Common Sense

What Does Leadership Look Like?

Issue: March/April 2021

Author: Lisa A. Moreno, MD MS MSCR FAAEM FIFEM
President, AAEM


(HINT: It looks like you…)

Leadership Academy is a tradition at AAEM, and this year, we kicked it up a notch. Instead of the usual approximately 25 potential leaders identified by the board, we invited the Chairs and Vice Chairs of all the sections, committees, interest groups and chapter divisions, the boards of YPS and AAEM/RSA, and sought nominations from other AAEM leaders outside the board of directors. I am proud to announce that 92 of AAEM’s future leaders attended the Leadership Academy and the discussion was vibrant with the fresh ideas and concerns they brought. The Leadership Academy was taught by some of the top faculty in emergency medicine, and we plan to make the presentations available on AAEM Online. The most important thing to understand about leadership was said succinctly by Vince Lombardi: “That great leaders are not born, they are made through a process of hard work and dedication.” Through the challenges of 2020, we have globally expressed concern about the crisis in leadership, but the boon of the pandemic is that from this crisis have emerged unexpected heroes and leaders of integrity. In this and my next President’s Message, I will share some of the wisdom that emerged from the Leadership Academy. And if you recognize the leader in yourself and were not invited to attend this year’s Leadership Academy, take the bold step, and contact me so that we can include you next year. A big part of being a great leader is stepping up.

  1. Great leaders learn from great leaders.
  2. Great leaders surround themselves with brilliant, trusted experts.
  3. Great leaders listen to all voices.
  4. Great leaders think about their legacy.
  5. Great leaders recognize the responsibility to create other great leaders.
  6. Great leaders make decisions, knowing that they will make enemies.
  7. Great leaders know it’s about the organization first.
  8. Great leaders do not engage in personal attacks.
  9. Great leaders accept the ultimate responsibility for everything that happens in the organization.
  10. Great leaders give responsibility for success to those around them.


1. Great leaders learn from great leaders.

There are hundreds of books available about how to be a great leader but think about who the authors are. They may have made a tremendous amount of money for themselves and their cohorts. They may have taken a company out of obscurity. If, however, we consider the leaders who have made a profound difference in the lives of others, the leaders whose names and philosophies are known decades and even centuries after their passing, you will not find a how to book writer among them. They were too busy doing the right thing. These are the people you want to emulate and from whose wisdom you want to learn. As different as Dr. John Snow is from Mohandas Gandhi is from St. Catherine of Sienna is from Martin Luther King, they have so much in common. They were passionate about doing the right thing, even when they were criticized, mocked, and sometimes hated. They persevered against astonishing odds. There was no “try” for them; only “do.” (Thank you, Yoda.) They put the well-being of others ahead of their own interests and were willing to sacrifice to make the lives of others better. They were willing to be unpopular. They led by example. True greatness does not come from making a lot of money. True greatness comes from doing the right thing. Said St. Catherine of Sienna, “Be who you were created to be, and you will set the world on fire.” Think about who you were born to be and move forward to your greatness. Look at those who you admire and want to be like. Study their lives and policies, and don’t hesitate to ask for advice and mentorship. Most leaders derive pleasure from mentoring others and recognize their obligation to do so (see #5).

2. Great leaders surround themselves by brilliant, trusted experts.

Now more than in any previous decade, it is impossible for anyone to be an expert on everything, even within a specific field like medicine or even within the specialty of emergency medicine. Great leaders are humble; aware and not ashamed of not knowing it all. They ask for help and seek that help from proven experts. Moreover, those experts are not sycophants but rather truth tellers. Secretary of State Dr. Henry Kissinger, Prof. Arthur M. Schlesinger, Jr., and Mayor/Ambassador/Congressman Rev. Andrew Young are among the most notable expert advisors to Presidents, providing scholarly and objective advice through turbulent times. The ever-popular President Franklin D. Roosevelt relied heavily on his First Lady, Mrs. Eleanor Roosevelt, for her cognitive and emotional intelligence. Many believe his presidency would have been mediocre without Mrs. Roosevelt’s counsel. What stands out about these advisors is their willingness to speak the truth, to recognize that when someone you like does wrong, it is wrong, and when someone you do not like does something brilliant, it is brilliant. While mediocre leaders are threatened by those who do not agree with them, great leaders welcome someone telling them that they are wrong and presenting them with the opportunity to learn. Rawle Adkins said it well: “I don’t mind criticism because at the end of the day, I never have learned anything from a compliment.” A few years ago, Past President Mark Reiter and I were conversing about how much more enlightening it is to talk to someone who disagrees with you. People who agree with you tend to have considered the same facts that formed your opinion. People who disagree with us can teach us about facts and opinions we may never have heard before. “I never learned anything from any man who agreed with me.” (Author Robert A. Heinlein)

3. Great leaders listen to all voices.

If we are to be truly enlightened, we must consider the perspectives of all stakeholders. While those who differ from us have much to teach us, as discussed above, it is also important that all members of the organization have an integral role in the life of the organization. DeNine J. Fleming, EdD, from the Office of Diversity, Equity, and Inclusion at the Medical University of South Carolina explains that, “Equity is inviting someone to the dance. Inclusion is inviting them to dance.” And when we genuinely invite someone to dance, we invite them to dance in their own way, and we invite them to show us how they dance and to then to include us in their dance, sharing their perspective of life in a meaningful way and allowing us to be part of their life. First Lady Eleanor Roosevelt was genuinely skilled at inviting people to show her their lives and perspectives. In 1934, she insisted that her visit to Puerto Rico was not to be restricted to the military base. After viewing the devastation caused by two hurricanes, being driven over muddy dirt roads, and visiting the San Juan housing where the tuberculosis rate was five times that of the U.S. mainland, she told her husband that it was an outrage that any citizen of the United States should live in such conditions. She partnered with PR House of Representatives member the Hon. Maria Luisa Arcelay, a former high school teacher and small business owner, to substantially influence Roosevelt’s New Deal aid to the island for building roads and housing and developing education. Roosevelt appointee Governor Winship was mandated by the President to take on Rep. Arcelay as his advisor, and she compelled significant change to his previously colonialist policies. Create a council for yourself of individuals from diverse backgrounds who can provide advice and guidance as you move towards your leadership role. And remember to include those whose opinions, life experiences, and expertise differ from your own.

4. Great leaders think about their legacy.

Make it your policy to leave everything you touch better than you found it. While many people “fall into” a leadership position, great leaders consider what they want to accomplish when given an opportunity. Leadership is a privilege. We can all recall that childhood wish to be a king or a queen who can have anything they want and could boss other children around. All too soon comes the knowledge that monarchs are deposed, poisoned, locked in the Tower, and have their kingdoms invaded! But mature leadership is service and given that no one person has the time or resources to accomplish all things, a mature leader focusses on what their organization needs most, what they are skilled at doing, and what they are passionate about. Leadership gives us the privilege of a platform. People listen to us because we have a title or hold an office. With that privilege, comes responsibility. Reality is, three generations after we have left this world, no one will remember our names. Hopefully, we will leave a program, or a policy, or will have effected a change that will continue to benefit others. That is our immortality. What is your passion? What would you do if there were no barriers; no obstacles that could not be overcome? What do you want to be remembered for? Think about the legacy you want to leave, and make it happen. “It always seems impossible…until it’s done.” (President Nelson Mandela)

5. Great leaders recognize the responsibility to create other great leaders.

Booker T. Washington told us, “There are two ways of exerting one’s strength. One is to push down. The other is to pull up.” As we know from our gym workouts, when you push down, you yourself go lower, but when you pull up, you yourself rise. A good leader recognizes that she herself is made better by pulling others up with her. A great leader recognizes that she has an obligation to the organization and to the profession to create the great leaders of the future. We have heard many times that no one is indispensable. And while in early career, it is not a bad idea to make yourself hard to replace and thereby secure a sweet spot for mentorship and advancement, as we do advance in our careers, we recognize that we will someday want to retire or work far less than we do now, and we have a responsibility to leave the organization and the profession in the hands of well-trained and able leaders. I remember thanking Dr. Sarah Stahmer for mentoring me early in my career. “Oh, don’t kid yourself. None of us do this solely out of the goodness of our hearts. We do it because we enjoy it and it feels good,” was her reply. I have never forgotten the graciousness of her statement, and when I progressed to the point in my career that allowed me to mentor, I realized how right she was. Mentoring is a real joy. Watching the look on the face of a learner when he “gets it” is priceless. Watching that learner pay it forward by teaching yet another learner is even more fulfilling. If you aspire to leadership in EM, know that those above you on the career ladder will welcome the opportunity to mentor you. We will find pleasure in your achievements. We will feel good about investing in the future of the Academy and of the profession. And we will realize that by pulling you up, we rise.

As I told the attendees at Leadership Academy, do not keep your dreams a secret. Don’t be shy about your aspirations. You are offering us the gift of your time and your talents, and we want the best, the most talented, the hardest working, and those with the most integrity to make their mark right here at AAEM. If you participated in the Leadership Academy, thank you. We look forward to reconnecting with you at the Touch Back Sessions. We look forward to mentoring you. If we missed you and you want to be a leader in AAEM and in our specialty, speak up, reach out, reach up, and become a leader! We want to see you shine!

Next issue: Great leadership characteristics 6-10 explored.


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