As part of LG Health’s investment in leadership education, we have incorporated a day-long tour of the Gettysburg battlefield into our Physician Leadership Academy curriculum. Our battlefield guide is a former Army ranger and professor at the U.S. Military Academy. He is a longtime resident of the area and has a unique perspective on both the battle and the community.
 
The exercise has been so well-received that we have extended this to team-building exercises and CMO guests from outside our health system. Like many Fortune 500 companies that send their executive and operational leaders to Gettysburg, we recognize the value of learning about leadership challenges and lessons in the setting where they occurred.
 
While two great armies faced off in this small Pennsylvania town over 150 years ago with their nation’s future in the balance, the margin of victory was small and often hinged on leadership decisions and actions. Over these three days, leaders were tested and decisions made. Time and circumstance did not allow the luxury of committee work or task forces. Strategy and tactics gave way to opportunity, initiative and heroism. Training and experience allowed for reaction to the unthinkable. Leadership anchored individuals and units during periods of chaos. Visible leaders and their colors rallied those in desperate situations. So many gave their full measure as a testimony to their cause and the stakes of the engagement.
 
Across the battlefield, there are salient examples of command and control, clarity of direction and speech, seizing the initiative, recognizing threat and opportunity, adapting to rapid change and even political savvy. Both armies had undergone restructuring and new leadership. In virtually any industry, this is associated with quality and productivity challenges.
 
Gen. George Meade had been in charge of the Union forces for only five days and was 20 miles away when the battle began. Fortunately he had the high ground on Cemetery Ridge, with interior lines allowing him to meet with his divisional leaders and obtain their commitment for the battle. Gen. Robert E. Lee had lost his “right arm” with the death of Stonewall Jackson at Chancellorsville and restructured his entire army’s leadership. These new leaders not only failed to comply with Lee’s directives to avoid engaging the enemy but later fragmented his complex offensive assaults. 
 
Lee potentially lost the advantage on Culp’s Hill on day one because of mitigated orders/speech. Only an observant signal corpsman on Little Round Top -- Gouverneur Warren -- and the clarity of Cols. Strong Vincent and Joshua Chamberlain saved the Union left on day two. I cannot think of anything clearer than Vincent’s command to Chamberlain: “You are the end of the line. They cannot advance past you.” It is an eerie feeling standing on that site.
 
Finally, on day three, the ill-fated Pickett’s charge was questioned by many but not stopped. How often in healthcare has quality been compromised by mitigated speech, adverse outcomes avoided by those willing to act and speak up, and changes in leadership accompanied by confusion?
 
One of the reasons to highlight the Gettysburg National Battlefield is the Aug. 25 centennial celebration of the National Park Service. It has been the subject of magazine features and PBS specials.  As you plan your protected time off this summer from your professional duties -- one of the recommendations to combat burnout -- perhaps consider a visit to a nearby national park. Aside from the escape into the natural environment, you might find a learning opportunity translatable into your and your loved ones’ daily lives.
 
To follow up on previous Progress Notes articles on change, stress and burnout, Dr. Pam Vnenchak has shared a link to an exercise called “30 Minutes to a Better Practice.” And in this month’s issue, Chaplain Keith Espenshade provides insight on “healing the healer.” The power of the human spirit is not endless. He offers some recommendations on how to recharge.

Monty

Lee M. Duke II, M.D.
Chief Physician Executive
Progress Notes' Editor-in-Chief
LMDuke@lghealth.org

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