Serving the team, making it safe, and being authentically positive

Enduring leadership principles can help in navigating in tough times

brian bolwell md

There was a time when leadership skills were assumed to be qualities that people naturally accrued as they ascended the organizational ladder. These days, we know better. Some people show a natural affinity for leadership, but nearly everyone can benefit from coaching on skills development. Intentional practice can mean the difference between good and great.

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As Cleveland Clinic’s Chairman of Physician Leadership and Development, Brian Bolwell, MD, is passionate about sharing tools and information that help leaders become more effective in their roles. In a recent interview, Dr. Bolwell shared thoughts on practices that endure, as well as what healthcare teams need in times of challenge.

Dr. Bolwell’s insights come from his own hard-won experience, as well as through coaching interactions with Cleveland Clinic physician leaders.

“I do an awful lot of coaching, and I find it wonderful. I’ve had an opportunity to meet leaders from throughout the entire organization, from Northeast Ohio to London and Abu Dhabi,” he says. “I’ve met hundreds clinical leaders, which has meant a lot of enjoyment for me.”

Physician leadership development has long been a priority at Cleveland Clinic, he says.

“I don’t think anyplace else comes close to doing what we do, and that’s something to celebrate. It has definitely helped us as we handle the business challenges that everyone in healthcare is facing right now: workforce shortages, increasing expenses, and reimbursement and revenue rates that are not changing. The financial constraints are quite real. The vast majority of hospitals are having a very tough year.”

The difficulties are very real, but strong leadership practices make them more manageable.


“There are two overarching leadership principles that I believe are really important,” Dr. Bowell says. “The first is serve your team. Leadership is not about you. It’s not about some sort of fancy title. Leadership is about hiring good people, supporting them and keeping them engaged and motivated.”

The second principle, he says, is that leaders need to be willing to examine themselves and their practices with an aim to improve.

“Ultimately, the goal is to have the courage to live your values,” says Dr. Bolwell. “This is where things like psychological safety become important. You want others to be able to speak up and offer their opinion. Maybe you need to course correct. You need to try to get better, so you have to create an environment where it’s safe for others to say difficult things.”

Dr. Bolwell cites writer and speaker James Hunter. “He says leadership development and character development are one and the same, and I believe that to be true,” says Dr. Bolwell. “I’m also a big believer in [writer and researcher] Brené Brown. She’s all about the courage to be vulnerable. Having the courage to be who you are and to be authentic and to be real is a glue as you try to navigate challenges.”

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Better communications

In addition to the fundamentals, improving upon specific skills has benefits for teams. Communication is at the top of the list.

“You can never over communicate,” Dr. Bolwell says. “And one of the most important facets of communication is to understand that your words have an emotional impact on people. Try to understand what that impact is or will be, because it’s very easy for communication to get derailed. Your intentions may be very noble, but if the impact of what you do or say or act is negative, it’s not going to be well received.”

Dr. Bolwell cites Tomislav Mihaljevic, MD, Cleveland Clinic CEO and President and Morton L. Mandel CEO Chair, who communicated a commitment to keep caregivers employed as the health system faced the grueling early months of the COVID-19 pandemic. The challenges of that time were numerous and fierce, but because Dr. Mihaljevic communicated leadership’s intentions, worrying about layoffs did not become one of them.

Writer and speaker Simon Sinek points out the importance of communicating the “why” of a given mission, Dr. Bolwell says.

“Many times when we try to deliver a message to our constituents, we start with what we have to do. That’s not as motivating as the why,” he says. “Sinek likes to use Apple as an example. Apple didn’t say ‘We’re going to make a better computer.’ Apple said ‘We’re going to change the world,’ and they did. “Here at Cleveland Clinic, we in fact do change the world. And we have a unique mission and value statement that talks about the importance of patients. Very few other academic healthcare centers have something like that. We say ‘Patients are the most important thing we do,’ and yet we’re still a very academic organization. We know that why we’re doing things is extremely important, and it’s important to focus on that in communications.”

Expect and embrace the unexpected

Acquiring a tolerance for unpredictability and upheaval is another keystone skill, says Dr. Bolwell.

“You can have a schedule at the beginning of the day that looks great and makes sense, but inevitably something is going to happen that derails it,” he says. “You will have to take time to address problems as they come up, and to be OK with that. Because if you don’t learn to do that, you’ll constantly be irked.”

For those in leadership roles, days punctuated by unplanned events commonly outnumber those that stay on schedule. “Become comfortable with the unexpected, as it’s a rare day when everything will go as planned,” says Dr. Bolwell.

Prioritize the building of great teams

Investments of focus and energy for creating strong, functional teams go a long way toward establishing leadership success. Strong teams also attract great talent and support talent retention.

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“Be very picky about who you bring onto your teams, and then listen to them,” says Dr. Bolwell. “Ask their opinions on problems. You’re not going to have all the answers, but that’s fine. Let them do what they do best. That’s one way that great teams stay great.”


Demonstrating positivity is an important skill. It replaces worry and doubt with a focus on problem solving and forward thinking.

“Leaders have to be positive. They have to show a way, and have some sort of vision,” says Dr. Bolwell. “One of the themes you have to reinforce, especially in difficult times, is that we’re going to get through this. We’ll figure it out. It may take us a while, but, boy, I’m happy to be here, and I’m glad I’m doing what I’m doing.”

But positivity has to be authentic, Dr. Bolwell added. That means the positive focus has to be grounded in facts; problems must be acknowledged so they can be addressed.

“Positivity can’t be faked. People can see through that very easily. You’ve got to be authentic and you got to believe it,” he says.

Along with telegraph a positive attitude for others, Dr. Bolwell notes, it’s essential for leaders to remember how empowered they actually are.

“When leaders express challenges they’re having, one of the things I hear frequently is ‘I can’t do this, I can’t do that.’ I would argue that physician leaders have a lot of autonomy,” he says. “I would much rather hear an attitude of ‘I can do this,’ or ‘we collectively can do this.’ If you just open your eyes to the I-can opportunities versus saying ‘I can’t,’ they’re abundant.”