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The power of physician leader confessions

January 14th, 2014

by Kenneth H. Cohn

Although I knew my job was to talk about the impact of physician behavior on quality and safety at an annual medical staff meeting and that the content needed approval to qualify for risk management credits, I also knew that spouses and significant others would be present. "Keep it upbeat, entertaining, and brief," counseled the medical staff president, who invited me to speak.

My wife looked horrified when I answered, "Whose mistakes will you discuss," with "Mine."

"You're kidding," she hoped. "Why would you want to do that?"


"Because it is a proven way to engage the audience. Physicians enjoy learning from other physicians' painful learning experiences." She squirmed when I told her, "I promise not to embarrass you (too badly)."

I could tell by the physicians' body language they were with me as I described the errors that I made, the punishment that I received, and how I benefited from a 360-degree feedback process. Afterward, more than a dozen physicians sought me out to confess similar mistakes and how they enjoyed my slide on how to avoid amygdala hijack.

Amygdala hijack occurs when the midbrain's fight-or-flight response center takes over in times of stress. Although it is a time-tested way to deal with life-threatening issues, it destroys team cohesion when overused at work. The key is to recognize when the response is about to occur and pause long enough for the frontal cortex, which handles executive decision-making, to resume control.

For example, we can:

  • Take a deep breath (but not a loud sigh of exasperation)
  • Drink a sip of water
  • Ask a clarifying question; it may be that the other person was unaware that s/he was causing stress
  • Exit the room for a minute (disguised as a bathroom break) long enough to collect our thoughts

I write this post only to confess that when we are tasked with influencing others' behavior, a good start ensues from revealing our own inadequacies. I invite fellow healthcare leaders to share their stories on this subject. All confessions are welcome.

Ken is a practicing general surgeon/MBA and CEO of, who divides his time between providing general surgical coverage and working with organizations that want to engage physicians to improve clinical and financial performance.


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