The 4 C’s of Leadership

9 12 2013

By  Bradley Harper MD FCAP, COL (Retired) US Army

Thank you for asking me for my Commander’s Philosophy.  When I was in Command and General Staff College we were required to create one, and this product served me well through four commands.

My Philosophy is simple, for I believe that important things are.  We spend a huge portion of our waking hours engaged in our workplace.  If that experience is unfulfilling, it is difficult to have an overall good quality of life.  As a Commander it was my job to impart to my staff what “Right” looked like.  I had subordinate leaders and very competent staff whom I desired to impart my vision so that when confronted with a challenge, they knew instinctively what action I would want them to take.  I knew many commanders who were afraid to take leave.  They were afraid that the organization would collapse without their constant guidance.  I had much the opposite philosophy.  I felt that my confidence in my guidance to my staff coupled with their competence and decency allowed me to be absent both to allow me some respite and to allow them to grow.  One does not learn how to ride a bike if the parent never lets go.  I would allow various of my deputies the chance to be acting commander for I recalled how much I had learned when I had been entrusted by my previous commanders with that responsibility. Part of my job was to grow those whom I was responsible for.

So. My Philosophy boils down to what I call the 4 C’s.  They stand for the following 4 words, and the precedence of the words is deliberate.

Compassion. I commanded health care organizations, so you would think that this would be unnecessary to articulate, but I had too often seen people in pain or fear treated as a “Case”, or a “Customer”.  A bad experience I had with an Army Doctor led me to go to Medical School.  Before we could initiate a therapeutic relationship with someone we had to establish trust.  You do that by showing that the patient is important to you.  That you sincerely want to do them good. I liked to quote Dr Larre, surgeon to Napolean’s Grand Armee` who wrote in his memoirs, “I cured a few. I helped many. I cared for them all.” I challenged my staff to be able to say the same at the end of every day.

Competence. I commanded small organizations. We were not Walter Reed.  We should look at what we treated, and get as good as possible at managing it.  Establish protocols and SOP’s. That which we can do well, do as best as we possibly could.  I said that you do not want to fly with a pilot who flies 3 times a year. You do not want to have your coronaries operated on by a surgeon who does one case a month to “keep his hand in”. If it is not something we do on a regular basis, refer to those who do. Also Competence requires that after you learn your job as well as you possibly can, you teach your subordinates your job, and learn your supervisor’s.  We were in an organization that was constantly evolving.  Every year 1/3rd of our military left for new assignments, and often I would have to send soldiers off to augment a unit in combat on short notice.  We could not afford to allow anyone to become indispensable. It limited our ability as an organization to grow, and stifled the education of our staff to be able to progress in their careers.

Conscientious. Our customers had to know what they could reliably expect from us.  We had to be humble.  Our organization existed so that soldiers could go to war, and recover from that.  If they doubted our Compassion or Competence, our ability to serve them would be impaired. If they doubted our promises, it would become impossible. If we could not deliver, tell them so, then seek means to serve their needs via other organizations, or see how we might be able to accomplish the mission in innovative ways. If we failed to meet their expectations, acknowledge that, and make it right.

Cost Effective.  I am not saying Cheap.  Quality is cost effective.  Getting something right the first time is extremely cost effective.  We will never have all the resources we would like in staff, facilities, or supplies.  Get over it. The more we do with what we have, the more we do.  Among the resources we have to manage is time, both ours and our patients’. Do not waste either. Think about how you spend your day, and realizing that you cannot do it all, prioritize.  At the end of the day I am asking that you provide good value, both to the patient and to the taxpayer.

I told my staff that when they had a new proposal for me, to show me how their idea supported one or more of my four principles.  The more principles that it fell under, the more likely I was to support it.  It freed my people to take ownership of their job.  Many have told me years later how much fun they had working there while I was in command.  If you have a bad commander, people say he was bad.  If you have a good commander, people say he was good.  When you have an excellent commander, people say they did it all themselves.

I likened my role to that of stage manager for a play.  My staff were the stars.  I was there to make sure they had the resources and proper environment to excel.  Then stand back and applaud.