• NCCL Leadership Sessions Call for Full Selfhood, Participation

    May 25, 2023, Scott Wilson (Kansas City, Mo.) — Leadership as authentic identity and personal imperative: These twinned definitions bookended the first day of the 2023 National Conference of Constituency Leaders, which met here May 9-11, in a pair of events that keenly resonated with their audiences.

    “I grew up at NCCL, my first AAFP function of any type, ever,” said Tamaan Osbourne-Roberts, M.D., of Denver, who opened the day with a talk titled “Joy as Revolution: On Leadership, Intersectionality, and the Profound, Freeing Altruism of Choosing Oneself.” He added: “This is coming home.” 

    There was indeed a valedictory ring to Osbourne-Roberts’ words — and not just because the chief medical officer and vice president of health strategy for the nonprofit Colorado Access system said he was on the eve of graduating from the Yale School of Management. The commencement he’d come to describe to his fellow family physicians was instead a path from the expected (education and career, a résumé) to the unique (heritage and family, a whole self).

    At the end of the day, a session titled “When Everyone Leads” unrolled a similar map showing a path from individual confidence and expertise to shared positive change.

    “Think about the kind of culture you want every day in your organization, in your state academy,” Julia Fabris McBride, chief leadership development officer for the Kansas Leadership Center, told her audience of about 40 before offering some guidance on achieving that culture. “When you understand leadership as a practice, something to exercise — not a position or an authority — then anyone can do it and all of us can get better at doing it.” 

    Story Highlights

    Physician, Know Thyself

    Osbourne-Roberts recounted the particular way he began to conduct this exercise.

    “Leadership calls upon us to claim the multitudes within us, but too often only in part and only as defined by those around us,” he said. “We find ourselves defined by what we are asked to exclude, frustrated by what we are asked to ignore and ground down from the conflict between a system that demands one story from us and a spirit that demands a deeper, more personal authenticity.”

    The vital work of escaping that conflict, Osbourne-Roberts said, requires relearning one’s own story and renewing one’s pride in conveying it. This, he added, is also a way to elude burnout.

    “Too often this is how we live: splitting one life, one identity from another, until we can find our way back,” he said. “What I’ve learned over time is that you can’t live like this. You can’t live partially. You can’t live halfway.

    “So I decided to lean into my identities. All of them.”

    To illustrate his point, the ­first-generation American of Trinidadian parentage produced a piece of fabric: the flag of Trinidad and Tobago, his reminder of the annual event held there on the Monday and Tuesday before Ash Wednesday. It had been a regular destination for Osbourne-Roberts — “an utter pilgrimage,” he said — but took on new symbolism this spring.

    “When I couldn’t go this year, I wondered: Could it come to me?”

    The answer turned out to be an easy yes, as Osbourne-Roberts showed the audience photos of the day he took “this incredible celebration of happiness, joy and life” to work with him, complete with impromptu dance lessons.

    “I made an entire room of executives at my company dance to soca music while I pulled out this flag and waved it over my head,” he recalled. “It was me showing up at work as my whole self.” 

    He challenged his audience in the full hotel ballroom to do the same for themselves, the first of three tenets he offered: Lean into who you really are.

    Get Together and Remember Joy

    A handful of family physicians who approached him afterward confirmed the wisdom of this advice by reporting their own related discoveries. One member eagerly told him about her habit, started during the pandemic, of dressing as Disney characters to cheer her patients. Doing so eased her own anxieties as well, she said.

    “All of us are intersectional, composed of various pieces that aren’t separate and are all important,” Osbourne-Roberts told the audience. “We need to express them as we walk through the world. Most of us carry parts of our identity that we’ve chosen to hide, cultural or idiosyncratic. But reintegrating that, leaning into that, showing up as your entire self once again, is an incredibly important part of the process of living and healing.

    “This process of coming back to yourself is a hard one,” he added, establishing his second tenet. “Rather than doing it alone, lean into others who can help you. Whoever these people are in your life, lean into them when things are difficult, when you’re tempted to separate out the parts of who you are.”

    Finally, Osbourne-Roberts said, call on those people in good times as well as difficult moments.

    “It’s also important just to go out and have a good time,” he said. “Lean into health and joy. Cook. Be with your family. Do something physical. Go outdoors. Some of us are marginalized, and our joy has been taken at times. It has happened to all of us. Lean in and reclaim your mental health and well-being by doing whatever brings you joy.”

    Learning to “lean” in these three ways, Osbourne-Roberts said, better equips family physicians to lead, including at NCCL.

    “As you work on making serious policy about serious things, what you’ve seen in your lives and in your patients’ lives, I encourage you to bring all of yourselves: the serious part, the joyful part, the sad part, all the parts that make up who you are,” he said. “That’s how the best decisions get made.”

    Don’t Wait for Someone Else to Lead

    “Research supports that when everyone leads, and when everyone exercises leadership, we build cultures that are more inclusive, equitable and flexible, and where people feel more engaged in their work,” said McBride, distilling counsel from a book she co-wrote, published by her organization.

    More than once, she asked the audience to identify concerns and challenges, and allowed a few minutes for conversation among attendees, who were seated at round tables in groups of four or five. Among the responses this prompted, a physician from California described the frustration of dealing with institutional backslide following the COVID-19 public health emergency.

    “We had a glimpse into what would happen if we just took care of people as people. Doing the right thing for the person at the right time. Less prior authorization. Less administrative burden. Why are we questioning some of what we learned now?”

    “Patients feel challenged, feel unseen and unheard,” another member said of patients. “Social media is a ruse for actual connection. There’s a lack of honest, authentic connection. Loneliness is a barrier.”

    Bridging such gaps between problem and solution, McBride said, starts with not waiting for someone in a position of authority to make a decision. She added that issues such as the ones cited in the session often represent a gulf between adaptive challenges — “people, systems, culture,” she explained — and more technical problems.

    “The hardest thing is when people want to apply technical leadership to adaptive challenges,” she said. “Quick fixes don’t work. Everyone leading really is the only way we’re going to make progress.”

    To activate leadership from the ground up, McBride urged family physicians to start “right away” by

    • asking powerful questions,
    • making tough interpretations of the responses,
    • acting experimentally and
    • making leadership less risky for others.

    Get Started

    There is no shortage of leadership opportunities with the AAFP and its chapters.

    In addition to official roles, family physicians can add their voices to important conversations by taking part in educational opportunities and development programs, joining Member Interest Groups and emailing legislators with the AAFP’s Speak Out tool.