You might not think of yourself as a leader.

You might even say, I'm just here to do my job.

But in the world of healthcare, leadership isn't a title you earn.

It's a role you step into, whether you realize it or not, in this

episode of You Are Not a Frog.

I'm joined by Dr. Paul O'Dwyer.

He's a dental surgeon and leadership expert.

And we're asking a deceptively simple question, are you really not a leader?

Because here's the thing, if people look to you for answers, if you

influence how your team works, if you shape the experience your

patients have, if you supervise anyone in any way, then guess what?

You are already leading.

In this conversation, we explore why so many healthcare professionals miss

the leadership roles they're already playing, and how a few small shifts

in mindset and a few small increases in skills can make a big difference.

We'll cover why leadership starts with listening, what to do if you just feel

too busy to lead, and we also talk about how knowing your personal mission can

transform the way you show up at work.

So whether you're a doctor, a nurse, a dentist, or any kind of senior

healthcare professional or clinical leader, this episode's for you as long

as you are ready to stop hiding in plain sight and start owning your impact.

So grab a cup or pop on your headphones for your next walk, and let's discover

the hidden leader inside of you.

If you're in a high stress, high stakes, still blank medicine, and you're feeling

stressed or overwhelmed, burning out or getting out are not your only options.

I'm Dr. Rachel Morris, and welcome to You Are Not a Frog.

I'm Paul O’Dwyer, I'm a dentist.

Graduated University, college Cork, 1997.

Uh, I'm currently working clinically in oral surgery, but also lecturer at the

Royal College of Surgeons in Ireland.

And I'm group clinical advisor with PortmanDentex here in Ireland.

It's wonderful to have you on the podcast.

Paul, thanks so much for coming.

You've got a really wide portfolio of things.

What, what would you say is your main interest right now?

That's a, an excellent question.

Um, I'm juggling many balls like everybody listening to this podcast.

Um, I'm currently midway slash three quarters way through my

PhD, which is looking at nonverbal communication between patients in

the dental surgery and çdentists.

That's kind of my main focus at the moment, and I say that for the benefit

of my supervisor who may be listening.

Get it in there.

Yeah.

It's always the PhD and I'm, I'm already thinking nonverbal communication.

How do patients communicate verbally when they've got their mouths open and

people got instruments in them anyway?

Hey Rachel, you have hit the nail on the head, uh, because that's exactly right.

That's what we're looking at and how, how do we get around that?

And it fe feeds into consent.

It also feeds into patient dignity and things like that, that we listen

to so regularly on your podcast.

And I know you've also got a really big interest in in leadership within practices

and departments clinical leadership

so the leadership thing is, is interesting, and again, I hear this,

uh, quite regularly in your podcast too.

A, a number of years ago, I finished a masters degree in healthcare management,

and one of the things that struck me, I had just taken over a role as a group

clinical director with one of the larger dental corporates here in Ireland.

And I'm, I'm sure like many of the clinicians listening across

all healthcare aspects, we tend to get trained really, really well,

uh, clinically, which is terrific.

Um, but that leadership component is missing.

And as I was exiting the healthcare management masters degree, uh, one of

the faculty staff at Royal College of Surgeons in Ireland, uh, was developing a

brand new program called the Professional Diploma in Clinical Leadership.

And this is a short nine month course, which looks at elements of

how you link clinical tasks with the actual roots of leadership.

So vision, mission, uh, all of the fun things that we learn about.

So I was brought in to develop, and I still do, I deliver out on module

three, which is organizational structure and writing proposals for leadership.

This podcast is about helping doctors, dentists, other busy

healthcare professions, beat burnout and work happier.

So why would we be talking about leadership?

So, we often find ourselves, and this is something I've said to the undergraduate

medical students particularly, 'cause you can imagine these are boys

and girls of 18, 19 years of age.

Uh, their minds are filled with pathology and biochemistry and

anatomy and things of that.

So when we come to talk about leadership, you al almost see the, the blinds

being drawn down across their eyes.

But the reality is for all of us in any healthcare position there is a

leadership responsibility behind that.

Um, so you might say, well, you know, um, I'm gonna be finishing up now I'm

gonna be a, a nurse practice manager in a general practice, or I'm gonna

be a general practitioner in beautiful North Tipperary, or I'm gonna be

a consultant in vascular surgery.

Any of those roles has inherently a leadership position.

You're going to be managing and leading yourself.

You're gonna be managing and leading the people who work with you.

And importantly, of course, you're gonna be leading and managing your patient.

So even if you see, don't see directly the value behind formal

leadership, um, there is a need for it.

And the example I always give is sometimes, and I'm 104 years

of age, as you can tell, but uh, when I was training, I

You only a year older than me, I think Paul.

So let's like, let's just,

So T 21 a piece.

I like it.

Uh, so what I would say is when, when we were finishing clinically, uh, I finished

in 1997, this was never spoken of.

Um, and there is that inherent, uh, kind of legacy issue within

organizations, particularly in our, in our national health service here in

the HSC and indeed privately as well, where you pick it up as you go along.

That famous phrase, whoa.

You'll pick it up as you go along.

To which I always respond and say, well, listen.

Imagine if you've been a passenger in a car and you're watching your

father or mother drive the car, and then suddenly they stop the car,

open the door and say, now you've seen me do this for long enough.

Off you go.

You'll pick it up as you go along.

You'll pick it up as you go along.

So, so there has been a need established.

I think we've all agreed that, uh, leadership is there and we can see

this in the clinical leadership framework that the NHS has is a

tool that we use on the program.

Um, and I think it's really important.

So it's showing you both the theory and the practice behind it.

Yeah.

How, how does it, I'd love to hear how it affects others in the team, and I'm

sure we've been moving on to that, but how does it, it affect you if you are

not taking your own leadership seriously?

What issues does it cause for, for you as the leader who's not

acknowledging that you are a leader?

I.

Yeah.

I, I, I think that's really important.

So, sometimes, and again, Rachel, this is something you've, you've

touched on your podcast before.

We tend to be very much, um, our training tends to be very personalized,

so we are the problem solver.

I. Uh, very much of what, what, what we do is solving problems.

Uh, and indeed, recently on one of your podcasts with Cathy Dimarchos,

you talked a lot about identity.

Uh, and we seem to be the people who, for whom the buck stops here.

And if we take that responsibility on wholeheartedly, we can lead

to, it can lead to burnout and we can burn ourselves out.

Indicators around that will be micromanaging.

Taking on tasks too much and I'll, I'll wear my dental hat for just a second.

So if you can imagine you're a patient coming in, I might be someone who

I'm reliant on my nursing colleagues and my receptionist colleagues, and

my waste management colleagues and my health and safety colleagues to

provide the ability to me to do my job.

If I don't understand that I'm leading within that team, that causes problems

because suddenly it becomes my responsibility to make sure the patients

are booked in that cross infection control is, is, is followed to the

letter of the law, uh, that, uh, my gloves are there, and so on and so forth.

So it, it shows itself that this lack of appreciation leadership can

show itself in a very simple example like that, where you're doing too

much, you have a very specific role.

You have a very specific task and it's leaning on others to

help you to do that, but also providing the leadership behind it.

I, I understanding your role.

Again, I'll echo Cathy Dimarchos here, when we talk about

identity, it's what we do.

Um, it's not defining who we are, but it's what we do.

I'd never thought of it like that.

That's really interesting.

'cause I, I do think of the people that I know that will go around

going, oh, I'm not a leader.

I'm leader.

I'm just here to do the work.

But they're, they're consultants or their GP partners.

And yeah, they are the people who are taking a lot on themselves

because they've never taken that leadership role seriously.

You are right.

So they're not then able to delegate effectively and make sure that

the task that they need doing.

And they do end up burnt out.

So what you are saying is actually, if you really take yourself seriously as a

leader and think actually this is part of my professional responsibility, how

I'm trusting other people, first of all, giving them tasks, but then trusting that

they're gonna do them, that is part of the leadership skills that I need to develop.

Yes, exactly.

And, and you know, I know many people listen to this podcast, but because

they're in a patient facing role, if we think about it, just flip it slightly.

So when a patient chooses and, and obviously dentistry is mainly

elective, so patients are choosing to see us rather than going to Xis

emergency or whatever the gets be.

There was a very interesting paper a couple of years back by, um,

Campbell and Tickle, which looked at the reasons why patients, uh,

choose to attend a specific dentist.

Um, and I read this with interest 'cause I was thinking, hmm, is it a price point

thing or you know, is it access, whatever?

The number one thing is, trust, trust, access, and then finance.

In that order, it was quite interesting.

So if we think about how a patient views us, and this goes across all disciplines,

medicine, dentistry, surgery, you name it.

They're putting their trust in us to do the job right.

By the same token, we as clinical leaders within our own sphere, we're putting

our trust in our teams to work with us.

And for that to happen, to take my driving analogy again, let's get the lessons

done, let's reverse around the corner, let's do the three point turn, parallel

park, uh, and understand how that works.

There is theory behind it.

There are concepts behind it.

Everyone listening, I'm sure to this podcast has had a scientific

training and background.

And one of the first questions that we will always ask about

any course of action is, why.

So why should I, you know, be a leader?

Why should I be aware of these concepts?

Why should I?

And, and the proof of the pudding is in the eating.

It's lending that support to you, helping to guide your team, providing best

patient outcomes, um, all of that's, uh, it's becoming more and more apparent.

Yeah.

Well, when you put it like that, like better patient outcomes, helps

you work better as a team, all that sort of thing, what else have you

seen happen apart from micromanaging?

If people aren't seeing themselves as leaders

I think Frus, uh, yeah, that's, that's a good que I think

frustration is the big one.

Um, because, uh, oftentimes, and I'm, I'm, I'm thinking particularly of medical

and dental colleagues here, who, our career pathways tend to be quite linear.

So we finish second level, we go into third level.

We, uh, you know, get our degrees, usually do very well, all the

jazz move on to our next job.

And it, it's like building like Lego blocks all the way through.

We never really stop to think about, you know, all of the skills

and stuff that we need there.

So it can be very frustrating.

A lot of the tasks fall to us.

We are the problem solvers is the term I often use.

And so when we don't think everybody else is up to speed,

that can be very frustrating.

The other thing as well in relation to frustration is we're

not the, uh, if you like the.

The all problem solvers.

So I am reliant on the electricity company to make sure the light is on.

I am reliant on the water to come through the door, uh, through

the, through the pipe to get to my surgery and so on and so forth.

So it can be quite frustrating to understand that we need to have

relationships with everybody around us who support us in everything that we do.

Um, and so that level of frustration can then show itself in burnout, absenteeism,

taking time off, uh, all, all of those things that feed into, um, issues with

regard to ignoring that leadership thing.

So you are gonna get frustrated, these things that you like aren't

un, aren't under your control.

And it's interesting you say that because actually one of the, the most

powerful shapes that we teach is a zone of power, which is all about what's in

your control, what's not in your control.

And we did start all our sessions out like that, whether you are, you

know, whether we're doing an away day with a, a, a practice team, or

whether we are with a, a group of say, trainers, like, what's in your control?

It's out your control.

It's amazing what what trainers feel really responsible for with

their trainees when they can't possibly be responsible for it,

because they're not in their control.

You know, the, the trainees health, you know, their wellbeing, how their

kids are going on, you know, it's just like, that's not in your zone of power.

That for me, that, you know, that's a really fundamental leadership thing

that, that, that we need to understand.

But if you're not seeing as the leader, you're going, well, I don't

really need those leadership skills.

I'm not going to develop that.

And then it has all these knock on effects that we, we don't think of, and

I've not really thought of that in the tens of the patient sense before either.

and you know, I, I'll give you one example, which I think

your listeners might enjoy.

Um, we now deliver this course online, uh, at face-to-face using X two oh and

Blackboard collaborate and interesting things, and it's really good.

But when we started off in 2017, we did face-to-face.

So a lot of it was, a lot of gps actually came to it initially from

beautiful places like County Kerry, Tipperary, and places like that.

And they'd come to the, the, uh, the lecture theater at Sandford and they'd all

walk in the door and walk out the door.

It was great fun.

Really enjoyed, really engaged and open to, you know, I could see a

lot of light, light bulbs going off.

But one of the fun things about it was understanding, as I've just mentioned, how

everybody plays a role within what you do.

So one of the questions I often ask is, uh, and this is a, this is a good

one where, where I say, you know, some people ask me and say, who is

the most powerful person in the Royal College of Surgeons in Ireland, right?

And everybody's expecting me to say the president or the registrar, or the program

director or whoever, the module elite.

And I always look at my watch and say, it depends on the time of day, right?

Right?

And they say, well, what do you mean by that?

So, so said at 8:30 in the morning and it's tumbling rain, and I've

forgot my swipe card, John, behind the desk, he is the most important and

powerful person at the Royal College of Surgeons 'cause he's gonna let me in.

And I preface that by saying, does anybody here know the name of the man at

the desk as they walk through the door?

So these are the future leaders of our profession, filing by

walking through and very few I've stopped to say, hello, how are you?

My name is, and what's your name and how long you been here?

And thank you for your support and making sure everything's all set to go.

Uh, that's a really powerful lesson.

It's, it's visualizing, you know, having pe, being aware of people

around you and how much they're part of your team directly or indirectly.

I think one of the big problems with people not seeing themselves

as leadership is people think, oh, I'm, I'm not a leader.

I'm, I'm, I'm too humble.

You know, I'm, it's bigheaded to say that I'm a leader, therefore I'm just gonna,

'cause I'm not really a leader, I'm just gonna keep my head down and do my work.

Um, why have we got this idea that it's.

Big-headed to think of yourself as a leader and get the skills that you

need when, when you might not be?

Yes.

That's a really good question.

And again, you know, it's funny, uh, the undergraduate medical crew particularly

'cause they're 18, 19, and, and exactly as you say at that very early stage, uh,

the, I call it the larval stage of, of being a doctor, they're gonna say, well,

no, hang on a sec. I'm not a leader, I'm just, I'm just gonna be a doctor.

That's all I'm gonna be.

Um, and I say, well, hang on a second.

Within this room, you are, yes, one of maybe 60, uh, candidates who will

be a doctor in a few years to come.

But remember how you're seen by other people when you step out

of this room, when you leave this building and leave this place in

five or six years time within your community, you're seen as a leader.

And the majority of people who will cross your path when you introduce

yourself, part of what you do, and part of identity, as Cathy said in the

last podcast, is around what you do.

It isn't necessarily who you are, and I'm, I'm keen to stress that,

but it is part of what you do.

And so PE people will see you and say, well, they've trained at university,

they've done this, that, and the other.

So therefore they must be a leader.

And if you fail to recognize that, or if you fail to embrace it, you're not just

doing yourself a disservice, but you're also having a, doing a disservice to

the people that you're, you're treating and also the people that you're working

with, because all eyes will be on you.

It's a sort of weird false humility, isn't it really?

It is, yeah.

Absolutely.

And I, and I think, you know, uh, one of the things I say in, in the lectures

that I give is I say, you know, if you think you're not a leader, uh, too late,

you signed up for it already, whether you, whether you realize it or not.

Well, I think so.

You know, any healthcare professional, you know, whichever branch of healthcare

you are in, whatever your role is, as soon as you've been there more than a year

or something like that, you're a leader because there's always people coming up

behind you, more junior, that you are supervising, that even if you've been

there for ages and ages and ages, and you feel that your role is sort of very minor.

You know, you've still got all that experience and people will be coming

to you and asking, so you just, you just can't get away from it, can you?

And I, I think, I think as well, Rachel, you know, one of the things I'm always

keen to, to stress is that sometimes we get, and you know, that, that word

about being in a silo and that we don't talk to each other, and that this can

happen across all healthcare disciplines.

But there was, um, I do a human factors thing in the diploma, clinical

leadership as well, and we talk about, um, you know, being efficient

around delivery and things like that.

So I'm always keen to learn from, uh, as many wide variety spaces as I can.

And I think you might be familiar with this, but a number of years ago and going

back well over a decade Greater, Greater Ormond Street, um, the pediatric service

there, they looked at the movement of child patients from theater to recovery.

And I'm not a pediatrician and I'm certainly not medically qualified, but

I do understand the urgency behind that timeframe between getting the patient from

the table to the high dependency unit.

And various consultants and people who are there and there's a massive

team, as you can imagine, around some of the more complicated surgeries.

They, uh, they decided to say, well, you know, who does these

time lapses really, really well?

So they brought in.

F1 McLaren.

So Formula One, McLaren, uh, team came in and they, they were there

for, I I understand from the paper, about seven to 10 days.

And they examined the rules of everyone around them.

They looked at where the leadership was coming from.

They looked at the coordination, they looked at the team management.

And based on their findings, and this is just purely from a logistical viewpoint,

they implemented a lot of the significant changes in role responsibility, task

management, et cetera, based on them.

I've just got this image in my head of like the changing the wheels on the,

the incubators and stuff like that.

Be fascinated to, to hear about what they actually found.

It's interesting.

What, what else?

How else does this affect other people if you're not seeing yourself as a leader?

Because I'm just thinking, I was doing some work with a, a GP partnership

team recently, and there was one particular person who was very much,

oh, I'm just a lowly partner, i, I'm only very part-time and I don't

really like, you know, I just keep my head down and I just see the patience

and, you know, all this leadership malarky, it's not really for me.

And i, I knew from having spoken to a couple of the other partners that actually

this was a real problem for everybody in the practice because staff were

coming to this person who was just like, abdicating all responsibility of this,

oh, I'm just a lowly partner type thing.

And, um, it really was affecting the whole of the practice team that this

person wasn't identifying themselves as part of the leadership, even though

they always sat in on all the leadership meetings and all that sort of stuff.

I, I think, yeah, so if we, we take it back and one of the key, and that's

a really good point actually as well.

I, I, I say to particularly the people I work with, I always ask the

question if I'm, if I'm heading into a new team or if I'm ex, I sometimes

do observations around teams.

I'll ask them all about themselves.

And then I'll ask them, what exactly is your role and responsibility?

And from that I'm getting not just what they believe it is,

but also what it is they do.

And they can be two very different things.

So one of the, uh, cost proposals that I do in the diploma clinical leadership is

to talk about how we put a, a healthcare change or quality improvement in place.

And the one area that they all struggle with is costing because most clinicians

haven't a notion, absolute notion.

Some of them will, will do a bit of research and say, well, this

equipment costs this and this service costs that, and et cetera.

So rather than get into the nitty gritty, I just ask one very simple question.

And I think you'll enjoy this story.

So one of the, part of my role and responsibilities within, uh,

corporate dentistry is interviewing new dentists for positions.

And these are competency-based interviews.

And I'm sure your, your listeners will have heard of these before

where you ask them, you give them a set of clinical tasks and you

ask them what they do, et cetera.

But one of my last questions, and if anybody's ever gone for an

interview, this is a spoiler alert, is to say, and you'll laugh at this,

how much is a box of gloves, right?

So you say, uh, okay.

So I have 60 candidates in my diploma clinical leadership, and the price is

vary wildly from one pound or 99th century if you wanna do Euros or Starling, all

the way up to like 20 pounds a box, and I say, whoa, hang on a second.

I'm saying 10 euros.

Oh, okay.

I wouldn't be shopping with you now.

Oh,

Uh, yeah, yeah, yeah.

So

Or

how many gloves?

Yeah, yeah, it's a box about 50 pairs, a hundred pairs, depending.

So all the big, all the big suppliers have come in at around €4.99, so about

maybe five, five or six pounds roughly.

Uh, again, depending on the quality and the style and powdered and latex, and

there's all other variables as well.

But the, the reason I give that example is it shows me not just that they're,

you know, price savvy or pound foolish, or whatever the case may be, but

it's just their appreciation for it.

How this links with your question is very simple.

If you don't know the cost of things, then you're going to run out very quickly,

uh, of, in, in this case, gloves, okay?

Because you won't have ordered in time, you won't have observed what's going on.

If your role is in verta commas, I just look after the gloves, you are actually

an incredibly powerful and important part of the cog that turns the whole wheel.

So if you feel that you are, you are somehow exempt from being part

of a management team, being part of a leadership team, remember that.

So if I, if I ru reach for the box of gloves and there are no gloves left, and

that's because we overspent our budget because we didn't know the price, this is

chicken and the egg stuff here going on.

that really, that's a very powerful example of, of understanding that

no matter what role you have, no matter what position you occupy, no

matter what your task responsibility is, there's a reason for your role.

Healthcare does not suffer su supercilious or superfluous people

in roles at all, as you well know.

I just ask you something there, Paul, because I think in the NHS healthcare

perhaps does suffer some supercilious people, because I think there are, when

when costs aren't directly born by that direct leadership team, then people do get

away with not doing their role properly.

And they get away.

In fact, the amount of people I have heard about, the amount of

absolutely dreadful managers I've heard about ,in very in hospital trust.

Nearby who, and I, I quote from someone, we've got the wor, someone

told, told me, oh, we've got the worst manager at the moment, but don't worry,

they're being promoted out into a different department soon, so they,

their leaders just get promoted out.

And one of the big issues I'm seeing in teams that, that are, people that

aren't doing their jobs, aren't in their roles, but nobody's challenging them.

Um, and, and maybe that's because this person not fulfilling their role isn't

directly causing a financial problem to that team that they're all suffering from

instantly, but they are causing other problems everybody's they experience.

There's nothing like finances to focus their mind, but other stuff goes on.

Like people are leaving 'cause this person's so awful and people

aren't taking that seriously.

Yeah.

Uh, and you know what, you've, you've touched, you've, you've exactly

encapsulated the conversation that I, I tend to have with people.

So I, I'll highlight that through the glove example as well.

So many people listening to this will have worked in hospital environments or in

general practice where gloves, gloves are the, the bread and butter of what we do.

Uh, I can't see a patient without gloves, okay.

So a management person comes in, let's say a fictitious organization, right?

Be it national healthcare or otherwise, and they look at the

balance sheet and they're told, you know, our budget has to be cut.

So they look through each line of item, they say, you know, well,

we can't cut salaries 'cause that would cause a trade union issue.

Uh, we can't really negotiate with our utility crew because they've

already given us the best deal.

So what can we look at

? And they often, the the, the magic roulette ball lands on globes, right?

And I'm sure if anybody here listening to this, uh, I'll hear a, I see a

lot of nodding digital heads when I say this, they'll say suddenly.

The gloves changed and we put them on and they tore right down the middle,

and I ended up having to get to my third pair before it actually worked.

So what has happened exactly as you said, is that someone who has been in

a nonclinical position, who has never had to wear gloves before, has never

used them to treat a patient, is making the decision to cross off that line,

produce a cheaper on cost level, looks really great, you're saving money.

But when it comes to value, I now, as the clinician using them, I'm using

three times more pairs of gloves.

Uh, so even though there might have been a 33% cheaper thing,

it's actually cost more.

My clinical waste has increased 'cause it's now in contaminated goods.

And the knock on domino effect is remarkable.

And this goes back to the, the, the leadership thing as well In that up

to relatively recently, and then by recently, I mean the last 10, 20 years,

we have tended to trust professional business people to run health services,

be it privately or, or publicly.

And in some respects that makes really good sense.

However, there is now the school of thought, which I would agree with, is

that you get clinicians with that business savvy, with that roles and responsibility,

with that leadership component in, because they know, um, that, that simple

example of having the right gloves, the right place, the right time that does

the job, rather than, you know, uh, the cheaper ones that break in the middle.

Yeah, you already, you always need people, don't you, that are actually using

the services that people are changing to be able to, to be able to do that.

Yeah.

And, and I guess it's not so tangible, but it's just as important around

the people management skills around the, the supervising teams, around

the, just how people interact.

That, that, that partner that I was talking about that didn't see themselves

as a leader and was very passive, people are still watching what they

did, whether they identify as a leader or not, and they're still being, you

know, they're still following them.

And even if they step right back and say, well, I'm not really part

of it, they are representing what the leadership is standing for.

What should people do?

So I'm thinking of if, if someone's listening to this now, Paul, and they are

thinking to themselves, oh, crumbs, okay, well yeah, I don't see myself singing,

but I guess from everything you've said, I probably am, where should they start?

Because you know, there's a million different leadership courses.

They're great.

And you know, if you wanna go on a lead short.

SHIP course.

Great.

And I don't think you should wait until you've got your official

leadership title to do that.

And I think you learn all sorts on leadership courses

that don't just help you lead.

They just help in life.

I mean, one of the best leadership courses I'd ever did bizarrely was

learning to coach, interestingly.

My coaching course taught me huge amounts about being a leader.

Okay.

But I know you've also contributed recently to book on emotional

intelligence, and I think this is probably where you need to start.

Would you say that.

I would agree with that too.

Yeah.

I, I think, and thank you.

Yes.

Uh, so there's a brand new book called Emotional Intelligence in Dentistry.

It's a kind of a pioneering book.

Uh, my colleague, uh, Dr. Mary Collins here at the Royal College of

Surgeons, she, is the main editor and she got a lot of dental colleagues,

including myself, to contribute to it.

I think if someone is thinking about leadership in general, first of all,

as you say, there is a. Plethora of books out there that they can access.

I'd say do your own research first of all, and, and, and, and,

and look at what fits for you.

The second thing is look at the, at the role that you're in, 'cause I'm conscious,

I'm speaking to many, many different, uh, healthcare professionals here.

Look at the role you are, you are in.

Also look at if you are.

If your line manager or your direct boss has had, uh, has done some leadership

training, maybe talk with them first and say what fits best for you?

Not all leadership, courses, RD diplomas or degrees or whatever

will, will fit exactly what you want.

You will definitely learn something obviously.

That's the first thing.

The second thing is read, read, read.

I know we don't have time to do that, but read, read, read is

always a good thing and start small.

I mean, when it comes to, to leadership in general.

I mean, one of the, one of the fun books I, I, I always like to mention

is the one called Make Your Bed.

I dunno if you've ever heard that one before.

no, but I might get that for my teenagers.

Yeah, but well, hey, you're on my team.

I've got four girls, uh, so I'm on your team there.

McRaven, um, retired Navy Seal and, uh, it, it, it kind of encapsulates that

famous one, which I'm a huge fan of as well, which is celebrate the Small Wins.

Um, and he was looking at motivating, uh, his SEAL team and all that kind of

jazz and he said, you know, one of the big things you can do in the morning is

when you get out of it, is to make your bed so it's absolutely made ready to go.

And it does two things.

One, it's accomplished a task really early on in the morning.

And second of all, when the day is over and you're absolutely exhausted, you know,

you're getting into a freshly made bed.

and it's a really good start.

It's, it's a fun look, act, and it's serious leadership stuff in it too.

But it, it, it.

Really struck a chord with me, and it's one that I often recommend.

So make your Bed, buy McCraven.

Um, and it's, it's, it's, it's a bestseller.

So to answer your question, I think that's the, the first thing to do.

I think.

Then if you are thinking about a more, you know, structured approach, take a look at

the colleges, obviously here in Ireland, we do an online digital blend thing,

uh, for diploma clinical leadership, which has very, been very successful.

There are other courses out there too.

But I think it's finding the course that best suits your role and responsibility.

And on that point as well, by the way, and you, you mentioned this earlier on,

when you talk about, know, people say, oh, I'm not really ready for this, or I,

this isn't something I do, I have often asked people about, when's the last time

you looked at your organization's mission?

What do they do?

So, you know, mission, vision, and values, and I know these are kind of,

some people band these words around, they say, oh, this, that, and the other.

And I often say, well, look, if I'm going to do a piece of work for

somebody, I need to understand what, what's, what's their goal, right?

So, because it gives me an insight into what their leadership is, if

they're leading their team towards a particular, uh, area or goal,

I need to understand what's there modus operandi, how do they work?

What, what's driving them to do that?

Have a look at your organization and, and say, you know, what is that their

mission is, and then how does my own personal leadership fit within that?

So, for example, if we look at RCSI, its, its mission is to recognize and develop

leadership, uh, and indeed innovation.

And if we look at their values, it's things like respect, collaboration,

scholarship, and innovation, RCSI.

I love those books that you are recommending.

I, I would hit, hit on it from a slightly different angle.

Interesting.

So you'll hit looking at that organizational mission

and things like that.

I guess I would look on it from a, um, I guess, the, the personal skills angle.

So the personal skills books I also love are the one that's affected

me the most is the 15 commitments of conscious leadership, which

is all about the drama triangle.

If you're a, if you're a fan of the drama triangles, stop rescuing people, get out,

victim and stuff, it's all about what lead as leaders, how we keep ourselves

in victim, what other people in victim, and how we get what they call above the

line and be conscious of what we're doing rather than just like being sort of bashed

around like a, you know, ship in a storm.

And that's been really, really helpful for me.

So that's one I absolutely love.

The, um, seven Habits of Highly Effective People I think is Stephen Cove.

I mean, it's, it's a classic one, isn't it?

Quite a long book, but it's really, it's really, really good.

And I was just thinking, Paul, when you were talking about finding out your

mission, I was thinking, right, how many, how many GP surgeries actually know what

their mission are and how many consultant, depart, you know, depart surgical

departments know what their mission is apart from, you know, to have really

good outcomes and keep, keep people safe?

But I really like the concept of the Stevens question, which we used

for a time, which is based on there was a rowing coach in Cambridge.

And um, he would set a question whenever they wanted to either get a new boat

or try different training regime or get a new kit, the one question he asked

was, will it make the boat go faster?

And I think there's a whole book written on that isn't there?

And this question of what's our, one thing that we're trying to work out?

Now, and in fact legend has it, and I think this is true, that when the

Olympic eight went to Sydney, um, in 2000 and something or other, um, and

they won the gold, but they didn't attend the Olympic opening ceremony 'cause

they asked themselves the question, will this make the boat go faster?

And it wouldn't.

So they didn't do it.

And I think for, for GP practices, for example, and we talk about this

a lot in our Shapes Academy, you know, it might be will this help

us work safely and feel better?

Or you know, will this decision help us retain our staff?

Or will this decision help us keep the practice open or improve

our access, or whatever it is?

But this, this one thing that you are, you are leading to.

And something that's sometimes if you don't have this overarching vision, just

working out what your Steven's question is for the, the season can be quite helpful.

Do you use stuff like that as well?

I do, I do actually.

And yeah, I, I'll give you one classic example from a practical point of view.

So I, I spent o over 10 years in a beautiful, uh, town, just very close

to where I'm here in general practice.

So I was as, I call it, drilling, filling, and billing.

But, um, so, but what I used to do was I used to work late on a Monday evening.

Until 8 00:32:30

00 PM and then I would take a half day on Tuesday.

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Um, and the reason was that it balanced each, uh, each other out.

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It was a really good thing to do, actually, to have some time

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off in the middle of the week.

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So, you know, working, banking, all that kinda stuff and shopping.

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so, uh, the, the, the, the time where I was working,

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this is a number of years ago.

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It's a very much old school, middle Ireland, very picturesque place,

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but very much stuck in history.

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And so I had a, a, a very small sign on my window, which would had my

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opening hours and I had, you know, Tuesday afternoon it closed and

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that so forth, so on and so forth.

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So I was there about five years and I happened to be there on a Tuesday

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afternoon doing paperwork, which I, I hate doing like everybody else.

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And there was a knock on the door.

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So I opened the door and there was this wonderfully friendly

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farmer, um, in his late seventies.

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And Tuesday afternoon was the day when most of the farming community come in

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to buy their supplies, 'cause there was a sale on in the hardware store.

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And he said to me, every time you, how long are you here?

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I said, I'm here five years.

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Every time I'm in here, you're closed.

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It's terrible.

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Are you ever open at all?

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Right?

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And I said, when do you come to town?

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Tuesday afternoon.

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That's, you know, uh, he never read the sign.

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He never read the sign, and it was gone.

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In relation to how leadership works there, i, I then said, okay, right.

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So I, I think I'm great and I have a really good staff, good surgery.

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I think I've got everything all sorted out, but in actual fact, my

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signs need to be bigger about what I do, and this is the reason for it.

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And then we made an appointment and I said, you'll have to just change your

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rota slightly to come in to see me.

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But it's that idea in his mind, 100% of the time that he came to town, I was shot.

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And so if anybody asked him, is that guy open?

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No, he's never, he is never open.

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I've never seen him open there, whereas an actual fact I've been exhausted

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from Monday night at eight o'clock.

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One of the things, I was over at the, um, the American Dental

Until 8 00:34:15

Associations Conference was in New Orleans last year was gorgeous.

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16,000 dentists in one place.

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Best place to have a toothache and.

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I looked at some of the marketing and the Americans are great at

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marketing and stuff, but I saw one thing that really struck me and

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I thought that was really good.

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Um, because as a, as a, as a practitioner, and particularly as a

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self-employed private practitioner, I'm obviously constantly aware

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of cost and what's involved.

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So when you give your patient their receipt for your treatment that they've

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had done, may have just that one line that said examination and the fee, it

Until 8 00:34:44

might be 50 Euro 60, Euro 70, or whatever the case may be, and that's all it says.

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And so the patient in their own mind is leaving the building thinking, you know, I

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just gave that guy 60 euro for sitting in a chair for five minutes for him to say,

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I need this, that, and the other done.

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And, uh, one of the American crew that was there, they had an itemized

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receipt and it says examination, and the fee was the same, but underneath was

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sterilization, cross infection control, use of gloves, rental, light, heat,

Until 8 00:35:10

salary for nurse, IT, insurance, GDPR.

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And he had a whole list itemized right down to the last cent

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of what that made the 60 euro.

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So it was no longer the 60 euro going into my trouser pocket, but an actual

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fact to feed the beast, that is general practice as everybody will know.

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Oh, totally.

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Totally.

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And we just don't tell people what we do and therefore then

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it's not valued by the patients.

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Absolutely.

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Sort the problem is in the NHS when they're not getting the

Until 8 00:35:37

bills, you know, someone's getting the bills, but the patient isn't

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directly, that's really hard.

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It just reminds me, a really good friend of mine is going through chemo at the

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moment and was sent for an investigation.

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Now, she didn't know what it was for, and um, I looked, when she told me, I

Until 8 00:35:54

said, well, it sounds like it's a routine thing that they would do halfway through.

Until 8 00:35:57

Just to make sure that the chemo isn't affecting this particular bit of the body.

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But no one had really said to her, they just said, turn up in this ward

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at this time for this investigation.

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And she went and it, it was just a, a, a routine thing, but even just having

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some, this is why you are doing it, and actually this is what we do and

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this shows us this, and there are sort of leaflets that come out, but it's

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not sort of written around, you know, even in a, I don't know, a physio

Until 8 00:36:21

department, this is what physios are for.

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This is what we do, this is all the training that we have, this is a thing

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I think would be be really helpful.

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But what skills do people need?

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If, you know, we can do leadership courses and learn about leadership

Until 8 00:36:35

and all that sort of stuff.

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But actually if you're talking about the three top emotional intelligence skills,

Until 8 00:36:41

so these are all the brackets soft skills.

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I don't think they're soft at all, you know, but to be a leader, if

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you had to assess if, if you could only assess three things when you

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were choosing your next deputy, what would you be looking for in somebody?

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Number one skill listener.

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It's as powerful as that.

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It's the ability to listen, not hear, but to listen.

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People will tell you things both overtly and inadvertently, and unless

Until 8 00:37:08

you have your ears open, I think the listening skill is hugely important.

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That's number one.

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I think the second thing is, uh, reading, showing progression, um, showing that

Until 8 00:37:18

you're continually developing yourself.

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So one of the questions I'll often ask, and, and this isn't in a, you know,

Until 8 00:37:23

subterfuge way, but I'll often say, you know, what are you reading at the moment?

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And so I, ID, I love to hear a, they're reading something, and this

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goes from teenage children, by the way, all the way through to colleagues

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as well, uh, is reading something.

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And then the third thing is application.

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So how are you applying those two skills?

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So I would often ask and say, you know, what have you learned, you know, both

Until 8 00:37:42

clinically or administratively in the last three, three months that you've,

Until 8 00:37:45

that you've listened and heard about?

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And then how have you applied it?

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They're the three skills.

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And I think if you apply that, not just to your role, but also clinically

Until 8 00:37:51

as well, um, and oftentimes it's what's not said, and that's why the

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listening thing is so important.

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And you know this from practice, I'm sure as well, uh, and it's the same with us.

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People will tell you what their, their burning issue is, uh, but

Until 8 00:38:04

they may not tell you what is a secondary issue, which actually

Until 8 00:38:06

could be more, even more important.

Until 8 00:38:08

The reason that they're late for the appointment isn't that they

Until 8 00:38:10

were running late, it's that they didn't have access to petrol.

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To get put in the car to get there, or the bus was late and they don't have

Until 8 00:38:15

a car, or whatever the case would be.

Until 8 00:38:17

That's interesting you say that because I have noticed that a lot of people

Until 8 00:38:22

who are leaders, they say they want to listen, so you'll tell them something

Until 8 00:38:26

and immediately they'll come in with a defensiveness, and the, oh, yes, but,

Until 8 00:38:30

and this is why we did it, rather than the, oh, that's interesting, okay,

Until 8 00:38:34

tell me more about why you, why you think that and getting really, really

Until 8 00:38:37

curious and digging, digging down deep.

Until 8 00:38:39

Because they think that their role is to defend and to explain.

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Actually, if you start doing that too early, it just makes things

Until 8 00:38:47

much, much worse, doesn't it?

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Actually, your role is to understand first.

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That's one of Stephen Covey's thing, isn't it?

Until 8 00:38:52

Seek, seek first to understand.

Until 8 00:38:54

In the seven habits of highly effective people, it, it really makes a difference.

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'Cause you can defend and explain later, but if someone feels that

Until 8 00:39:01

they've been heard and understood, then they're gonna be more receptive.

Until 8 00:39:04

In fact, they won't hear and they won't hear you until they

Until 8 00:39:08

feel that you've understood them.

Until 8 00:39:10

Yes, exactly.

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Reading skills and professional development would be number two.

Until 8 00:39:14

And then applying them is really, and so you might say, well, how do I apply them?

Until 8 00:39:17

Give me an example or.

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Is there something recently that you put in place that will do it,

Until 8 00:39:20

um, that will show that you've demonstrably learned from this?

Until 8 00:39:24

And again, I, I'll take a, I'm, I'm, I'm conscious of the people who are

Until 8 00:39:27

listening who may be clinicians, but again, I, I help out, I manage an

Until 8 00:39:31

oral surgery practice and I work a tiny bit clinically there as well.

Until 8 00:39:34

But because we're in the private sector, uh, we are dependent

Until 8 00:39:37

on referrals to come in.

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And this goes back to relationships with your fellow colleagues.

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And so, so general dentists will send stuff in and we'll get the

Until 8 00:39:44

referrals in by post or by email usually, or whatever the case may be.

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But contacting people, this is a, we live in a really busy 21st century.

Until 8 00:39:51

Uh, your phone and my phone are pinging away.

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I'm sure once we switch them back on today, they'll be like

Until 8 00:39:55

a million female and phone calls and texts and stuff like that.

Until 8 00:39:57

And so getting through the noise, is, is, is an issue.

Until 8 00:40:01

So, when patients are referred to oral surgery, oftentimes they are obviously

Until 8 00:40:05

in pain, they've had infections, infected wisdom teeth, things like that.

Until 8 00:40:08

And that's a, that's a great driver to attend.

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We all know this, and this is the kind of bread and butter dentistry.

Until 8 00:40:13

However, if they're left for a while and the infection has gone

Until 8 00:40:15

down and they're kind of, well, again, they're less inclined to come

Until 8 00:40:18

until the next boat of infection.

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So understanding how to make sure that they attend is really important.

Until 8 00:40:23

Um, so I send out a very, very carefully word, text message.

Until 8 00:40:27

And initially it started like, you know, you've been referred,

Until 8 00:40:29

contact me for an appointment.

Until 8 00:40:30

Response rate, 40%.

Until 8 00:40:32

You've be referred by your dentist, contact me for an appointment.

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And the appointment is on next Tuesday, again about 40% success rate.

Until 8 00:40:38

And I, so I did a bit of digging around this and one of the things that I

Until 8 00:40:41

learned, and this the listening thing was patient said, I get so many scam

Until 8 00:40:44

texts, I didn't think it was true.

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So I then change my text to you have been recently referred by Dr. Rachel

Until 8 00:40:51

Morris on the 17th of April, 2025 to our practice here at blah, blah, blah.

Until 8 00:40:55

Um, and we are setting up an appointment for you.

Until 8 00:40:58

And again, so the, the success rate went up.

Until 8 00:41:00

However, here's the kicker, and this is what I learned.

Until 8 00:41:03

I then added one line and this has brought the response rate up to almost 100%.

Until 8 00:41:08

If you no longer require a text, no other patients, many in discomfort

Until 8 00:41:13

can use this clinical time now.

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That's what they call the poke, uh, that they can do.

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There's a great book, by the way.

Until 8 00:41:18

I'll mention one more called Nudge by Cass Sunstein.

Until 8 00:41:21

I'm sure you've read it.

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Have you?

Until 8 00:41:23

I've got a book called Inside the NI was just thinking, I've got

Until 8 00:41:25

one called Inside the Nudge Unit, so it's a very similar thing.

Until 8 00:41:28

And there's a really good podcast actually called, um, Nudge by Phil, Phil

Until 8 00:41:33

Agnew or something like, it's brilliant.

Until 8 00:41:34

It's a marketing podcast, but yes, it's really interesting.

Until 8 00:41:37

Yeah.

Until 8 00:41:37

Yeah.

Until 8 00:41:37

So nudge, nudge, and that's where I got the

Until 8 00:41:39

Yes.

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The Nudge, the Nudge series.

Until 8 00:41:41

So you are appealing to sort of altruism, they don't want other people

Until 8 00:41:45

to, to, to miss out there, do they?

Until 8 00:41:46

Yeah.

Until 8 00:41:47

Yes.

Until 8 00:41:47

Because they themselves had been in pain two or three weeks previously.

Until 8 00:41:50

And so they're saying, well, that could be me, that could be my

Until 8 00:41:52

sister, that could be my brother.

Until 8 00:41:53

And so, so this goes back to the skill of listening as understanding reading around

Until 8 00:41:58

it and then applying what you've learned.

Until 8 00:42:00

Yeah.

Until 8 00:42:00

And, and.

Until 8 00:42:01

That really is a skill of influence, isn't it?

Until 8 00:42:04

So once you've listened, you then need to be able to influence people.

Until 8 00:42:07

And if your manner is very competitive or defensive or whatever, then you

Until 8 00:42:12

are not going to be able to influence because yeah, something like a leader

Until 8 00:42:15

who can't take anyone along with them is just going on a walk or something

Until 8 00:42:18

that, there's that saying, isn't there.

Until 8 00:42:20

But often you are leading, you are taking people with you, but in complete the wrong

Until 8 00:42:24

direction, 'cause you've not actually thought about the fact that you are

Until 8 00:42:27

taking people with you and maybe you've been moaning to all your colleagues about

Until 8 00:42:30

this, that, and the other, and you've not actually thought perhaps this isn't

Until 8 00:42:33

helping our organization, perhaps isn't helping me achieve what I need to achieve.

Until 8 00:42:38

So a lot of leaders in healthcare and teachers and always, they are

Until 8 00:42:43

so busy delivering the day job.

Until 8 00:42:45

It's seeing the patients teaching the lessons that they have no time to

Until 8 00:42:50

actually think about that leadership role.

Until 8 00:42:53

And you know, I'm really keen on this aspect of thinking time, deep work

Until 8 00:42:56

or whatever, but how do you teach people to apply that sort of thing?

Until 8 00:43:00

Yeah.

Until 8 00:43:01

So a couple of things and that's really that, that if you were to

Until 8 00:43:04

say to me what is the one cruncher about anything, uh, is time.

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Uh, because we all, we're all spinning plates madly, right?

Until 8 00:43:09

As we know.

Until 8 00:43:10

And I'm a huge fan of the podcast.

Until 8 00:43:11

So I've listened to many really good examples over the, over the years.

Until 8 00:43:14

Uh, so I'm a big podcast fan, um, and I will listen to your

Until 8 00:43:17

podcast and others in the car.

Until 8 00:43:19

And I find that's great one.

Until 8 00:43:20

So if you're commuting, if you're traveling, if you're doing that,

Until 8 00:43:22

don't forget your mental health.

Until 8 00:43:23

So get out for your walks.

Until 8 00:43:24

Sometimes you can have your, your headphones in if you're safe to

Until 8 00:43:27

walk when you can listen at the same time, it's carving that time out.

Until 8 00:43:30

I think that allowing yourself, uh, the time to progress, to read,

Until 8 00:43:36

to listen to podcasts, to develop yourself is as critical as showing

Until 8 00:43:41

up for work or cooking the dinner, or making sure the house is clean.

Until 8 00:43:45

I would put them on an equal priority.

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Because if you, you know, stand still, if you get stuck in the mud, not progressing

Until 8 00:43:51

and ultimately it's going to both impact not just on your clinical, uh,

Until 8 00:43:55

outcomes and stuff, but also leadership capacity and how it affects your roles

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and responsibility on your organization.

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It's a domino effect all the way through.

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Everything is interconnected.

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Nothing stands by itself.

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How you do that, if you figure out how to absolutely get, uh, protected

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time, as they call it here in the public service, let me know.

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In the private sector, we are on the go the whole time.

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So what I, I tend to do as a, just as a practical example, I tend to get

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up early, uh, and go to bed early.

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Usually I have, I. One night where I'm given a permission slip from

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the home office, um, here, uh, to go out for lemonades with my friends.

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Uh, so, but I would say early Saturday morning, early Sunday

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morning is really great.

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Um, so I make pancakes on a Sunday morning listening to podcasts.

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That's, uh, that's my little, little time to do that.

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I like that.

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Yeah.

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Lots of listeners tell me that they listen to the podcast on dog walks or in the gym

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or on their commute, and people always say to me, Rachel, how, how do you have

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time to do all this reading and podcasts?

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I say, well, first of all, I say, well, it's part of my job.

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Yeah.

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I couldn't do this podcast I wasn't doing it.

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So that, and I don't have the clinical pressure that other people do.

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But I, yeah, if I'm in the car, I've got a podcast on.

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Or if I'm walking to, to work, which I do sometimes, I've got a podcast on when

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I'm planting my plants, which that's my opposite world, I've got a podcast on.

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I'm just constantly listening.

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And then when the books are recommended on the podcast, I'll

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buy them if they sound good.

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Um, I'll flick through them.

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I don't think to myself, I've got to read all of this book.

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If I often say, here's a quick tip for books.

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If you find the author, the author often goes on some of the bigger

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podcasts of these bestselling books.

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You listen to like an hour of podcast, you listen to it on 1.25.

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You get the whole book in about 45 minutes and you just

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listen to it as an audio thing.

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So even if you've only got 10 minutes in the call, that's four journeys, you've

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listened to the whole book pretty much.

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The author's told everything that's in the book.

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Boom.

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You've read the book.

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So I think, you know there, there's hacks and things around it.

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A lot of people like audio books as well.

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Put what people find audio books really, really good as well.

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So it's about being intentional, isn't it about thinking right, okay,

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what is advice you wanna learn?

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What book's been recommended that are gonna be good?

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Can I find the author on a podcast?

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Do I want the audio book or should I just sort of sit down

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and flick through it for an hour?

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Yeah, yeah.

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No, absolutely.

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Yeah.

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And you know, I'm, I'm, uh, so, you know, one of my pals recently said to me, he

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said, you, you should come with 1.25, by the way, if I could just, or, or is

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there also an option to skip trailer?

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I said, okay, I'll skip trailer on this one.

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Just give you the, what you need, you know?

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Yeah, that's why we have YouTube Shorts, so that's why they can

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get stuff on YouTube Shorts.

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But I think walking is meditation.

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It really can be.

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And I think with all that advice, I listen to podcasts all the time, I

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would also say you do need time when you are not listening to anything, so

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your brain just like solves problems.

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I have my best ideas, honestly, it's in the shower after my tennis lesson.

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I always come out going, I've got it bizarrely.

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I agree with you.

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I agree with you.

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I think, I think it's good.

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I think it just clears the head.

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And actually walking.

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Walking by yourself without the podcast on, and even if you have the

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dogs or whatever the case would be.

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Yes, absolutely.

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So be intentional about.

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Being a leader.

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Find out what you need to do, work on emotional intelligence, as

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Paul says, work on your listening.

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Really, really important.

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There's a great book by Nancy Klein, Time to Think, which is about how

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to create a listening environment.

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Now, if people wanna find out more about you, about your work,

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about courses, where can they go?

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Yeah, the best thing to do is actually just drop me a quick email.

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Um, so paulodwyre@rcsi.com, the Royal College Surgeons in Ireland.

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So that's very simple.

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Perfect.

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Well, thank you so much for your time and we'll speak again soon.

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Thanks Rachel.

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Thanks for listening.

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Until 8 00:47:20

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Until 8 00:47:25

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Until 8 00:47:30

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