Naji: Hello, leaders of the world. Welcome to spread love in organizations, the 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 am Naji, your host, having the pleasure to be joined by Dr Dominic Abrams Associate Professor, Harvard Medical School, Cardiovascular genetics and cardiac electrophysiology expert. Dominic specializes in cardiovascular genetics and cardiac electrophysiology at Boston Children’s Hospital and Harvard Medical School, and he is active in both clinical medicine and scientific research. With his team, Dominic provides personalized, multidisciplinary care to individuals and families, and drives novel research strategies in varying aspects of cardiovascular genetic disease. He has developed clinical programs in both the UK and US, with attention focused on organizational culture, leadership, clinical innovation and maximizing value to multiple stakeholders. Dominic has developed excellent collaborative relationships with individuals and organizations within the wider healthcare ecosystem.
Dominic Abrams: Thank you so much. It’s really great to be here and thank you for the invitation.
Naji: I would love first to hear a little bit more about your personal story and really what brought you to become this amazing physician and specialist and leader you are today.
Dominic Abrams: Thank you. So I originally started, as you can tell, I’m from the uk. Uh, I grew up in England and then moved to London for medical school when I was 18 and went through the British training system in the. Way it was in those days, which if you look back, is rather chaotic. But actually at the time was fantastic cause I was able to experience lots of different areas of medicine and train and lots of different things, but ultimately settled on cardiology, uh, because it just generally really interested me.
And then over time evolved to how much of a, more of an interest in electrophysiology and then. Cardiovascular genetics, which sort of to some degree goes hand in hand with that because many of the heart rhythm disorders that we care for have a genetic background. Um, at the time I was training in pediatric cardiology, but really wanted to get a broader understanding of the, um, Specialty.
So I went to a hospital called Barts Hospital in London, uh, which is why I did most of my electric physiology training, which was just a fantastic experience. And I stayed there for, um, many years initially as, as a fellow, and then on fa on then on faculty. Um, and I was there for about four or five years before moving to the us.
So it’s sort of an opportunity that came up to come over to Boston, which has, uh, has been really exciting and challenging in many different ways, but in, in a, in a good way. Uh, it’s been a lot, a lot of fun to do and makes you look at yourself in a different way and sort of what you’ve done and what you’ve achieved and what you wanna do.
Uh, it’s always a good thing. Change is, is exciting. Um, so I’ve sort of been working here for some time now and really, Clinical work has evolved into doing much more cardiac genetics, uh, than electrophysiology. And we’ve sort of built a very exciting team and a program at Boston Children’s, which has been very re rewarding and very enjoyable.
And I get to work with many, many great people, and the patients and the families that we care for are fantastic. So it’s a great position to be in and I’m very lucky and honored to, uh, be able to do what. And
Naji: David, have you always wanted to do to become a physician? ?
Dominic Abrams: Have I? Yes, I have from, from quite a young age, but I couldn’t really tell you why.
Um, I remember as a, as a young kid, I always wanted to be a doctor. No one in my family was a medic. Uh, there was no sort of pressure for my parents to become a doctor, but it was just something I always wanted to do. And apart from a few sort of flirtations with other things that most kids go through, Yeah, it was always medicine, so something I’ve always wanted to.
Naji: that’s awesome. And you’re doing, and you’re obviously helping so many, uh, so many patients today. And as, as you shared, this is something I would like to, to go first, um, and discuss with you. So you’re a cardiovascular expert. You manage very challenging, uh, situations. Uh, with, with families, um, while ensuring, uh, one of your passions is this personalized medicine, but also in a multidisciplinary way.
So really leading those cross-functional teams, uh, treating and caring for patients and families. So I’d love to hear how you combine both personal approach. While also working in it with large cross-functional, multidisciplinary disciplinary teams to keep it personal at the end of the day for the patients when you have so many different, uh, people
Dominic Abrams: managing them.
So I think, um, We have many different people in our team who all have a very different and complimentary role. So I think it’s about understanding what each person in the team delivers, what their specific function is in regards to any one particular patient or family that we see. And everyone does a slightly different thing.
And it’s very interesting to see the way that patients perceive the team and how we look after them and, and I think they sort of, Many have reported back to us. They really like this sort of wraparound care that different people provide, and I’m sure that different patients have a different. Um, or have different relationships with all of us in different ways and may particularly gravitate more towards one or towards the other.
Um, so we have sort of the clinical piece where we actually make the diagnosis. We look into the clinical findings on ECGs and cardiac imaging cetera. Then we have the genetic piece, which is again, different people coming in for that. Uh, we have a psych. Uh, team as well involved because the stress of having these diagnoses, often they’re made in people who are completely asymptomatic.
So it’s all of a sudden I was fine and now I have this dag diagnosis, this label that’s attached to me. And just coming to terms with that, understanding what it means is very, very important. So I think that yes, ultimately we all work in a slightly different way, but ultimately we’re kind trying to bring together.
A strategy for the patient that makes sense for them. And it’s not just about sort of this is what you have to do medically, that’s what you have to do medically, but all of a sudden many of these families are adjusting to a new normal, if you like, a new sort of state of their life. And so it’s about helping them adjust to that, coming to terms with that, but also not letting that dominate their life.
I think that’s really important and we sort of very much emphasize. Um, you know, many of these many things they were doing before should go on and can go on. So exercise is a classic example, but there are many other things as well. So it’s about helping them navigate this journey. And, you know, I always say to patients at the beginning, once we’ve made the, uh, once we’ve met ’em for the first time, now you will look back in six months and things will look very different and you will look back again in 12 months and things will be different again.
So it, it’s a process of evolution and I think it’s our job to sort of help guide them through that in different. Can
Naji: you share with us, uh, your leadership learning along, along the way, doing this and also with the, the, the word evolved, obviously, and as we discussed last time, uh, both of us, there’s, there’s so many.
New innovations coming for the patients. So I imagine the way you’re caring for them, as you said, this is your main focus as a care team. What are your leadership learning for you to be able to provide what you’re trying to provide for those patients, especially with those new innovations that they are dealing with
Dominic Abrams: too?
So I think from the leadership and team perspective, I was in a very lucky position that in 2016, a number of. Events, if you like, came together that allowed me to start to build this team, uh, and obviously be very much part of it, but to build it from scratch. And I think that’s a very exciting thing to be able to do.
Really. It was triggered by a wonderful philanthropic donation, um, that we got, which allowed us to build the program, uh, by someone who personally had to experience this, uh, a sudden death in a family member from a cardiovascular genetic disorder and his. Uh, fundamental request is that no other family should go through this.
So ultimately what we’re trying to do is get towards that point. We’re still some way from it, but I think we’re making progress in many different ways and trying to understand the condition, prevent these things happening, and, um, In some ways develop new treatment strategies that allow us to overcome these disorders.
So really, I had the sort of a mandate to create a team and without a team culture from scratch. And there were sort of many things that I look back on at that time in my life to sort of help myself understand. How I wanted to do that and what examples I could take from my own experiences. And in 2016, I started the MBA at mit.
So that gave me a really sort of rigid construct around which to think about this and actually sort of to put some of the academic principles of leadership, of organizational culture, these things into play and allowed me to write about it as well and, and, you know, have it sort of assessed and graded by the professors at mit, which was very interesting and exciting.
But it was actually a conversation with, um, Gail Grad, who I know we both know well. And she was talking to me and she sort of said to me, So what does life look like post mba? And I just started talking and I, which went on for about 25 minutes I think, and she stopped me and said at the end and said, halfway through that conversation, your face completely changed.
And that was when you spoke about your team. And I was completely unaware of this, but that’s, at that point, it’s sort of really made sense to me. This is what was really important to me and having these people around me and really building that and how valuable that is and how much I enjoy doing that, and how much I enjoy being part of that and belonging to that team.
So I sort of started to look back at my own training, and when I was a junior doctor in the uk, we had this concept or this, um, the way the medical system was structured. We had these things called firms, which was basically a team of doctors with one or two taken from each grade throughout the junior doctor, um, hierarchy, if you like.
And I was the real, I was at the bottom of this team, but, um, it was a, it was a really tight knit group. You know, you worked with these people day in, day out. You saw them every day. You were with them at three o’clock in the morning in the emergency department, seeing people who were really sick and ill, and then you were with them on Friday after the after work having a beer.
So you got this really tight team bond, and I think that was something I look back on and felt really was a very powerful way for me to learn about medicine in so many different ways. Not about the academic aspect of medicine, but about being a doctor and how we deliver the. For our patients and create that real sense of empathy.
And I’ll never forget, at one time, one of our team, we admitted this lovely gentleman, he was in his mid to late seventies and he was clearly dying. He had motor neuro disease and that was, you know, we, we knew he was gonna die by the end of the day. And we went to see him and his wife was sitting by his bed.
And this doctor just said to her, Tell me about him. Tell me about him as a man. And it just gave her this 20 minutes to just reflect on his life and to speak to him in front of him and tell us what a wonderful man he was and all the things he’d done. Uh, it was a really moving and very incredible experience for me to watch is a very junior doctor.
So learning that empathy, learning. Not the medicine, but learning about what it means to be a doctor. So I think that sort of sense of team, that sense of togetherness became very important to me. And again, I look back at different people who’d influenced me in my life in different ways. Um, both through medicine, through sport, through different team concepts, and started to read and think about this a great deal more and how I wanted to take different aspects of what I’d experienced and sort of build that into the team.
So it’s a real pleasure to be part of that. I, it’s something I really, really enjoy. And I think it’s very important. It’s like how do we function as physicians, as a a, a group of people in very complex situations to maximize our own performance, uh, both as individuals and as a team. And then how that translates into patient care.
Um, so. Can
Naji: you tell us a little bit more on, uh, the culture, because you’re passionate and this is how you look at things, developing this culture, uh, and the leadership in the culture. So can you tell us a little bit more what culture you try to build and how do you, how do you do
Dominic Abrams: this? I think one of, um, you know, I see my role in the team as.
Creating an environment where everyone can be their best, everyone can achieve the best that they can be and achieve what they wanna achieve. And I think that’s a sort of really important thing for me to try and create. Um, and people sense that people know it. And if you. Actually deliver on that. And you, you act that out and say, Well, how can I help you do this?
How can I help? What are the obstacles to stopping you doing what you wanna do? I think it’s really, really important and different people respond in very, very different ways. Um, you know, as I said, I’ve taken sort of experiences for my own life, some of which. Would come from very, very different contexts.
So wouldn’t necessarily work in a medical team, but did work in a sports team, for example. So how do you contextualize that? How do you take that and reframe it and change it? But I think that’s a really, really important thing to do, is to, um, create that sense of you are, you care about you, you know, the, the environment should be very caring.
You should really care about your team. You should get to know them professionally and personally, uh, and understand. And I think that’s really important. And we just have this amazing group of people who sort of come together and everyone was sort of, I think, thinking in a similar way about what they wanted, what culture they wanted to be part of.
And I think it’s understanding your own perspectives on it and helping to shape that. And then everyone helps to be part of that as well. So I think it’s one of great honesty, It’s openness. Um, you know, we have conversations. I think as a leader you need to. Humble. Um, you need to recognize that you’re never gonna have all the answers and that different people are gonna see things that I just don’t see, and that’s really important and valuable.
So I always, you know, I might have certain people in conversations cause I know they’re gonna pick up on different things from me, then they’re gonna see things differently and their perspective may be much more important and relevant than mine. So it’s understanding the value that each person brings and how you can sort of shape those together and mold those, uh, to, to get a team that where the performance is maximized.
But everyone feels that they’re gonna be their best every day and they have the opportunity to do that. So I think it’s a, it’s a fascinating thing and it’s. When you look back at great cultures I’ve been part of over my life, it’s often very difficult to say, Well, why was that great? But you just know it was.
But it’s been a sort of interesting process to try and through, think through that in a bit more depth and how can we reproduce that and how can you, um, adapt to that? Because the situations change all the time. So our situation change, our team grows, people come, people go. But you’ve gotta sort of keep that central culture there, uh, at the core because that’s ultimately what sort of shapes and drives the team.
Naji: I love that. And obviously you’re a part of what you do is also to maximize value to multiple stakeholders. So I imagine your experience have shown, starting with this culture of care as, as you shared, is ultimately giving you those results.
Dominic Abrams: Yeah, absolutely. I think that’s, that’s front and center what we do as a group of healthcare providers.
But you know, everyone, as I said, everyone brings a very different component to. The patient experience and you know, one of our team who’s now our team manager, You know, every week in clinic we hear from patients, Oh, she’s so wonderful. Thank you. You know, just please say, Is she here? Can I meet her? Can you say thank you to her?
For us? And she’s never actually with the patients, but she does all the organization collecting data, collecting information, helping the patient. Get to the clinic or you know, where do they need to go? Everything. And people are so, so grateful for that. It’s really, really interesting. Um, but we hear all the time about her and in often in very difficult circumstances, people have stopped me to say.
This is the best experience I’ve had in 20 years with this individual because just of what she did and how she helped and organized and structured things. So it’s not just the sort of clinical patient facing time as well. It’s the whole team, often behind the scenes who make what we do possible, but also who drive the patient experience so forcefully.
Naji: And can you give us some practical examples? You said the team grow. It shifts, I’m sure during the pandemic Also, things were different. Like is there like a key piece that you always try to keep as a practical thing you do in a team to keep this caring culture, to keep the team, All the togetherness, as you said, towards your purpose to be able to serve patients is, is there a key learning of a practical practice that you do and we’ll keep on doing as you
Dominic Abrams: move forward?
Yeah, I think it’s really important to get to know the people that you work with and get to know them individually. So, for example, um, you know, when I was in, in the UK it was always about going for beer on a Friday night after work. And it was something that sort of, you know, oh, the Britt’s always popping down the pub after work.
But it was, it was a very culturally powerful experience. It was very level. You know, the senior people were having a chat with the person and who was there for their first week coming in at the, at, at the other end of the spectrum. So it was always a great, to me, a really great experience. And of course at the time you don’t realize that, but looking back, that’s exactly what it was.
So I’ve tried to replicate these kind of social, um, uh, events. So we always try to go to lunch together on Friday after clinic, you know, and, and have lunch and not really talk about work, but talk about other things. Talk about. You know, someone’s dog or you know, what, whatever it may be. But to have that personal connection between people, uh, and I think that’s really, really important.
And if you, if you like and care for the people that you work with, it really drives that cohesion. It drives that maximizing performance when you’re in the professional situation because you understand the people so much better. So that’s something that we’ve always really tried to do and it’s that social context as well.
We’re all humans and we all need that social contact and that was why the pandemic was so hard because we sort of lost that. And so, you know, it was great now that we’re all sort of back and it’s interesting speaking to people, you know, recently about really liking coming back and sort of being part of the team and being physically with people again.
I think that’s really important. So I think that social. However hard you work and however much the cohesion is in the professional setting. I think the social piece is really, really important to me as well, because it just allows you to get to know people on a completely different level and I think really enhances the culture and the collaboration between individuals.
Naji: Uh, can, can’t agree more, and, and it’s true. Pandemic was hard and at the same time showed us the importance of this human war, right? Like this human connection. Absolutely. So tha thanks for sharing this. Uh, I’d love not to give you a word and get a reaction to it. So the first word is leadership.
Dominic Abrams: So I think, um, when I think of leadership, I like to think of a, of three words that summarize that best in my mind, which is value, belonging, and purpose.
I think you have to value people that you’re with. There’s a great quote. From Ed Cat Capal, who was the CEO of Pixar, who says, Great ideas can and do come from anywhere. And so if you really value the people you work with, recognize that everyone brings something unique, an individual, um, and let them know that really, really value them.
Let them know you value them, and that people are there for a reason. They’ve been chosen to be part of that team for a reason, because they bring something special. You’ve gotta give people purpose. That’s really, really important. If people believe they have a purpose and they understand the purpose individually and as the team, then it really sort of helps drive things forward and people feel motivated and their performance undoubtedly goes up.
Another great quote I love is from Greg Dyke, who was Director General of the BBC at the time, and someone said to me, What, what? What do you see your job as being in charge of the bbc? And he said, very simply, my job is to give people a reason to get up in the morning and come to. So you have to give people purpose.
You have to make them feel that they’re really part of something that they’re helping towards improving that. And for that us, obviously that’s the patient care and people have to need to feel they belong. I mean, that is an incredibly powerful human. Emotion to belong. And I think that’s why I sort of went back to my early experience in London as a junior doctor, that sense of belonging to that firm of belonging to that team.
This was your people. And I think that’s really, really important. And Amy Edmondson’s done some wonderful research on this in. Uh, the medical set set setting, I think it was a big emergency department where people felt when they were in teams, they belonged in their performance. Measurable performance improved significantly.
So that sense of belonging to me is very, very important. And there’s a wonderful book by a guy called Owen Eastwood, uh, called Bonging, um, which I would recommend to anyone to read. It’s a really, really fantastic book, which goes to that in great detail. And of course it goes back. Many hundreds of thousands of years when if you didn’t belong to a tribe and you were on the outside, you were in trouble because whatever was gonna come along and you would do so because you are isolated and on your own.
So I think it’s a really, really important concept. So that’s how I like to think of it in those three words.
Naji: This is, this is great value, purpose, belonging. And you touched on so many important things. You know, when we talk diversity, inclusion, equity, belonging is now a big part of it. And I had the opportunity and pleasure to, uh, host Amy Edmondson where she shares her work on this.
Um, so thanks for that. Uh, the second word is innovation.
Dominic Abrams: I think innovation can, you know, be thought of in so many different ways, but I think sometimes it’s looking at things and just seeing things from a very different perspective sometimes and understanding that although certainly in medicine, we like to think of things. Being causal in a certain way or a certain mechanism, that’s not always the case.
And sometimes you can look at it from a completely different perspective, and that’s why I think that having multiple voices at the table, having multiple people who feel they can give their input. Is fascinating, uh, and really, really helpful to innovating because someone might say something as a bit of a joke or off the cuff and you think, Hang on a minute.
No, that actually is really important. That’s a really useful insight. So to me, innovation is just constantly bringing new ideas, constantly thinking of things in a different way, and driving our understanding of different situations forward. And that can be, you know, innovating from. How the patient gets into clinic to innovating a new therapy for a rare disease.
So it, it’s such a spectrum of different things, um, that it’s, uh, always exciting and it’s always something that’s present in our minds. Um, the, the gentleman who I spoke about earlier, who was the philanthropist who gave us that wonderful donation, that kickstarted everything used to come to meetings. And he would look at me and he’d say, How do you define.
And that was a great question because you can think of it in so many ways, and I think innovation can be thought of in many different ways as well. And it, it, it’s really interesting just to hear different people make different comments, uh, and just throw out different ideas that can, Sunny, yes, we need to think of it like that.
So that’s how I think of it. What about health equity?
I think we need to provide. Equal healthcare opportunities across the spectrum of human race, of human culture, all different ways that all, all the ways that we as human beings are different from each other. And I think it’s really important to understand what different things mean to different people and not just to draw.
The sort of traditional healthcare models of looking at one specific race, or one specific culture, or one specific, um, tree, if you like. A great example of that is the genetic. Makeup of, of us as human beings, what can be very relevant in one, um, ethnicity in terms of may cause a disease or a different disorder may be very, very different in another.
So that’s a sort of just a very simple example of thinking about how we need to understand everyone to provide the best treatment. And I think things are really improving now in terms of changing, um, how we think about things, not just perhaps from a medical and a genetic perspective, but also. What do these people actually really want?
What’s important to them? What are the meaningful outcomes to this group of individuals? Cause it may be very different to someone else. So I think it’s, it’s really important to understand what is important to our patients. What, what do they care about and what’s meaningful to them.
Naji: The last word is spread love in organizations
Dominic Abrams: Be. To be kind. It’s really two very simple words that can be thought of in so many different ways, but I think when you witness it, it’s so evident and it makes such a difference to people’s day. You know, it’s, it’s, um, really impactful and powerful in both ways when you are kind. It’s very empowering.
It’s very positive. It’s inspiring and uplifting, and. People are unkind. It has the opposite effect. So I think it’s really, um, that is a good way just to think about how to do it. Be kind.
Naji: Any final word of wisdom, Dominic for healthcare leaders around the world?
Dominic Abrams: I think,you know, I think it’s, it’s, I. Stress, the importance to me of team, of being part of a team, of being part of that, of understanding how that works and how we work together. It’s a very multifaceted, multidisciplinary specialty medicine, and you need all those different people at the table. You need different people bringing different ideas of interacting with patients and families in different ways.
Um, because. That ultimately is how you maximize their experience, how you improve their outcomes, uh, from doing in many, many different ways. So I think anyone who’s starting up and, and I think that’s a great way to think about things, is be part of a team. Understand that team, understand your own perspectives, what you are trying to do, and how that team comes together.
And then it’s about building that team and moving forward. But I think it’s a really. Important and key components of healthcare, uh, the people you work with and how you function as a group. And that’s been shown in many, many different situations. And I think it’s gonna get more and more important as we think about how we can improve both the experience and the outcomes of the patients that we serve.
Naji: Well, thank you so much for those, uh, great final words and for all this incredible chat we had together today. Thanks Dominic for being with me.
Dominic Abrams: Thank you. It’s been fantastic. Thank you very much!
Naji: Thank you all for listening to spread love and organization’s podcast. Drop us a review on your preferred podcast platform
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