019 - Mother-Daughter Discussion on Physician Leadership

In the first of two special Mother’s Day podcasts, I’m in the guest chair along with my daughter, Jamie Katuna. Podcaster Keith Carlson, RN, (aka “Nurse Keith”) starts this interview by asking how we influenced and inspired each other as mom and daughter, in medicine and in leadership roles. I talk about my admiration for Jamie’s intellectual curiosity and her willingness to take risks. Nurse Keith corroborates this by describing how he discovered Jamie on her aptly-named “Speak Out Medicine” Instagram account. As a medical student, she used her social media platforms to both speak out and to be vulnerable about the challenges in medical school. <br /><br />In this interview, we discuss the leadership lens that influenced Jamie’s thinking and her questions when she interviewed for her residency position. One of Jamie’s medical school rotations allowed her to see what profound physician autonomy looks like. She worked with Dr. Jenn Lentz (LTL episode #17) who left corporate medicine to start her own direct primary care practice. Jamie contrasts this with what autonomy means to physicians and others in larger teams and in organizations. Jamie discusses her novel interest in combining an emergency medicine career with caring for a small panel of patients where she is able to practice in-depth preventive medicine. <br />Nurse Keith mentions problems brought into sharp relief during the pandemic, when the business school mindset (BSM) of many leaders was exposed by their disregard for the actual humans within the organization. We discuss the dramatically underestimated costs of turnover in toxic cultures and the lack of attention to this critical measure. Nurse Keith, Jamie and I linger for a while on the concept of a “cone of protection” that excellent leaders provide by taking the heat from leaders above them, while sheltering their direct reports. We also talk about where excellent organizational cultures originate (spoiler alert: The Top) and how the neuroscience concept of “CARB” (clarity, autonomy, respect,