Advocacy Is a Team Sport

While advocacy is always a prominent topic in the Bulletin, this month has additional focus on the efforts the Academy makes on behalf of its members, and by extension, their patients. You have recently read much about how the elected and appointed leaders of the Academy have successfully intervened, contributed to, and positively influenced healthcare policy on our behalf—sometimes in concert with other societies with shared issues, and sometimes specifically and exclusively regarding otolaryngology. Examples of the former include our comments on the Patient Protection and Sunshine Act (PPSA); support of the Council of Medical Specialty Societies’ “Code for Interactions with Companies;” or our many comment letters on proposed rules for a host of elements of healthcare reform legislation. The latter category is illustrated by our response to the FDA on the issue of blackbox warnings for the use of codeine for pain relief in children post-tonsillectomy; our participation in the Choosing Wisely® campaign; and our World Voice Day activities, among many others. How This Happens We have just completed the update of strategies, actions, and work plans for the next 12 to 18 months of Academy and Foundation initiatives and the extensive review and approval of our boards of directors, executive committees, finance and investment sub-committee (FISC), and our budgeting process. The manner in which the extensive scope of Academy activity is identified, prioritized, developed, and implemented is complex, but very effective. Considering our budget and resources, I believe we “accomplish more with less” than just about any other major medical society, in large part because of the tremendous spirit of volunteerism and the culture of contributing to the profession that characterizes otolaryngology-head and neck surgery. On many levels the Academy’s structure and governance requires teamwork and collaboration, mentoring and development, and the leveraging of assets to accomplish so much. While some of this is cultural and consistent with the personal attitudes and behaviors of our members and staff, a great deal occurs intentionally through training and skill-building of staff, management, board, and membership. Each year the Executive Leadership Team (ELT) of the Academy/Foundation engages in ongoing leadership and skills training to expand our abilities. Part of this year’s training included a discussion on “high performing teams” and taking action on specific elements of improvement. After a review of the expansive literature and the publications of the many experts on teamwork, we culled and focused on a collection of principles that we believe embody the most essential elements of highly functioning teams. We combined these principles into four categories: 1) superior communications and related learning environment; 2) alignment around a common purpose and supported leadership; 3) effective planning and work processes that lead to measurable solutions; and 4) a foundation of trusting relationships and environment. Communications: After several years of staff surveys with successful actions to address needed change, we note that “communications” always seems to be an issue raised in an organization committed to improvement. It is our experience that the need for improved communications is either a significant part of any problem, or a key to the solution. Alignment: Alignment is highly related to communications. We believe that the single most important element necessary for success is clarity and a compelling vision around a specific purpose or goal. The ability of all members of a team to articulate the desired outcome and to champion the cause is directly related to the degree of success of the team. The more team members there are who just “go with the flow,” the greater the likelihood of failure or stagnation. Effective processes: Processes include the identifying, prioritizing, and planning processes; as well as the work flow processes and measures of completion. There has to be a balance between those team members who excel at the planning and envisioning of the results and the pragmatic and realistic workers who implement and carry out the actions. People are rarely great at both, and mutual respect for the absolute necessity of each focus is essential. Trust: An environment of trust is built both on competence and character. While it is tempting to believe that trust is based only on honesty and integrity, being “able” is the key to being “accountable.” Failing to deliver on an agreed upon expectation can undermine trust as rapidly as being disingenuous or insincere. In fact, part of being truly honest requires us to accurately assess what we can accomplish and then to make good on our commitments. Your elected leaders and all the professional staff here in Alexandria, VA, and Washington, DC, commit to continuously improving our teamwork as we advocate with you to empower us to provide the best possible patient care.