Jessica Dudley

As the health care industry changes and becomes more complex, consumers, payers and government agencies are looking to leaders like Jessica Dudley, MD, chief medical officer of the Brigham and Women’s Physicians Organization (BWPO) and vice president for Care Redesign for Brigham and Women’s Health Care (BWHC) to work with their teams to find novel ways of providing the highest quality care at a lower cost.

Dudley oversees physician-led efforts to improve the quality and efficiency of clinical care at the hospital, risk performance with commercial payers and Medicare and strategic efforts to develop population health management and care redesign programs. Recently, she answered questions from the NEJM Open Group Forum about leadership, mentorship and gender roles. Here, Dudley shares professional advice and reflects on her own career development.

How did your career path lead you to become a leader?
JD: Being a leader was never an end goal for me. I was passionate about improving the health care system for all patients. In order to be effective and advance this work, many people needed to be involved. Once you involve others, you have the opportunity to lead—and in order to be successful you need to figure out how to lead well. Today, I am proud to be a leader because I want to continue to help change and improve a very large system. Working as a team is so important because making changes of this magnitude would be impossible alone.

What makes a leader exceptional?
JD: This is a great question with many different answers. I’ve been fortunate to work with some amazing leaders over the course of my career, and some key qualities they have in common include:

• Investing in your team, and making time for people who need you.
• Understanding and caring about the issues
• Engaging others in the process. Medicine is a team sport, and strong leaders engage those around them to get their input, regardless of the final decision
• Listening to others’ points of view, and adapting/evolving to support or refute them
• Asking for and leveraging the talents of their team members
• Having the courage to make tough—and at times unpopular—decisions
• Knowing how to give honest and constructive feedback
• Recovering from failures

Do you have any advice on becoming a leader?
JD: Leadership is a journey, not a one-time event. Be passionate about your work because that will give you the drive to achieve great things and ultimately become a leader. Surround yourself with smart, brutally honest colleagues who will always tell you the truth, even when they know it’s not what you want to hear. Engage in discussions with your peers and participate in programs like the Brigham Leadership Program (BLP), which fosters this kind of discourse and collaboration. And always believe in your team, knowing that the whole is greater than the sum of its parts — meaning a group that works together can go farther and accomplish more than an individual alone can.

Tell me more about the BLP.
JD: Many of the suggestions, values and visions that I bring to my work are influenced by the large group of physicians I work with at BWH – and I suspect the same is true of many others. Eight years ago, the Brigham Physicians Organization and Center for Faculty Development and Diversity worked to develop a leadership training program in collaboration with Harvard Business School.

The program provides physicians, other faculty and administrators with an introduction to strategy, operational efficiency, personal leadership, working with teams and introduction to financial principles. We also have additional efforts underway, including negotiation, process improvement, leadership skills training and a “hands on” program for front-line clinicians (called the Brigham Care Redesign Incubator Start Up Program – BCRISP) that will help them take opportunities to lead within their clinical area.

How is being a leader different for a woman than a man?
JD: Having observed many female and male leaders over the years, and in thinking about the senior leaders I know, their qualities, styles, successes and failures seem quite independent of their gender.

One area where I have seen a change is engagement with childcare. In my generation, most women were responsible for this, whether it was hiring a nanny, leaving work when a child got sick, or worrying about what was for dinner. Some women wanted to own this, while others simply had no choice. However, today’s generation seems very different. Many of the men and women on my team are married and share childcare efforts. The men have equal responsibility with their spouses for picking up kids from day care and leaving work if they get sick.

Has anyone ever underestimated you because of your gender?
JD: When I was on my surgical rotation in medical school, I remember a particular comment made to me after I answered a question. A male surgeon said to me and another (male) student, “Where did you get that differential diagnosis from, Ladies Home Journal?” I thought this was completely inappropriate, but didn’t speak up—I said I read it in Harrison’s [Harrison’s Principles of Internal Medicine]. This was over 20 years ago, and I am happy to report I have not had any incidents since then.

How do you define success?
JD: Success is different for everyone, because we all have different passions and goals. But we can start by defining it and then figure out how to get there. First ask yourself, “What is my definition of success?”

My personal definition of success has evolved over the course of my life. In medical school, it involved being challenged by what I do, working with people I like and respect, being passionate about my field and having fun along the way. These aspects continue to be important to me, but my definition has expanded to encompass my family, my community, my extended family and a personal commitment to being present and making time for the people and experiences I value most.

How do you measure success at work?
JD: To measure how I’m doing, I find it’s helpful to take a step back and reflect on whether I’m enjoying my work and time with colleagues, whether I’m challenged without becoming overwhelmed, whether I’m able to “move the ball forward” and whether I wake up in the morning every day—or most days— happy and excited to go to work. There are difficult days, of course…everyone has them! But all in all I still enjoy them.

How do you deal with and ultimately overcome obstacles and setbacks?
JD: One of the most difficult challenges I’ve faced over the years is continuing to advance and be positive even when you have lost the ability to control the outcome. I’ve found it very helpful to learn how to do this, and it’s a skill that’s served me well in life. I highly recommend the book “Mindset” by Carol Dweck, and her TED talk on developing a flexible mindset.

What are your views on mentorship?
JD: It’s so important. Many of us have been fortunate over the years to have found mentors—individuals we can speak with and learn from as we develop our skills and advance in our careers. I am now at a point in my career where I both make time to mentor young professionals and seek guidance and advice from my mentors. Sponsorship is something of a newer idea that takes that concept one step further – a sponsor is a senior level individual who will actively and publicly advocate for our advancement. I enjoyed Sylvia Hewett’s piece on sponsorship in the New York Times.

What do you know now that you wish you knew when you were starting your career?
JD: That it’s important to have fun! It’s about the journey, not the destination, and mistakes are opportunities for you to learn and grow. Don’t sweat the small stuff—if you find yourself worrying about something, connect with your friends and colleagues for support and to help you work out a solution. If you don’t know something, chances are others are also confused, so asking questions or working to find an answer will likely help not only yourself but others as well. Surround yourself with people you enjoy being with, who challenge you to push yourself and work hard.

To learn more about the BLP, read Dudley’s piece in Harvard Business Review or a recent CRN article about the program.

Dudley is also a co-author of a 2015 Harvard Business Review article about BCRISP. Learn more in CRN.