Are you in the right mind to lead? Exercises and tips to train and nourish your creative side Insight Article Professional Development Leadership Development Culture & Engagement Sign in to save Peter Valenzuela MD, MBA, CMPE Have you ever been called creative? What about innovative or visionary? If you’re in healthcare, odds are you’re more likely to be called logical, analytical or detail-oriented. This is what Peter Drucker refers to as a “knowledge worker.”1 It includes lawyers, doctors and many other occupations that require higher education rather than manual skills. Knowledge workers most often use thinking linked to the left hemisphere of the brain. To better understand the context: The left hemisphere (L-directed thinking) is analytic, cautious, literal, logical, planning, rational and textual. The right hemisphere (R-directed thinking) is adventurous, creative, emotional, holistic and intuitive. In Daniel Pink’s book, A Whole New Mind: Why Right-Brainers Will Rule the Future, he argues that knowledge workers have been critical during the Information Age. However, as we enter what Pink calls the Conceptual Age, three causes are diminishing the need for left brain (L-directed) thinking: abundance, Asia and automation. Below are my examples of how each applies to healthcare. Abundance (more selection available) — In the past, medical knowledge was limited to healthcare professionals. Today, the internet is a key source of information for many people who want to find out more about their health. Approximately 7% of Google’s daily searches are health related, which is equivalent to 70,000 queries every minute.2 As with medicine, the number of executives with healthcare expertise was limited in the past. Today, healthcare consulting in the United States is a $6-billion-a-year industry with more than 18,000 registered businesses.3 Asia (outsourcing) — Outsourcing overseas to save on labor costs has long been a strategy in multiple industries. Medical examples include after-hours radiology services, nursing triage and remote scribes. But outsourcing isn’t just occurring overseas anymore. Healthcare organizations are setting up centralized services in other states where language barriers do not exist and taxes and wages are lower. These shared services may house many departments such as analytics, finance, human resources, information technology, revenue cycle and call centers. Automation (technological advancements) — There are more than 318,000 health apps available today, with more than 200 apps being added each day.4 Many are incorporating artificial intelligence (A.I.) with complex algorithms and software to mimic human cognition. A.I. is being used to interpret images in radiology, dermatology and pathology. It’s also being used for disease risk assessments and symptom checking. On the business front, we’ve seen technological advancements in predictive modeling and analytics to prepare organizations for value-based models of care. As in other industries, much of what knowledge workers traditionally did in healthcare is being done by others, both human and artificial. With the evolving healthcare climate, we need to tap into our right hemisphere to lead others and engage organizations. You may think, “But I’m not the creative, R-directed thinking type.” If so, you’re not alone. Most people believe you’re born creative or you’re not. However, studies in twin cohorts revealed that only one-third of creativity is genetic. The other two-thirds is acquired.5 Pink’s book outlines six fundamental aptitudes essential for professional success and personal fulfillment: Design Story Symphony Empathy Play Meaning. Each of these aptitudes has application to healthcare. In addition to exercises you can use to improve your skills, I will also provide examples we’ve put in place at Sutter Medical Group of the Redwoods (SMGR), a multispecialty medical group composed of 125 providers practicing throughout Sonoma County, Calif. DESIGN Design is a combination of utility (L-directed thinking) and significance (R-directed thinking). For example, a graphic designer has to make a brochure that is easy to read and relays information (utility). But the brochure also has to transmit ideas or emotions words can’t convey (significance). Not everyone has caught on to the importance of design. Although design-led companies earn 32% more revenue than other companies, a recent study of 1,700 companies revealed that CEOs don’t understand design leadership.6 Besides profitability, there is more evidence to show that improving the design of medical settings helps patients get better faster. One study showed that surgery patients in rooms with ample natural light required fewer pain medications, and their drug costs were 21% lower than their counterparts in traditional rooms.7 How to exercise R-directed thinking in design Perhaps the easiest way to stimulate your right brain is to read design magazines such as Dwell, HOW and Real Simple. Another approach is to design something yourself on sites such as Canva or Placeit. In the past, I’ve used Placeit to design team logos for SMGR committees. I then used Printful to place the logos on mugs. We handed the mugs out to committee members as a way of thanking them for taking part. On a larger scale, all of our new facilities and remodels incorporate earth-tone colors and large windows to provide natural lighting. STORY Story is the ability to place facts in context and deliver them with an emotional impact. It’s a means of persuasion used in advertising, consulting and counseling. Economists believe that story is worth about $1 trillion a year to the U.S. economy.8 The most commonly used storytelling in healthcare is organizational storytelling. These are events that occur within healthcare walls that are used in pursuing organizational goals. Examples include reflections about patients at the beginning of meetings. The stories can inspire and remind participants of our purpose in medicine, or they can be cautionary to help us focus on patient safety. How to exercise R-directed thinking in story Interview patients and ask them about their life outside of their illness. Questions could include, “What was the happiest day of your life?” or “What was the best decision you ever made?” You can also do this with colleagues. We’ve interviewed physicians nearing retirement during our all-group meetings so they could share their stories of wisdom with SMGR colleagues. At an organizational level, we tell patient stories and read complimentary patient letters before meetings. SYMPHONY Symphony is about orchestrating divergent things into a cohesive whole. It’s linking unconnected elements to create something new. Symphony is also about seeing the big picture and being intuitive. Many of us remember the Hershey’s commercial during which a collision of two individuals carrying chocolate and peanut butter leads to the creation of Reese’s Peanut Butter Cups. In healthcare, we’ve seen giant leaps in symphony over the past decade. Today, there are more than 7,500 healthcare startups disrupting the industry.9 These companies are making non-traditional connections in providing care and who is involved in the care. They’re also disrupting the business and analytic aspects of healthcare. Examples include apps, sensors, telemedicine and voice recognition. How to exercise R-directed thinking in symphony Learn how to draw, doodle or use coloring books. A few years ago, I started creating comics called “Doc-Related” that satirize healthcare. They’ve done wonders to stimulate R-directed thinking and have been included in our SMGR Gazette. Try listening to great symphonies focusing on different instruments each time. At SMGR, we invite bands that include medical group members to play prior to all-group meetings. By connecting healthcare and transportation, Sutter Health partnered with Lyft to help patients with their appointments and hospital-related activities. This has decreased clinic no-shows and expedited the discharge process. EMPATHY Empathy is imagining yourself in someone else’s shoes and feeling what they are feeling. This ties into the emotional side of R-directed thinking and allows us to see the whole person. Although technology is a tool that can help diagnose conditions, it takes a human to understand what someone is feeling. Healthcare is all about empathy as we deal with individuals when they are most vulnerable. One of the best videos I have seen is Cleveland Clinic’s “Empathy: The Human Connection to Patient Care.”10 It has more than 5 million views on YouTube. I challenge you to watch it without getting emotional. How to exercise R-directed thinking in empathy Measure your empathy quotient with Simon Baron-Cohen’s 60-question assessment.11 A fun way to combine empathy with design is to use IDEO’s Method Cards.12 The most meaningful way to strengthen your empathy is to volunteer with people whose experiences differ from yours. We encourage this as part of our “citizenship” incentive at SMGR. Our members volunteer in more than 50 events and nonprofit organizations annually. PLAY Play is an important part of work, business and personal well-being. Pink defines play in three ways: games, humor and joyfulness. Besides gaming apps, playing video games enhances the right brain’s ability to solve problems that require pattern recognition.13 Physicians who spent at least three hours a week playing video games made 37% fewer mistakes in laparoscopic surgery and performed the task 27% faster than their counterparts who did not play.14 Games have also been used to educate patients and engage them in managing their disease. The right brain is also vital to understanding and appreciating humor. Studies show that humor represents one of the highest forms of human intelligence.15 From a managerial standpoint, humor reduces hostility, deflects criticism, relieves tension, improves morale and helps communicate difficult messages.16 From a patient care standpoint, laughter has been shown to decrease stress hormones and boost immunity.17 How to exercise R-directed thinking in play Start your meetings with a joke or a funny video to break the ice and stimulate creative problem-solving. At SMGR, we’ve also used Photoshop and Jib Jab videos to display our group leaders in fun ways. Once a year, we spoof “Star Wars” with our own “SMGR Wars” crawler video and play it at all-group meetings. These activities have kept our leadership and collegiality scores consistently above the 75th percentile nationally. MEANING According to Viktor Frankl’s book, Man’s Search for Meaning, the motivational engine that powers human existence is the search for meaning. This may come in the form of spirituality. Like design, studies show spirituality is a whole-brain activity.18 Along with spirituality is the pursuit of the “pleasant life” full of positive emotions about the past, present and future.19 Understanding this need for meaning, purpose and gratitude, our medical group budgets for medical missions and charitable contributions annually. When our clinicians return from missions, they share their experience at our all-group meetings. In addition, we make charitable contributions on behalf of individual members who have a passion for a specific nonprofit. These actions have improved group engagement and helped restore our sense of purpose as clinicians. How to exercise R-directed thinking in meaning Write a gratitude letter to someone who has been kind to you but whom you’ve never properly thanked. An alternative is to make a birthday gratitude list in which, once a year, you make a list of what you’re grateful about. The number of listed items should equal the number of years you’re turning. If you like self-assessments, visit the University of Pennsylvania’s Authentic Happiness Questionnaire Center to measure your happiness, meaning and life satisfaction.20 SUMMARY As leaders, we strive to gain the core skills needed to lead. This often includes studying business topics, Lean methodologies and emotional intelligence. However, we rarely study activities that stimulate the right hemisphere of our brains. With more healthcare choices, outsourcing and technological advancements available today, we need to apply R-directed thinking to be key players in the direction of healthcare. Practicing design, story, symphony, empathy, play and meaning will stimulate creative problem-solving and new innovations. It will also improve engagement and morale in your organization. Notes: Drucker P. “The Age of Social Transformation.” Atlantic Monthly. November 1994. Murphy M. “Dr Google will see you now: Search giant wants to cash in on your medical queries.” The Telegraph. March 10, 2019. “Healthcare Consultants in the US industry statistics.” IBIS World. August 2019. Available from: bit.ly/2R0rYgv. “The Rise of mHealth Apps: A Market Snapshot.” Digital Health. March 26, 2018. Available from: bit.ly/3bRuGNr. Dyer J, Gregeson H, Chirstensen C. “The Innovator’s DNA.” Harvard Business Review. December 2009. Available from: bit.ly/2X0w77X. Wison M. “McKinsey study of 1,700 companies reveals CEOs don’t understand design leadership at all.” Fast Company. February 19, 2020. Elias M. “Sunlight Reduces Need for Pain Medication.” USA Today. March 2, 2004. McCloskey D, Kramer A. “One quarter of the GDP is persuasion.” American Economic Review. 1995. “Healthcare Startups.” Crunchbase. Available from: bit.ly/2X61AWe. Cleveland Clinic. “Empathy: The Human Connection to Patient Care.” Feb. 27, 2013. Available from: bit.ly/3bMHlBe. Simon Baron-Cohen. “Empathy Quotient.” University of Cambridge. Available from: bit.ly/2JEShVb. IDEO Method Cards. Available from: bit.ly/2yvhG1x. Robillard G, Bouchard S, Fournier T, Renaud P. “Anxiety and presence during VR immersion: A comparative study of the reactions of phobic and non-phobic participants in therapeutic virtual environments derived from computer games.” Cyberpsychology and Behavior. October 2003; 6(5): 467-476. “Games at Work May be Good For You.” BBC News. Nov. 10, 2003. Shammi P, Stuss DT. “Humour Appreciation: A Role of the Right Frontal Lobe.” Brain 1999. Vol. 122, 663. Sala F. “Laughing All the Way to the Bank.” Harvard Business Review. September 2003. Berk S, Tan S, Fry W, et al. “Neuroendocrine and Stress Hormone Changes During Mirthful Laughter.” American Journal of the Medical Sciences. 1989; 298(6). McIlroy M. “Hard-Wired for God.” Globe and Mail. Dec. 6, 2003. Seligman M. Authentic Happiness. New York: Simon & Schuster, 2002. Authentic Happiness Questionnaire Center. University of Pennsylvania. Available from: bit.ly/3aD4Z2V.