Naji: Hello leaders of the word. Welcome to spread love in organizations, a podcast for purpose driven healthcare leaders, striving to make life better around the world, by leading their teams with genuine care, servant leadership and love. I’m Naji, your host, having the pleasure to chat today with Professor Amer Kaissi and discuss his most recent book Humbitious: The Power of Low-Ego, High-Drive Leadership. Amer is an award winning professor of healthcare administration at Trinity university, the top 15 program. His previous book Intangibles: The Unexpected Traits of High-performing Healthcare Leaders won the 2019 ACHE book of the year award. He is a national speaker and a faculty member with ACHE, the university of Colorado, Denver and Boston college.

Amer is the director of the executive program at Trinity university, where he teaches courses in leadership, professional development and public speaking. Amer works with MEDI, a division of Navis, and with the leadership development group as an executive coach and consults with hospitals and other organizations in their strategic planning efforts. Amer is also a certified executive and physician coach.

He lives in San Antonio, Texas with his wife and their two teenagers. Amer, I’m so honored to have you with me today.

Amer Kaissi: Oh, thank you, Naji. Thanks for having me. It’s a pleasure.

Naji: I would love to learn more about your personal story. What took you to research healthcare specifically and your current leadership philosophy?

Amer Kaissi: Wow. We’ll start from the beginning then. So, as you know, I grew up in Beirut in Lebanon and, you know, went to the American university of Beirut for my undergrad, but didn’t really know what I wanted to do with my life and with my career, you know, ended up doing an undergraduate degree in, in public health, which I enjoyed, but it wasn’t something that I’ve always planned for or dreamt about until I took a course in healthcare administration.

That was almost the last course I took in my undergraduate degree and really enjoyed healthcare administration, loved the material, loved the fact that as an administrator, as a healthcare leader, you know, the decisions that you make impact thousands, if not hundreds of thousands of patients, you know, on the provider side, you’re a provider yourself, you know, your actions are very important obviously, and impact one patient at a time. But what administrators can do is make decisions that can hopefully positively impact patients in large numbers. So that’s what appealed to me in the field of healthcare administration, so I went on and I got a master’s in healthcare administration.

I worked at the hospital that is associated with the American of Beirut and really enjoyed my work in hospitals, in healthcare. At the same time, I started feeling that I had a passion for teaching, that teaching was gonna be my calling in this life and I wanted to teach.

So I started looking for ways where I can marry my love for healthcare administration, with my passion for teaching and I decided to pursue a PhD in healthcare administration. So I left Lebanon and that was back in 99. So, you know, I came here just after Columbus came and, you know, started a PhD program at the university of Minnesota and really enjoyed the research in healthcare administration. And part of my focus was on the patient safety part and the medical errors part, but also I had a huge interest in leadership and started looking into leadership issues within healthcare organizations, as well as at large.

Now, when I finished that degree, I took a job at, Trinity university in a healthcare administration program, you know, to two each future healthcare leaders. And as I started working with the graduate students, you know, I start realizing that, we kind of have a way of penalizing the individuals that are more humble, the individuals that are more compassionate, more empathetic, we tend to reward the loud students. We tend to reward, you know, the self-centered students. Organizational practices also favor the student, the applicants that are more focused on themselves and that brag and that, you know, talk about themselves. So all of these things started planting seeds in my head that I wanted to understand this better. I wanna figure out what are the best traits of leaders, especially the leaders in healthcare, because that’s my field.

So a few years after I got, you know, tenure here, I took a sabbatical and I wanted to read everything I can read about leadership traits, which obviously is a lot, you know, you can, you can’t read it all, but I read as much as I could and what started emerging from that research is that the traits that are responsible for high performance, especially in healthcare are totally unexpected ones.

You would expect that the leaders who are the most successful will be the confident, decisive my way or the highway kind of leaders, but it turned out, it’s actually the opposite that the research showed very clearly that, the traits that lead to high performance are empathy, compassion, generosity, and humility.

So that’s when, you know, I wrote that book that you mentioned in the introduction called intangibles, and I showed how the research supports that thesis. However, these traits are not enough by themselves. They have to be complimented with accountability, with competence, as well as with ambition.

Now, when I took that book on the road and spoke to different organizations, especially in healthcare, the one trait that was the most intriguing to people and that I felt was the least understood was the humility one. A lot of people were one wondering about humility and really questioning the research and saying really humility can lead to high performance? I’ve always thought of humility as a weakness. I always thought of humility, as you know, if you’re humble, you lack assertiveness or you’re not confident in your own abilities. So I felt that there was a need to do a deep dive on humility to better understand how is it a strength for health for leaders, but also to understand what else should be in there in addition to humility and what the research pointed to is that you need to have ambition. And that’s where that term Humbitious came from. Another thing that I realized, is that this doesn’t just apply to healthcare leaders. These two traits together can lead to high performance for any kind of leader in any industry.

Naji: Thank you so much, Amer for sharing part of your story and you know, one of the questions I usually like to ask leaders and thinkers, I have the opportunity to have here on spreadlove is the traits, the common traits are for successful leaders and high performing teams. But I think you smarized it in a new word called Humbitious. So if we take this work and start with humility, as you said, many times it’s perceived negatively. Sometimes people, you know, and we’ll talk later on different cultures and what it means also from your point of view in different cultures. I personally believe it’s one of the most important ones and obviously you just shared it, that it keeps us at check. It help us even continuously learn as leaders, and reinvent ourselves for our people. But how do you define it yourself?

Amer Kaissi: Sure. Let us start with defining humility at three different levels.

So the research points us to the direction that, you know, we can understand humility in terms of our relationship with ourselves, that’s the first level. Our relationship with others, that’s the second level. And then our relationship with the world, which is the third level. So starting with humility in terms of our relationship with ourselves, the first building block there is self-awareness, is understanding yourself really well in terms of your strengths, but also in terms of your limitations or areas for improvement, and that can only happen through self-reflection. So it’s very important for humble leaders to take the time, to think about their strengths, but also their areas for improvement, to think what the impact that they are having on others.

You know, when we talk about misperceptions about humility, it’s important to understand that humility is not thinking less of yourself. It’s not underestimating your, you know, skills and abilities. It’s just about looking at them as accurately as possible. So that’s the first level, which is humility with ourselves.

And then we have humility in terms of our relationships with others. And here we talk about our generosity as leaders, we talk about whether we’re willing to give from our time and our effort, to grow others and develop, develop them. We also talk about our appreciation and gratitude towards others. When you realize that you are not always the smartest person in the room, then you have a newfound appreciation to the intelligence of the group and to the skills that every individual brings in. And then another aspect of that humility in terms of relationship with others is what we call open-mindedness or teachability.

That is the ability to go into every conversation and every interaction with curiosity, with the mindset that says I’m gonna learn from you something new, regardless whether you are the CEO of the organization or a junior intern that just started. I’m gonna go into every one of these conversations with the assumption that I’m gonna learn something new. And in order to do that, I’m gonna ask good questions and then I’m gonna listen to understand your answer. So, that’s the second level, which is humility in terms of relationship with others.

And then we have the last level. Which is a humility in relationship to the world or the universe, which is a little bit deeper, understanding of humility, and it mainly relates to our understanding of our own insignificance in the world. And, this is a tricky concept. So I wanna make sure that I explain that well. We’re saying we are insignificant, not in terms of the work that we’re doing right now in our efforts, but in relationship to larger concepts, such as the universe or history or nature, or God, if you’re a believer, right? So when you take the time as a leader to ponder these larger concepts, you realize that no matter how important the work you’re doing right now in the grand scheme of things, it’s insignificant. And when you do that kind of pondering, you get another level of humility and a better understanding of how things stand.

Naji: Wow, on this level, I imagine you’re touching spirituality at some point, right?

Amer Kaissi: A lot of experts, you know, go to that part of it, which is the spiritual aspect of it. Others like to take it more on the religious side. I think both are valid depending on what your beliefs are. So a lot of people would like to, you know, compare how they, as a creature, relate to the creator, which, you know, they believe in God, right? But others maybe don’t go to the religious part, but more the spiritual side, which can be found in terms of contemplation in terms of relationship to nature. So there is this great research study that was done in Australia, where the researcher himself was a nature tour guide.

So he took a group of participants on a full week trip down a large river in Australia, and what he asked them to do was during that trip while they were rafting in the river, after every day to record their thoughts, and then he interviewed them at the end and what most of them described their feelings as they were immersed in this beautiful nature. They had, you know, they start having these spiritual feelings of realizing how small you are, and one of the participants described it as ego dissolving. When you see how grand nature is, you realize how small you are. So you’re absolutely right. This is a deeper, a little bit more spiritual side of humility. In my conversations with leaders, when I talk about this aspect of it, it’s especially the seasoned leaders that resonate a lot with that aspect of humility, you know, what we call transcendence or humility in relationship to the universe.

Naji: So let’s take ambition and then we can discuss the word, right, Humbitious. So from the ambition side, it’s also obviously very different, right? From a culture to another, it can be perceived differently, I imagine from a culture to another. But also when I think about even gender biases, right? An ambition women and ambition men, and how we perceive those things.

So I would love to hear your thoughts about how do you define ambition, but have you seen different reaction depending on different cultures or different settings?

Amer Kaissi: Yeah, let’s start with defining ambition first. So the way I understand ambition as part of this concept of Humbitious is that ambition is about not accepting the status quo, not settling, right? It’s about setting audacious goals and executing on them. It really is about believing in your own greatness and in your teams and organizational greatness. And what that translates to in terms of the day to day behaviors is having the confidence to speak up, having the confidence, to confront difficult situations, having the ability to have crucial conversations and to hold other people accountable when appropriate.

Now, your question is very insightful about the different applications of this concept to gender, but also to culture. So let’s start with, with the gender issue. And as you know, this is a very, very wide topic. And a lot of research has been done on that. So I’m gonna try to summarize, you know, 20 years of research in two minutes by saying that yes, there are definitely double standards when it come to ambitious men and ambitious women, especially in leadership. Ambition in men is appreciated and rewarded because look at him, he’s a leader he’s so ambitious, right? Whereas in many different organizations and organizational cultures, it’s not that appreciated when it comes to women. I interviewed a lot of male and female leaders for Humbitious as well as for intangibles, and one of the common themes I heard was when you are a female leader, it’s almost like you’re in a double bind. On the one hand, you have to act like a leader, which means you have to show ambition. But on the other hand, there is a gender stereotype that you should be more accommodating, that you should be more nurturing, you know, these kind of words that people refer to female leaders.

So, female leaders find themselves in this double bind. Do I act like a leader, which means like a male leader and show that you know, extreme ambition so that I can be taken seriously. But then risk being perceived as too aggressive, or, you know, some, some of the terminology that is used, like the B word or whatever, right, versus acting like how a female is supposed to act or how they want female to act in this culture and being perceived as someone who is, you know, more accommodating, more empathetic and so on and so forth, but maybe not what people think about when they think of a leader. So it is a very difficult situation in some organizational cultures, obviously it’s not everywhere.

And, we have a lot of research on that. And here I would mention a great book called Why do so many incompetent men become leaders and, it’s a great research basebook, and it’s not an attack on men, obviously, it’s just shows through research how much easier it is for a male leader to get into a high leadership position and how much harder that is for a female leader with the same capabilities.

Now, the last aspect of your question I believe was about the culture, right? And, you know, both you and me understand other cultures because we grew up in different cultures. So for example, in our culture back home, you know, in Lebanon, but in general, in the middle east, you have this perception of humility as not being something that you want to portray to other people, right. I remember growing up in Lebanon, you know, people would say, oh, haram matwadei, kalbo tayeb, right. And I’ll translate that, you know, God bless his heart, he’s so humble, you know, he’s so nice with other people, so that’s not always seen as a positive thing. So, trying to translate some of these concepts to different cultures is a little bit hard.

And then we have the whole aspect of, for example, the Asian culture, which, you know, while overgeneralizing is more appreciative of humility, because it’s less focused on the self and more focused on serving others and other centeredness. And by the way, a lot of the research that we have on humility and leadership comes to us from a lot of research done in Asian countries, especially in China and Singapore.

So it really is very interesting to start thinking about this concept of humility. Now, when we bring it back to the Western world, sometimes it’s also not that appreciated as we started with because many people are taught since early on, that you have to brag, you have to show self-confidence so you can stand out. So you can get chosen for sports teams and, for you know, plays. And then later on to be promoted for leadership positions.

Naji: and this is definitely true, right? When we, as you’re stating on this ambitious, and we see it, right, and incorporate sometimes from your stars where you’re good at and how to brag about it, right? So when is it too much, right? Like when do you think ambitious get in the way and what is the right equilibrium and what I liked and how you were framing it also for it to be clear, it’s not only ambitious for yourself, you talked about being ambitious for your team and how you drive your teams.

So any thought on, you know, this balance between it’s too much or is it not enough?

Amer Kaissi: Yeah, you’re right. I mean, if we think about it in terms of a continuum, right, and the continuum starts with being passive on one hand and then being aggressive on the other end, right. The sweet spot right there in the middle is to be appropriately assertive.

And you’re being appropriately assertive for yourself, but also for your team and for your organization. So that appropriate assertiveness shows up in terms of standing up for what’s right. Standing up for yourself when appropriate. Standing up for your team in terms of making sure your team has the appropriate resources, so it can achieve its goals and its tasks.

So we start seeing that aspect of ambition, as being appropriately assertive and also in terms of holding others accountable, when you need to do that, right, it’s about not shying away from difficult conversations. It’s about making sure that when there is one of these conversations to have with someone who, for example, is not pulling their own weight or not performing well, you don’t just let it slide, but you address it appropriately.

You know, as BrenĂ© brown said: kind is clear, right? When you are clear what your team members, you are being kind with them, you are showing that humility that we we’re talking about. So, you know, your question was about when is ambition too much? I’d say ambition is too much when it starts showing up as being too aggressive and the kind of leaders that I talked to, and I coached when that starts showing up, you see it in their interactions with others, as someone who is always talking and never listening. Someone who is always making statements, and not asking enough questions. You know, sometimes as an executive coach, the first thing that I do is I go and observe a leader in their natural habitat right, in the organization when they’re holding their staff meetings. And the only thing that I do in those meetings when they’re talking with their staff members is I count the number of statements that they make versus the questions, and I also count how many times they say I versus we.

Those two ratios Naji, by themselves can give you a great understanding of the leadership style of a certain individual right away.

Naji: I love it, and I love this idea appropriately assertive. Can you share with us a story of Humbitious leaders, and their impact on their organization?

Amer Kaissi: Absolutely, Absolutely. You know the one that I wanna share is maybe a little bit better known outside the us than maybe audiences in the us. But, given that your audience is global, I think it’ll be an appropriate one. So this is a leader that I have been fascinated with for the last few years ever since she became prime minister of New Zealand.

So we’re talking about just in the order and here again, you see, related to connections to what we talked about earlier with the gender aspect of it. So she became prime minister of New Zealand and thus becoming the youngest female leader in the world. Now, when that happens, when you have a junior leader, especially a female leader, there are a lot of cynics. There are a lot of skeptics out there. Oh, what is she gonna do? She’s probably all talk. She’s not gonna achieve anything. And, all of that negativity.

As soon as she became prime minister, she faced one of the biggest challenges that New Zealand was facing when they had the terrorist attacks in the town of Christchurch. Her response to that crisis was textbook Humbitious leadership. The first thing that she did was to take time, to go and be with the families of the victims. And if you see pictures of that time, pictures of her of that time, she wasn’t doing what politicians do in these situations, which is pretend to be there for the victims while getting attention for themselves. She was there really to feel with people, to mourn with them, to empathize with them and to tell them that she’s gonna do everything that she can to make sure this never happens again. So first stage was all humility and empathy. And then right after that, it was all decisiveness, it was all action, it was all ambition.

One of the first things that she did was to go to the parliament in New Zealand and make them pass gun control laws that they’ve been trying to pass for a long time in New Zealand, never been able to pass. Right away, they passed gun control laws that severely limited the availability of guns and, you know, people here in the us can debate whether that is a good policy or not. I’m not interested in that. I’m not interested in the politics. I’m just interested in the decisiveness, in the leadership lessons that we can take from that. So that’s how she dealt with that Christchurch and that terrorist attack and how she combined the humility and ambition.

A few months after that COVID 19 hit, and just like any other leader in the world, she had to deal with that in her country. And here again, we see this perfect combination of empathy and compassion on one hand, but also decisiveness and action and results on the other hand. One of the first things that they did in New Zealand was they closed the border right away, when no one was even talking about closing borders. And then they did an immediately a lockdown. Again, you can debate whether these are good policies or not in general, but for them that’s what they felt was the right thing to do. While she was doing that, she was doing daily interactions with her citizens on social media. So every day she would have a Facebook live or a LinkedIn live event where she would be talking with regular citizens off the country about how the government is going to be helping them, especially the small business owners. What are the programs that they’re putting in place to make sure that, you know, they’re not losing money and so on and so forth. You know, in June of 2020, we’re not talking about June of last year. We’re talking June of 2020, they had zero active cases of COVID 19 in New Zealand, zero! Sure, it’s a smaller country. It’s, you know, it’s an island and all of that, but I mean to talk about that kind of results with that leadership style, I just feel it is very impressive. So when I think of Humbitious leaders, she’s probably one of the few that come to mind.

Naji: It makes me think about something. We talk about women, men, right, and, and those type of leadership. Another question is generation that comes to mind. Do you think there’s a generational difference? And we might be seeing more Humbitious leaders? Or no, like any leader can be Humbitious and can work to become Humbitious regardless of a generational gap.

Amer Kaissi:  I certainly agree with those last, you know, last statements that you made there Naji about it can be any generation that embraces ambitiousness or not, right. However, what we are seeing, what the data shows us is that there is more appetite for this kind of leadership among the younger generation.

So the latest surveys that were done by, you know, divided and slice and dice the data by generation showed that it’s especially the younger generation, you know, people under 40 or even under 30 in their twenties, they have a very strong appetite for the leaders who are in touch with their followers, for the lead who are available, who are accessible, who are open-minded and there is much, much less tolerance for the leader that leads through my way or the highway.

Naji: Yeah. You know, and the more I see all those topics on the great resignation, the more I think, you know, what you’re proposing is what maybe the first solution for organizations to have Humbitious leaders and leaders who lead from a place of love.

Amer Kaissi: Absolutely, absolutely. You know, leading from a place of love, like you call it, I think is probably the most important factor in impacting employee engagement and employee innovation in our organizations these days. And this is not just touchy, feely stuff. This is not just, oh, let’s just hold hands and love each other. There is tons of research. There is tons of data that shows that this is the right way to lead. If you want your employees to go above and beyond, if you want your employees to generate new ideas and solve problems in creative and innovative ways, you know, this is not your opinion or my opinion. This is based on research that has been done in the last 10, 15 years, all over the world that shows that when the leader is inclusive, when the leader listens to inputs, when the leader asks questions, when the leader makes development, something legitimate in the organization, professional development, you know, when the leader admits and say Hey, I’m work in progress here, I’m not perfect as a leader. When you have that kind of leader that just rubs off the whole team and then everyone starts feeling like Hey, it’s okay to be work in progress in this organization, it’s okay to develop, it’s okay to learn, it’s okay to admit mistakes and limitations. And when that happens, the magic happens in teams and in organizations. Burnout is reduced. Engagement is increased and all of a sudden you have innovation and creativity that is unleashed throughout teams and throughout organizations.

So I agree with you a hundred percent about this could be one of the best ways that we fight the great resignation, that we fight burnout and, and chronic stress in our organizations.

Naji: Amer, I’m gonna go to a session now where I’m gonna give you a word and I would love your reaction to it.

The first word is leadership

Amer Kaissi: Leadership, I’d say misunderstood by a lot of people. There is this misconception about leadership being someone who is loud, someone who bangs on the table, someone who brags and yells at people, someone who overestimate their own abilities and underestimate others’ abilities.

And I’ll say all of these are misconceptions, misperceptions about leadership. So when I try to understand leadership, I always try to go back to that data and see what the science shows and what the research shows and the science is very clear. These kind of leaders that I just described do not get results in the long term.

Yes. They may be able to come in and change things in short term and do a turnaround what have you, but if we really want leaders that achieve a long-lasting impact, then we have to look for things such as love as you talk about, empathy, compassion, humility.

Naji: What about narcissism?

Amer Kaissi: Hmm. That’s a really good one. So narcissism is very interesting in leadership because again, if we look at the research, the research shows that narcissists tend to be chosen more for leadership positions. So if you and I are interviewing an applicant today and that, you know, we have two applicants, one is narcissist, and one is humble, chances are, even if we’re aware of the research, we’re gonna choose the narcissist because the narcissists tend to be more entertaining, more charming. They interview better.

However, and this is what I was just touching on a minute ago in the long run, narcissists are not effective leaders because they are poor team players. They’re lousy managers. They’re so self-centered, they’re not gonna get results in the long run. So when we think about narcissists, it’s very important to make a distinction between leadership, emergence and leadership effectiveness. Yes, they can emerge as leaders, but all of the indicators are there that they’re not gonna achieve long term success for their organizations.

Naji: The last word is spread love in organizations

Amer Kaissi: Spreading love in organizations, the way that I understand that, is that there are two levels of doing that.

There is first the superficial level that most people get stuck on, which is to be nice to say, please, and say, thank you. And you know, you’re standing in line in the cafeteria and you pay for the person behind you and all of that. Now all of that is good. You know, I’m not against any of that, but I think the real love being spread in organizations is done by being generous with others, by mentoring the young comers by taking time from your busy schedule, to sit down with someone and help them work through a problem or listen to their personal situation and being empathetic and being compassionate with them.

So the first level of spreading love, you know, we can call that confetti kindness. We can call that superficial kindness because it really doesn’t take a lot of time and energy and it’s very convenient, right? But the real work of spreading love in my opinion is the type that takes time, takes energy, takes commitment, and is sometimes inconvenient, but you still do it because it’s the right thing to do.

And as we just explained in terms of the research, it’s the only way to do it going forward with the challenges that every organization is facing right now. I truly believe that no organization is gonna be able to survive this, you know, COVID pandemic that we’re going through and burnout on all of that without love being one of its values.

Naji: Wow. That’s super powerful.

Any final word of wisdom for leaders around the world and even more specifically healthcare since this is also where you’re passionate is.

Amer Kaissi: You know, on the healthcare side, I’d say everything that we just discussed is amplified times hundred, right? I mean, if you think about it, healthcare is really the business of compassion. It’s the business of empathy. So, if you don’t mind, I’d like to end with a little story that a doctor friend of mine shared. Okay. So let’s call him Dr. Lee. So Dr. Lee shared this story with me. So Dr. Lee is an endocrinologist and he had a diabetic patient, come see him one day for a foot exam, okay. Now that patient is severely obese. So after the foot exam was over, Dr. Lee was, you know, was done with the examination. The patient was trying to put back his socks and his shoes on, but he couldn’t do it on his own because of his large size. So, what Dr. Lee did is he noticed that the patient was struggling, so he went straight and he knelt on his knees and helped the patient put his shoes on and his socks on. Now in that moment, the patient was embarrassed, but at the same time, he was deeply appreciative of this amazing act of kindness. Here’s this prestigious doctor down on his knees, you know, helping me put my socks on and put my shoes on.

Six months later, that same patient came back to Dr. Lee having lost 60 pounds, and he told him, he said I lost 60 pounds because of that one act of compassion and love that you showed me. I’ve been trying to lose weight all of my life, and I’ve never been able to lose more than five pounds at a time. But because of what you did, I started showing love to myself and that’s how I lost the weight. And not only that he told him, he said, I promise you Dr. Lee in six months, I’m gonna come back and. I’m going to have lost another 60 pounds. Now, I like to tell this story because it shows that in healthcare, we are in the business of love and compassion and empathy.

But my advice to leaders in healthcare is that it is not enough for us to show that love and compassion to our patients. Yes, of course that’s required. That’s great. But we need to show that same level of love and compassion and empathy to each other, within the healthcare team, within the leadership team, between leaders and clinicians, that is the kind of culture that we need to create in our healthcare organizations, otherwise we’re not gonna make it.

Naji: Thank you so much Amer, for such an inspiring and transformational chat, and definitely healthcare is a need of love as many organizations. But I agree with you. Healthcare is definitely in this need. Thank you.

Amer Kaissi:  Oh, it’s it’s been a pleasure. Naji, thank you for having me.

Naji: Thank you all for listening to spread love in organization’s podcast.

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