Strengthening Your Leadership Muscles: A Conversation With Karen Murray, MD

Karen Murray, MD, has been in the business of medicine and leadership for decades.

Today, as Chair of the Department of Pediatric Medical Subspecialties, she leads a team of nearly 70 pediatric providers across nine different medical specialties. As Vice Chair of Research, she helps to lead the research growth for the Cleveland Clinic Children’s Hospital, and as Chair of the Department of Pediatrics at Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, she leads the faculty programs in pediatrics at the medical school.

Dr. Murray is recognized internationally for her physician leadership and contributions to the field of pediatric liver diseases. Notably, she has led efforts to eradicate pediatric hepatitis C by bringing FDA-approved adult drugs to the pediatric population. She has also advanced treatments and care for children with hepatitis B and other chronic and cholestatic liver diseases of childhood.

Dr. Murray shares insights from an illustrious career in a wide-ranging discussion with Consult QD. Excerpts from that discussion are presented below, organized into topical categories ranging from leading multidisciplinary teams and challenging the status quo, to building your career, finding balance, and much more.

Work toward a shared goal

"It's very important to listen, to really hear and understand, what the opportunities and challenges are for those individuals. Leadership is about inspiring, enabling, and ensuring that individuals and groups are aligned with and working toward the same overarching vision."

"Clear messaging is needed around shared expectations across all disciplines. Equally, there needs to be awareness of the nuanced differences in each discipline to enable people to do their best work toward achieving those goals."

Strive for leadership (not boss) qualities

"A leader establishes a vision, engages people toward that vision, and inspires them to not only do what is expected but also rise beyond that. On the flip, they hold people accountable and can be decisive. A major part of effective leadership, in my opinion, is building trusting relationships through transparency, honesty, and strong communication. A boss, on the other hand, may set expectations to meet certain behaviors or metrics, but by telling instead of engaging, they are less likely to engender an inspired team of members who want to go above and beyond."

"The nuance in medicine is that we are, first and foremost, care providers. I feel very strongly that it's important to keep your hand in the clinical space and have some involvement regardless of your leadership status. This allows you to be grounded, stay true to your roots, build credibility, and understand what's happening on the ‘front lines.’"

Challenge the status quo

"Humans tend to like the status quo, but we will not get better if we do not change. The ability to think critically about how we could do something differently to achieve more, be better, or be more efficient, and engage folks to see the possibilities and move with you from X to Y because they now want to, is what leadership is about. In my mind, change to be or achieve better is a continuous process that never relents.”

Being a leader: Start in your day-to-day clinical work

"In medicine, we are, by definition, leaders. As a trainee, you have a leadership role within the clinical team: You are at the bedside in plan-of-care visits, rounds with the family, with your attending and nurses, and with other trainees. You're presenting the case, the overnight situation, and the plan for the day. Driving the conversations and engaging people around some initiative or vision for care are all opportunities to practice and develop leadership skills.”

“Equally, engaging in work groups or committees can help leverage those skills. Let your passion lead the way. Ask yourself, outside of clinical responsibilities, is there a complementary body of work in which you can get involved. Something that aligns with your passion, and for which you see an opportunity for improvement that you can drive forward."

Be clear on your priorities, and expect that they will change over time

"Focus on building your clinical career, research, or education program, whatever your career priorities are, acknowledging that ultimate goals do not need to all happen at the same time. Get involved and say ‘yes’ to things. Grow your reputation and focus on making a difference in medicine. Lead in what you are doing and demonstrate effectiveness.Opportunities for more formal leadership roles will likely become available over time, especially if you share your interests with your leaders."

"My only caveat is to be careful about derailing progression toward your personal priority goals by taking on distracting responsibilities too early. The work in major leadership roles is usually focused on others or goals outside of the leader themselves, and most good leaders are no longer prioritizing their own career priorities.”

“I've been fortunate to have leadership opportunities in my home institutions and nationally. The national opportunities would probably not have been possible, however, had I not built my reputation in a medical focus the way I did first.”

Leave some flexibility for 'yes'

"Say yes to things—with some exceptions. Today, there is an appropriately increased attention to work-life balance, and I respect it greatly. But I think there is a misconception that saying yes to an opportunity will always be offset by the provision of time.”

“To achieve your goals, there will be times when you just need to roll up your sleeves and put in the effort. In other words, be intentional about balancing work and life, but also enable flexibility in what that balance looks like for you so you can take advantage of opportunities that interest you and/or will advance your career. Lean in if someone offers you the opportunity, as more opportunities are likely to follow when you say yes."

Remember, confidence and humility can coexist

"Everybody can have a little bit of imposter syndrome; that's not a bad thing. In my experience, the best leaders have humility, allowing them to reflect on their abilities. But have confidence in yourself. When others have faith in you, believe them. Listen to those who know you well. Develop the confidence to say, 'I can do this and will give it my best, but if I fail, it's going to be okay.'"

"Over the decades, I've seen imposter syndrome disproportionately affect women. It's a reminder that good leaders intentionally recognize and encourage those who are underrepresented within their fields.”

Final thoughts

"I have an incredibly supportive husband and family, who have been my greatest champions. When I have voiced trepidation or fear that 'it might not work out,’ they've always said, “‘maybe, but regardless we will keep moving forward.’"

“Some calculated risk-taking is a part of pushing the envelope and changing the status quo. We're not going to advance—our own careers or the work of those around us—and we're not going to become the best children's hospital in the nation if we do things the same way they've always been done."

Dr. Murray is the President Elect of North American Society for Pediatric Gastroenterology, Hepatology & Nutrition (NASPGHAN) Foundation. This article was based on her session, "Growing as a Faculty Leader: Developing your 'Leader Muscles,'" which she delivered during the 2024 NASPGHAN Annual Meeting.