Act time. I share this because I know many of you are over-functioning, over-giving and over-committed. Many of you take on more than one person can do — and yes, it may be your passion, commitment and dedication to your career and your cause, and yes, you may find tremendous joy and a sense of accomplishment. And yet, in the pursuit we have a tendency to forget ourselves.  

What happens when that joy and feeling of fulfillment are no longer there? Or when your body gives you a clue that it needs to recover and to rest? 

I recently learned that rest and recovery are not the same. Recovery happens after a period of exertion — whether it be physical, mental, emotional, spiritual or a combination of any of the above. Recovery is most necessary for me after I’ve spent some time attending on the clinical services. It’s about engaging in activities that are rejuvenating — sleep, massage, positive social interactions, taking a vacation day or doing other enjoyable activities. If I’m honest, rest seems a bit of a foreign concept to me. The Oxford definition is “to cease work or movement in order to relax, refresh oneself or recover strength.”  

What would it be like to pause what you are doing and take time just for yourself? (Bonus points if you can do this without feeling guilt)  

In fact, when was the last time you truly took time to rest?  

Here are some reflections from Peak Performance by Julia (@peakperformancewithJulia on Instagram):  

“Rest feels uncomfortable when your worth has always come from productivity.” 

“You try to take a day off, but your mind keeps reminding you of everything you should be doing.” 

What thoughts come up when you think about the word “rest”? While I thought it was a nice concept, my mind would convince me that there were other more worthwhile ways to spend my time. We don’t mind when children rest. We don’t mind when our elders rest. We don’t mind when our pets rest. We don’t even mind when nature is in a state of rest. And yet, we don’t give ourselves the same permission. What permission would you like to give yourself for the next few days, weeks or months?   

As we enter the holiday season and in anticipation of the new year, I ask you to set aside 30 minutes to one hour to engage in the following exercise:  

Part 1:   

A. Write out a list of all your professional commitments. This can include committees, scholarly activities, research projects, responsibilities related to your leadership roles and even the clinical spaces you work in.  

B. With each item on the list, notice whether your energy contracts (tightness, feeling of “meh” or “ugh”) or expands (warmth, lightness, excitement, “yes”).  

C. Place an “X” next to the items where your energy contracts and a check mark next to the items where your energy expands.  

Part 2:  

Your next part of this assignment is to make some decisions about which items on that list are no longer serving you, are no longer bringing you joy or are not in alignment with who you are (becoming). Consider these three reflection questions: 

A. Which commitments would you like to step back from completely? (This is an opportunity to say, “No.”) 

B. Which commitments would you like to transition to other individuals?  (This is an opportunity for sponsorship.) 

C. What are the conversations that need to be had and with whom? (This is an opportunity to advocate for yourself.) 

Part 3:  

Create a strategic plan on how to step back, how to transition responsibilities to other individuals and how to have the conversation with key individuals that can be implemented over the next three months, six months and one year. While saying “No” and pulling back can seem difficult, we can reframe it as redirecting our energy into areas that are aligned with our values, our purpose and our end goals.  

With that, I am wishing you a beautiful holiday season and a Happy New Year! See you in 2026!