[00:00:00] Christine Ko: Welcome back to SEE HEAR FEEL. Today, I have Part Two with Dr. Vinh Chung. Dr Vinh Chung is a Mohs surgeon as well as a dermatologist, and he specializes in the diagnosis and treatment of skin cancer. He attended Harvard University for his undergraduate degree and also went to Harvard Medical School. He was a Fulbright Scholar and earned a Master's of Theology from the University of Edinburgh. He has a memoir titled, Where the Wind Leads, and has also written for Practical Dermatology on moral injury and burnout. He lives in Colorado Springs with his wife and four children. I will put a link to the show notes to some of his writing. I had a wonderful time speaking with Dr. Vinh Chung in Part One, and please consider tuning in if you haven't already. He covered moral injury and how that leads to burnout in physicians. He also talked about leadership and how a lot of leadership, especially in medicine, is simply based on power and authority rather than trust and especially inspirational trust.
[00:01:05] I've never taken many classes in leadership, and so I wanted to delve a bit more into Dr. Chung's concept of trust, inspirational trust, and leadership, and why he thinks it's a challenge for doctors to lead in that way. And we'll also get some of his advice on how he leads, how he builds trust and how he inspires people.
[00:01:29] So here we go.
[00:01:30] Why is it hard for doctors to lead well?
[00:01:33] Vinh Chung: The other thing that makes it so challenging for doctors to lead well is because we have been wired to focus so much on self achievement. We are doctors because we're top of our class. We got there by ourselves. We ran the fastest, the hardest. We worked the hardest, right? We got there by ourselves.
[00:01:53] But the problems of medicine's a team sport. And until we learn how to lead, we're gonna fail. I did, I failed quite a bit because I didn't know how to lead. We're all capable of learning how to lead. We just need to put the effort into it and the discipline.
[00:02:06] And the best leaders create a vision of the future of what could be. Those who lead with trust and with inspiration bring people along. They attract others because guess what? We're all humans. We all want to live a life of a meaning and purpose. We all want to be respected. We all want to be treated with dignity. We all want to experience love. And so back to the different levels of leadership and how we lead. When you lead with force and authority, the only thing that you could demand from another person is fear is intimidation. And that's how the vast majority of organizations work in the history of mankind, right? It's not just medicine, the history of that, because that's the most natural way.
[00:02:54] But if you think about our psychosocial needs, when we lead, we need to think about what is it that the people following this getting? What are they getting by following this? So if you lead through trust, you are creating an environment where people have their psychosocial needs met. It's a place where people come and they feel respected. They feel that they belong. There's a place where people know your name. We hang out together. We celebrate birthdays together. We celebrate weddings together, right? So you create a community where people get something out of coming to work.
[00:03:29] Christine Ko: When you said you failed, do you mean that like you started out in your private practice and you learned as you went?
[00:03:35] Vinh Chung: Yes. So this, my story is that, okay, I was in my, finished my fellowship, right? So this is 15 years after I graduated from high school.
[00:03:43] I finally gotta get a job. So I did well I got into every, the school that I won, the residency that I won the fellowship. I was very good as an individual performer. I was very good at individual achievements. Whatever's out there, I can get it. But then when I came out and I started a practice... actually my wife started a practice for me. But I realize, oh my goodness, that I could know everything in the world, but if my medical assistants don't show up to work, I'm worthless. If my histotech doesn't wanna work for me, I couldn't do anything about it. It's horrible. It took me several years to learn this idea that I must earn their trust, and then I must inspire them. And let them know why is it that we're doing what we're doing? And guess what? Now I have an incredible team that shows up to work early. They stay late when they need to. They add patients on and we all know why we are doing what we're doing here. Yeah. And we trust each other.
[00:04:38] Christine Ko: And this might sound like a stupid question, but, how do you earn someone's trust? How do you do it?
[00:04:45] Vinh Chung: Great question. It takes time. And this is the problem with a lot of medical organizations. For the same reason that foster children have trouble trusting adults and parents, doctors and organizations cannot trust people when the leader comes and goes every one or two years. Culture is something that takes a long time to change. And you gotta play the long game to have it. It just takes a long time. I need to explain to them, I need to teach them. I need to slow down. I need to laugh with them. I need to know their name. I need to know the name of their husband, their children. I need to ask about how their children are doing. I need to come across as a person who actually cares about them. Does that make sense? [Yeah.] It has to be authentic. It has to be authentic cuz you had to treat them as a person.
[00:05:31] For our staff members, we need to recognize that they're people. And here's the thing, I talk about how medicine burnout is a result of dehumanizing doctors. Guess what? When we yell at people and intimidate them, we dehumanize them and they're not gonna wanna work for us. I wouldn't. Right? So you think about the golden rule, treat others the way you wanna treat yourself. And so it requires you to practice the golden rule, every which way, in every direction, in both directions, at all times.
[00:06:00] Yeah, in front of the patients, behind the patients with the staff, without the staff, with entry level staff with higher authority, it needs to be consistent, and that's called integrity. Integrity is a consistency of the character of who you are. It is who you are when no one is watching. And so those are two values that we have.
[00:06:20] Humility, which is always think of other people first, and then integrity, which is just, it doesn't mean that you're the smartest, it doesn't mean you don't make mistakes, it's just that you're consistent. And when you make a mistake, you ask for forgiveness. And so that's one of the things I've learned too, is that is asking for forgiveness.
[00:06:35] I think in medicine, we're terrified of recognizing that we're wrong for multiple reasons. We're terrified of lawsuits, we're terrified because we've been trained to be terrified of getting the wrong answers. That's how we got to be top of our class. We've been trained to be so terrified of failing and apologizing to patients that we forget that we need to apologize to our staff members too.
[00:06:56] So I, on a regular basis, ask for forgiveness of my staff. I say, I'm so sorry. And guess what? It means so much to them because when I apologize to them, I am recognizing and validating their humanity. I am saying, Hey, I know you're a person. You're a person and I'm so sorry. I shouldn't treat you that way. And I really would promise to do better. And that's also a positive feedback loop to me to remember next time I'm stressed and anxious. There you go. So you just treat people that way.
[00:07:27] Christine Ko: And how do you inspire people?
[00:07:30] Vinh Chung: Ooh, good question.
[00:07:32] You can't inspire people to believe in something that you don't believe in it yourself. You can't. People can sniff out a phony. I can. The opposite of integrity is hypocrisy. And so if you are telling people all these wonderful things, but they find out that you're really not that way, it's horrible. People are very smart. Okay? And so it goes back to integrity again. I would tell myself, look, I'm not gonna tell a joke here that if I'm not comfortable if my wife or my daughter were hurt, I'm just not gonna tell her. And guess what? If I'm not comfortable around her, nobody's allowed to tell those kinds of jokes.
[00:08:06] Okay. And I'm very serious. And so it's a wonderful environment where it's safe because whether you are in a break room or in front of the patient or on the phone, there is an explicit expectation of your behavior. Sometimes we think that placing constraints in our behavior will make it stifling, but not at all, is actually you get a whole lot more freedom.
[00:08:26] The analogy I give is, let's say you're on a highway, you're driving, aren't you glad that there are lanes that separate people? Aren't you glad that there are rules that we all commit to following? And that's how you're able to have a good, efficient experience when you're driving from point A to point B.
[00:08:41] Culture is no different. And the problem though is that there may not be consistency of culture, right? And so culture must be homogenous. It must be consistent. And I'm not talking about demographic diversity here. I'm talking about sets of values that all across the board, whether you're entry level or you're a doctor or you're the CEO.
[00:09:01] If you don't, you have to be held accountable to it. And if you don't, and if you mess up, you apologize. If you don't and you don't change, then you need to be removed. So we take that very seriously here. And guess what? It makes me to become more of the person I want to become.
[00:09:17] It makes me become a better leader. It makes me to become more of the doctor and the man that I think my children will be proud of having as a dad. So that's what you do and in inspiration, right? Our mission here is to make a positive impact on our patients, our community, and our world. And that's why we take Medicaid. That's why I drive out to satellite offices to serve the poor, the vulnerable, the rural communities. That's why we give generously to projects in Rwanda for clean water. That's why we invest in regions across the world. It has nothing to do with dermatology, but it has to do everything to do with our humanity.
[00:09:55] Back to our humanity, right? And that this is how I am able to feel fully alive when I am at work, is that I'm doing my work, but I'm also living out my values and my dreams and my ideals. So I am fully alive when I'm here. It's not enough to show up to work and remove your humanity and just spin like a cog.
[00:10:16] And I think that's a problem that a lot of people feel is that, and that's what burns you out, is when you are not able to live out your values.
[00:10:24] Christine Ko: Yeah. Do you have any final thoughts?
[00:10:27] Vinh Chung: Oh my goodness. Final thought? I have a lot of thoughts. There's an African proverb that says, if you want to go fast, go alone. If you want to go far, go together. And that to me summarizes the transition that we all need to make as doctors. Where we are incredible individual achievers, but we need to move beyond achieving and to learn how can we collaborate and connect with our team?
[00:10:59] In order to create something that's more beautiful for the world and for ourselves, and it's not just a transition from individual performer to practicing medicine as a team sport, but it's also the transition between achieving, acquiring, accomplishing, to moving towards significance. Okay? We're all great.
[00:11:21] Look at all the CV stuff, everything on the cv, all the publications, everything we've done, throw it away. All that has done is to give us the privilege of practicing medicine. And so now when we practice medicine, how do we pursue significance? And so this transition is something that we all need to do, not just doctors, but anybody in any field.
[00:11:42] Because at the end of our life when we reflect on it, there will be a summary of our significance called a eulogy. Think about what's gonna be read in your eulogy and contrast that with what's in your CV. Your CV is individual accomplishments and achievements and ability. Your eulogy will be a reflection, a qualitative account of the values that you've lived, what you have given to people, your acts of courage, of integrity, of humility, of service.
[00:12:21] And the impact that you have made on this planet for generations to come. And so that's my final thought for anyone who wants to live a life of meaning and purpose. You want to transition from personal achievements to a life of significance, which inevitably will always lead to a life of service.
[00:12:45] Christine Ko: Thank you. That's amazing. Thank you so much for spending time, and I've learned so much.
[00:12:52] Vinh Chung: My pleasure. Thank you. I'm glad.
