The Chief Operating Officer and I were meeting one day, and the Director of the Laboratory was asked to join us to discuss a staff challenge she had been having.  As the director for the laboratory, she reported to me. We met regularly to discuss progress on her goals, any issues with the medical staff, and the other usual challenges that might arise. I was hoping to learn more about using a leader's two most important skills by observing my COO.

I was still learning the ropes about working with directors for critical hospital departments like the Laboratory. The COO was quite adept at sorting through difficult issues and building strong teams.

leader's two most important skills meeting

The lab director was very frustrated. She began talking about a particularly difficult employee who had repeatedly stirred up trouble in the department. Peter had been working as a laboratory technician for many years. Every few months it seemed he would be the center of some drama in the department. He would be “written up” and then not be heard from for several months until the next issue.

The employee had certain skills and certifications that would make him difficult to replace. So, in spite of his repeated involvement in various kerfuffles that impaired the morale of the department, he never received more than a slap on the wrist for his transgressions.

Sheila described her frustrations in detail. Several technologists and laboratory assistants had come to her with complaints about his behavior. They felt that they always had to make adjustments to avoid upsetting him, and it had created a very tense atmosphere in the department.

They complained that there was a lack of consistency in the way the work rules were applied in the department. Peter was repeatedly allowed to skirt the rules without serious consequences. There was a great deal of resentment among the staff members.

As Sheila described the situation to us, we mostly just listened. The COO occasionally encouraged her to “go on, tell us more,” and then we waited for her to go on.

Seeking a Solution

At one point he asked, “How is this behavior affecting the performance of the department?”

She replied, “The turn-around times have gone up because the staff aren't working well together. And one of our new technologists resigned 2 weeks ago, probably because of Peter.”

“How is this affecting your effectiveness?” he asked.

“I'm spending all my time putting out fires and trying to convince the other employees not to quit.”

“What have you tried so far to resolve the situation?”

She described various attempts she had made to work with Peter to improve his accountability and encourage him to address his behaviors. As she paused during her description, we listened without comment. After a few moments, she would continue.

Finally, Sheila said, “You know, it's going to be difficult to replace Peter, but I think I have to do it. For the department, and the organization. His presence is too toxic. If you agree, I'll meet with HR later this week to review the process. Then I'll meet with Peter and let him go.”

What I Learned

In the situation that I describe, as a physician and new hospital executive, my tendency was to jump in after about one minute and advise Sheila to fire Peter, and ask her why she was putting up with his nonsense.

But that would have been shortsighted and counterproductive. What the COO demonstrated was how to lead by asking questions and listening. He built trust with Sheila and helped her grow as a leader. He strengthened his position as COO by not allowing Sheila to put the monkey of the termination decision on his back. Rather, he deftly led her to the right decision by asking a series of questions, rather pushing her with declarative statements.

The Top Skills Leaders Employ

I believe there are many skills a leader needs to develop. These skills include the ability to:

  • Act decisively
  • Embrace change
  • Delegate generously
  • Continually learn
  • Challenge others
  • Build trust in teammates
  • Be authentic
  • Communicate with clarity
  • Inspire others

There are many others I'm sure you can think of. In my opinion, however, there are two critical skills that I see frequently forgotten or overlooked; two that I sometimes fail to employ.

A Leader's Two Most Important Skills

I believe that a leader's two most important skills are these:

  1. Listen (or I could say –  shut up and listen!).

  2. Ask questions.

leader's two most important skills listen

We worked on these two issue a lot when I was the hospital VP and CMO. When one of the executive team had a particularly challenging issue, the CEO would set aside time in our weekly strategic planning meetings to take the “hot seat.”

Taking The Hot Seat

This meant that one of us would spend a few minutes describing our challenge in detail to the rest of the team. During this part, nobody was allowed to interrupt. Once finished, the CEO would remind us that the rest of us could now ask questions, and ONLY ask questions, with no debating, no discussion, and expressing no opinions.

The person would then summarize what he or she learned from the questioning, and the possible next steps to resolving the conundrum.

This really helped to clarify important issues and allowed us and the presenter to recognize the important aspects of a new project  that needed additional fleshing out.

leader's two most important skills asking questions

Now Let Me Try It

I would like to use these two behaviors to finish out this post. Allow me to set the stage a bit, ask a couple of questions and then Shut Up And Listen.

Here's the setup…

You’re reading this, so you have at least some idea about the goals and intended audience of this blog. Over the past eight months, I have posted about 70 articles.

The articles have mostly been about three or four subjects:

  • Leadership
  • Management
  • Non-clinical careers
  • Quality and patient safety

My intended audience is physicians and other healthcare professionals interested in management and leadership, provided from my perspective as a former hospital executive.

But I am not sure if I am hitting my mark. I wonder if  my posts are resonating with you. I wonder how I can serve you better.

Please Help Me Improve

So, I am going to end this post with a series of questions for you, my reader. I ask that you take a minute and share with me the answers to the following questions.

Please respond in the Comments Section that follows.

Or email me directly at

Or take this short survey (use the last option and free text as much as you like to provide me candid feedback – it is totally anonymous!) .

Here are the questions I’d like you to respond to (answer as many as you like):

  1. What, if anything, do you like best about what you have read and would like more of?
  2. Knowing me (check out my About Page or site if you need to), what additional information, advice, resources, ebooks, tools, interviews, etc. can I provide to help you?
  3. What is your biggest challenge with respect to career, management, and leadership?
  4. What parts of the site are really annoying or broken?
  5. Would more stories that weave in my personal experiences (travel to Israel, Uganda, Nepal; eldest of 10 children; bluegrass guitar playing; competing as a sprinter in the USATF Masters events) be of any interest?

I really appreciate any direction you can give me. Be brutally honest.

I’ve asked a few questions. Now, I'm going to listen.