Author, emergency physician, and Director of Leadership Development for the Mayo Clinic Care Network, Dr. Richard Winters, tackles how to fight burnout, shake off an “us vs them” mentality, and track your organization’s vital signs, and explains the P.A.G.E.R.S. test of wellbeing, INformal leadership, the leadership qualities of producers like Rick Rubin and Brian Eno, examining our relationship with time, why he often thinks of Sisyphus, and the leadership experiment you can try for yourself today.

Dr. Richard Winters: Hey Stephanie, how are you?

Hey, Dr. Winters on well, how are you? Thank you

so much for being with us super excited to have you. If it's

okay with you, we'd love to dive in. Obviously, we know about

your background and your book, there's so much relevance with

what you bring to the table. And I'm going to start with, for me

personally, the why behind things are often just as

interesting as the content. So my first question, it's super

simple. But why the book?

Dr. Richard Winters: Why the book? Yeah, so So I'm an

emergency physician, right. So on one hand, I'm taking care of

patients. And then on the other hand, I also develop leaders and

provide executive coaching for many of leaders internally and

externally to Mayo Clinic. And I was noticing that as I was

meeting with leaders, and really leaders at all levels, this

could be the most senior leader or individuals just stepping

into leadership roles, but there were common themes. And so

instead of each coaching session talking about these themes, I

thought, well, let me write a book about this. And I can put

some of these things in there. And and the common theme, really

is people moving from these places of expertise is these

things they know very well they know how to do they know how to

take care of and then once they become leaders finding that they

can no longer necessarily like flex that expertise, like the

they're used to walking into a room making a decision, and then

moving on, as you're a leader that actually is very

distracting and and oftentimes not the right way to go. And so

how do you put down your expertise, kind of help

facilitate and coach colleagues to be the best they can to move

forward. And so that's what I tried to put into the book, also

wanted something that was something where a leader could

just open up the book and find, okay, I'm having some issues.

There's this person that keeps interrupting What do I do? Or

this individuals burned out? Or I have to run a retreat? What do

I do so something that they can just open it up and find some

tactics there?

So almost like a guidebook?

Dr. Richard Winters: Yeah. And so as a coach, the things that I

like to talk about are the really messy things like how

people are making sense of this really complex world. And so I

find that people face two different kinds of challenges.

One, are these really messy kind of thorny, adaptive challenges?

We're, all these things are coming together? And how do you

process it? I love coaching around that stuff. And then

there are things that you coached around that are really

more like the technical challenges, which is like, I

don't know how to do this. And so okay, then how are you going

to learn how to do this, or you need to gain a skill, you need

to gain some experience. And I prefer to jump to the more

adaptive stuff. And so I tried to put a lot of the technical

stuff like how do you actually do this stuff, the frameworks

into the book. So really, it's as much to help the individual

is to help myself to try to get into the things that I think are

meatier, actually, for the leader to move forward?

Were there any byproducts or outcomes from the

book that were different than what you would have thought or

expected?

Dr. Richard Winters: I mean, the great thing about writing in

general is you go into writing a paragraph or some chapter with

some intention. And then as you're doing that, you start to

learn new things, you start to see your words, you start to

think about how is that being, you know, thought about, and how

do I best, say these things. And so I think the process of

writing a book, just as, like, as we're running meetings, like,

we run a meeting, and we hear ourselves saying this, and doing

this, and then afterwards, we're like, I don't know that I wanted

things to go that way. Or like, I'm talking to my teenage

daughter, and I approach it in that way. I'm like, Okay, well,

I've been to high school, and this is what I would do. If I

were you. And then afterwards, I think she's probably not the

best approach.

So hang on, are you also suggesting that there

are guidelines for raising teenagers?

Dr. Richard Winters: I think that guideline is we all as

parents have expertise, but our teenagers are gonna say, I don't

care what you say, I do what I want, you know that. And so how

do you help them figure out the best thing for them, as opposed

to, you know, from our own perspectives?

Very cool. Diving into a little bit of the

meat of the book, you address this idea of burnout, as a

society today, that is a huge topic, burnout, the Great

Recession, quiet quitting. These are kind of the buzzwords that

are, you know, in everybody's work life, professional life,

how do you address them once they're there? Because

unfortunately, I think the reason why we're hearing so much

of this is it's already there. It's not about prevention. Share

with us some of your suggestions around really dealing with that.

Dr. Richard Winters: Yeah. So I think this is where frameworks

are helpful, like, ways of like, how do we think about this, and

there's a couple that popped to mind here. And so one is if

you're on social media, and you're talking about burnout,

it's oftentimes you get into the talk of what we have done, and

what they have done and how they didn't listen, and how it

oftentimes you get into this kind of victim mode. And so

where it's blame, and this is what's being, and I think that's

that is that is a space that is part of burnout, but let's like

let's step back. And so as we're thinking about burnout, let's

think first of all, it like we can be shouting about whoever

the politician is, at the time, we can be shot up shouting about

whoever the big name in the news is, or you know, the insurance

companies or the lawyers or the doctors, but there's not a lot

we can do about that. And so we're kind of like shouting into

The fog and still feeling burned out between saying nothing, do

nothing and shouting into the fog. There are three different

levels of things that we can think about as we're approaching

burnout. So the first one is just as we're working in

organizations at this organizational level, is the

organization working in a way that they think well being is

important. And burnout is something that we'd like to try

to decrease. If so, what's being done about this. And so I think

about from a system level is, is the organization thinking about

burnout and well being. And so as an emergency physician, and I

go see a patient, there are vital signs. And so if I see a

patient and try to make a diagnosis without looking at

Vital Signs of not a very good emergency physician, for

organizations, there are vital signs. And I think burnout, well

being is one of those vital signs. And so we look at costs,

and we look at revenue, and we look at quality, and those sorts

of things. But we also need to be looking at the well being the

burnout rates of individuals that we're employing, if we're

not looking at that long standing, it's not going to be a

healthy thing for the organization. This is part of

our responsibility. This is a system that we are a part of,

therefore, let's do something about it. And so that's

organizational level. And so the second level I think about is

inter individually, like how we're interacting with

colleagues, and that is, on the one hand, are we working with

people who were enjoying working with or having positive

interactions with or not, it kind of stinks to be working

with people that you don't enjoy working with? So that's one

thing. And then the other thing is, how are we meeting together?

How are we conducting our meetings and making decisions?

And so we call these things meetings. But are they

oftentimes meetings, people think they they like I hate

meetings. But oftentimes, meetings are not meetings, like

it's oftentimes tellings. And so how do we create a workplace

where we're actually getting together? And we're talking

about things and understanding what different people are

perceiving? And how do we move forward. And then I think then

the final layer is just individually like personally, on

a personal level, there are kind of different things that we can

look at. And so yes, meditation is important for for those who

like that, certainly eating healthy and having healthy, you

know, activities and working out and sleeping well, all those

things are a base, I know that if I'm working the night shift

in the IDI, and if I haven't eaten well, and someone was mean

to me, that the next day, when my teenage daughter comes and

talks to me, I may be a little bit more crusty than usual. And

so if I'm keep having those sorts of days, it's likely I'm

gonna be burned out. So that's, that is one part of of the

individual thing. But the other part is also how we make sense

of our own situation. And it's, and this is like, as I was

talking about to begin with, like how we deal with the

complexity of our world. And if we feel like we're trapped, then

we're going to be trapped. I talked to leaders, for example,

who have difficulty speaking up. So as a coach, I'd be trying to

figure out how you might be able to speak up in ways that allow

you to actually voice your opinion. There are other

leaders, for example, who speak too much, they, whenever they

say something, someone else disagrees with them, they're

gonna repeat what they say they're going to talk about

their past and all their experience. And so for those

individuals, they don't like feeling that way. And certainly

they're causing burnout, likely by silencing others, but for

themselves, like their view of the world of me, being a leader

means I need to be speaking up and talking over people is

something that needs to be challenged. And so I think it's

important for us to look at all three of these levels, the

things we can change the things that we can change, that are a

part of our organization that we were meeting together, and then

ourselves, I give a talk to all the new Mayo Clinic physicians

and scientists, and I'll ask them, I'll see how many of you

can name the four chambers of the heart? And everyone raises

their hand? What are the 12 cranial nerves, all of them will

raise their hand and then we'll say, so what are the components

of well being and their silence? They can't necessarily say what

are the components of well being? And so would it be nice

to have a language about this thing that we're trying to get

to well being and as we're moving away towards burnout, and

so for me, the thing that's helpful for me is thinking about

this thing called psychological well being also called

eudaimonic. well being, and this is different from hedonic. So

hedonic well being is like last night, I went out and had drinks

and ate a whole bunch. And that was great today, if you like,

you know, this is bad, I don't feel so good. That's not the

kind of well being I'm talking about. So it's psychological

long term, like how we're actually assimilating the world

and feeling about ourselves. I as a physician, like mnemonics,

and so there's a mnemonic that I can put together called pagers

that's around this, and so pagers P is purpose. And so this

is a sense that we are aligned with the purpose of the

organization and the values of the individuals that we're

working with and meeting with and that are our friends. If

that's not happening, it's we may start to feel burned out.

And so that's a PA and pagers is autonomy. And this is the sense

that we're being heard that actually our experience counts.

And so as we have, as we perceive the environment, we

have ideas for things that might change or that we would tweak

that were being heard, and not being silenced, and that and

that it's kind of safe for us to do so. Not that we want others

to do exactly what we want. But if we're moving forward and we

don't feel like we're being heard than our autonomy is hurt,

and then so G is personal growth. Do we feel like today

we're having an opportunity to be better than we were

yesterday, we have an opportunity to grow and pursue

idea is of interest. If not, that could hurt our well being

and we might become burned out. He is environmental mastery, do

we have the things the resources that we need to get the job

done. And so if you go to work and you're being asked to do

something, you don't have the resources to do something that

can be a big driver of burnout and of hurting well being. And

it may be as an as we're talking about recession, and we're in

situations where things are more restricted, we don't have the

revenue to do some things. And so that is E RS relations,

positive relations with others, we've talked about that. And

then self acceptance, our sense of being able to accept that we

at times do things that we would not have wanted to have done, if

we were to look retrospectively or even going forward that we

make mistakes. And that can be paralyzing for individuals, if

you get stuck in that space, like you're living in the past.

And this can be a huge source of burnout. I think for all of us.

I mean, we've had interactions with friends and colleagues

where, geez, I wish I didn't do that. And our ability to Okay,

learn from that, and accept that is so important for us moving

forward and finding well being.

Okay. So I envision this book appealing to

a couple of different types of leaders. And I think you've

addressed some of this. So I'll try not to be too repetitive,

you, you've got the folks that have been in leadership for a

while, they're doing things a certain way, and it's just not

working anymore, or maybe never was, but they're finally seeing

the writing on the wall or whatever the case may be. And

then you've got maybe somebody who is new. And oftentimes our

own experiences frame, how we do things. So for example, if they

had good leadership, they will try and implement what they were

able to witness. And then I can also see folks who just have a

strong desire to transition into leadership. And if this is a

part of you want to be something that's a part of your future,

here's what you can start learning about now to be

effective when that day comes.

Dr. Richard Winters: So think about so what is it to be a

leader for some people, they want to be a leader so that they

can have control. And so it means that they want to have

followers because they have ideas of what should be done and

just everyone fall behind them. I guess that is a form of

leader. I mean, that is that's, that's difficult. And that's not

the approach that I like to think of in that sort of space,

you really need to have the answers. Things need to work out

well. Like you have so much expertise, you know how to solve

it. And I think that becomes quite uncomfortable. But

oftentimes, we do find ourself in these positions where we're

like, I don't know what these people are doing, I need to step

up and like show though, and I think that's a good place to

start. It really is it's authentic, and all of us can see

opportunities where organizations are in our

interactions with others can improve. And so I'll put that

aside. Now you're you've become a leader, I think the really the

definition of leader becomes not one of having followers, who are

who you can kind of control and stuff. But really, I think of a

leader is someone who develops leaders, someone who can help

other individuals find their voice and find their pagers like

their sense of purpose or sense of autonomy, they get the

resources and things that they need. And so when you're doing

that, you're really putting on a different hat. It's not the hat

of the experts on who knows what to do. It's more of the hat of

someone who's a facilitator and a coach and a teacher. That's

how I think about leadership. It's those individuals that can

do that. And so then also, I'm thinking about what is

leadership? Is it a flick a formal title? Does it mean that

you have to have a like I have to you have to be the CEO, or

the director or the VP there is that that's that formal

leadership structure where you have the power to hire and fire

and but I think what's even more interesting to tap into for each

of us is the our informal leadership roles. And that is

the person who people go to during times of difficulty, I'm

the person who's most likely to be the champion and move forward

may not have any formal title, but they are a leader, they're

the person who can help the group of individuals that they

work with become better and work forward and find answers. I like

that. I mean, I like to think about informal leadership, how

can we be more like that those great informal leaders in our

formal leadership roles? How do we how can we relieve some of

the pressure of on ourselves to be able to have to know the

answer in the moment and be able to collect and find the answer

together from others. So that being said, I do want to put

aside, there are times that a leader needs to make decisions,

difficult decisions, and we need to step up and do that. But

those are some of the times a lot of the other times are

bringing people together and facilitating and how do we kind

of adapt to those environments?

Fascinating. Let me shift gears slightly. One of

the things you mentioned earlier, this self acceptance,

to get there takes such an incredible amount of self

awareness that I think a lot of us don't have or need years of

therapy to get. You provide a platform, but it still can be so

overwhelming. Talk to me about that.

Dr. Richard Winters: Yeah. So I think there's a couple things

like as I started learning to become a coach, one of my

instructors said, like, the thing you like to say is you

don't have to change if you want to stay the same, like so we

don't have to change, right? Like, it's working out where

you're at, that's fine. It's like you cannot coach someone

who just wants to be where they're at. And so we have to

assume that we're We're in this growth mindset sort of phase

where we're looking for new ways of being better, more fulfilled

and, and getting the things that we think, you know, that are

important accomplished. And so on the one hand, we have to want

to change, we have to want to have this kind of growth

mindset. And on the other hand, we have to think that things

don't change in giant leaps. They change in small steps. And

so wouldn't it be so great if we could be like this, this this

whole person we envision, which is perfect in the future, but

it's not like we can just put on clothes and be that person we

have to be trying things on, we have to kind of walk with them,

and see what's comfortable and what's not comfortable and

Thrillist experimentations be VP identifying those parts that we

like, and the parts that we don't like and learning from

there. So, so very much as we're developing as individuals, as

we're developing as leaders, we are really kind of trying things

on for a moment, which oftentimes feels quite

inauthentic. Like I'm really good at numbers, you know,

telling the story with graphs and things like that. And I feel

like the numbers should just speak for themselves. Okay,

well, that's great. But maybe individuals need to hear a

story. And they need to have a more grounding of behind the

purpose. And so then, as a leader who likes to talk about

numbers, I need to somehow learn now how to how to tell these

stories, which it's a process just to get to there. As I was a

kid, when I was in high school, I'd make Miss mixtapes and I'd

like try to find like the best songs right to put out there.

And you know, some songs work, some didn't. And the next

mixtape would be better. And writing the book. It's almost

like I'm a, I'm putting a mixtape together. It's like

being a producer. And I look at those individuals, like there's

producers like Rick Rubin and Brian Eno, who can bring a bunch

of individuals very talented individuals into a room and have

them producing like these wonderful albums that are

platinum selling their ability to take all these different

ideas, put them together, and like create something really

cool is I think what we're all doing as leaders, we're like

finding these different songs, these different things, these

different programs that we take, and we're starting to kind of

try them on and figure them out, play them in our own minds, and

then see how they work. Oftentimes, also, leaders will

come and they'll have this idea that this is something that

needs to change. Now I'm gonna push it, I'm gonna push it, it's

not working, why isn't anyone listening? I think it is

important to kind of step back and just look at our

relationship with time, oftentimes, we're thinking about

things that we want to be changed by tomorrow or next

week. But all we need to do is just step back a little bit and

think about next quarter or next year, and how things might be

different. And so think about Sisyphus, like pushing the rock

up the hill. Like he's rolling back down. I also imagine

Sisyphus is in the subdivision that's changing. And all of a

sudden, this boulder by pushes that mountain away. And then

this was like, Oh, I can roll this rock easily. Sometimes we

just need the patience to let the rock be moved, you know, the

hill to be mowed down by itself?

Oh, I think that is hopefully something we'll

highlight. Sometimes we just need to have the patience to let

the rock be moved. Okay, if we were having this conversation

five years from now, what do you think the biggest challenges to

leadership are going to be in five years from now? What's

coming?

Dr. Richard Winters: Yeah, I think the biggest challenges for

leaders all along since the onset of humanity, I would say,

is just dealing with complexity. And we were dealing in these

environments, where the things we're considering the amount of

unknowns are so high, it's rapidly evolving. And so how do

we bring individuals together amidst these unknowns, like to

try to move forward with these goals we have. And then as we're

doing that, even like the outcomes of the goals, we cannot

predict, because it things are changing. So fast, things are so

volatile, and complex, those are going to be the problems of the

leaders as as we move forward. And I think even more so if

you're in an organization that's wanting to be successful, how do

we help the individuals that we hire, you know, I'm different

now than when I was 20 years old, I'm different than when I

was a baby, like, I can do different, I was just able to,

like, move from crawling to standing. At that time, I was

probably wasn't gonna be a good leader. And so now I'm 20, you

know, and I'm just like, I don't know, like second year of

college, or whatever that is, I'm probably a better leader now

than I was then. And each of us is we're in organizations, like

we have these arcs of our career where hopefully, we're getting

better this month versus the previous month, our best leaders

were able to understand that. And so a lot of times, we're

talking about disengagement, and quiet quitting and things like

that, right now, it may be that this individual is at a moment

in their life where they need to maybe less focus this week, this

month, this quarter on this work task, and they need to be

focusing on family or they need to be focusing on these other

things that are going on their life, but they need to be

focusing on this thing of personal growth that's going to

they're going to be learning a whole bunch from are we going to

be leading organizations in the future? And I think not where

individuals are commodities, where, okay, you're disengaged,

you're out of here, there are going to be some organizations

like that. But I don't think that people are going to want to

work as much in those organizations. It'll, it'll

fulfill some needs. But for others, those organizations that

have less churn that have individuals who are able to kind

of be themselves in the moment, we're going to find ways of

finding that just people throughout their lives

throughout their professional lives are are changing, and

we're going to be able to help them adapt, we're going to be

able to give them a little space when they need to, we're going

to have them step in. It's not like we're not going to be

producing revenue and producing our goals goals during each

moment. But we're going to be able to identify and help

individuals kind of where they're at to help them go from

where their ads to where they want to be in the future. And so

it's just, it's really more about a holistic view of how

we're working together and how together we can accomplish these

really difficult things and volatile and uncertain spaces.

I think, actually, what you just said,

there's some pretty neat foreshadowing, again, it's what

we've seen coming is that holistic approach, and that's a

perfect analogy with medicine. It's not just treating the

symptoms. Anything we haven't talked about that you would like

to share, you think would be important to share?

Dr. Richard Winters: I think it's important, again, for us to

recognize the importance of our expertise, our experiences, the

things like we've been there. And we've done that, and how

much this adds to our efficacy and our ability to get things

done. But also on the other hand, to be able to then

separate from that, and move forward in ways where we're not

necessarily leveraging that. And that really is more as being a

coach and a facilitator. And so I think just as an experiment,

as someone comes up to you, and they're asking you a difficult

question, maybe how do you in that moment, not give the

answer? How do you in that moment, not think about what's

happened to you in the past? And like be going through a year

kind of database of experiences? How do you in that moment, just

actually best help that individual who's talking to you

understand their database of moments to reflect on what

things are like for them and how they're experiencing it? And

then given that, what might they do? And then given that, what

will they do moving forward? I think on a one to one

perspective, that's powerful. And then I think, on the group

level, the same thing happens, where we face these really

difficult issues, staffing, we need to change the product we

need to improve. I mean, there's like so many things that we

face. And oftentimes, as leaders, we go in us, or maybe

just a small executive group, and decide like in the moment

based on our database of experience, what needs to be

done, but how powerful it can be during certain moments to to be

asking that our colleagues like so what are your database of

moments? What are your percept perspectives about this, and

then only after you receive kind of developing the shared

reality, this this shared perspective of what's going on,

which includes all the agreements, all the

disagreements, all the fears and worries, but really a much

better perspective of the total, like, challenge ahead. Only

after we find that do we start to think about what we might do

and what we will do moving forward. And so it's really how

do we as individuals, as leaders, as parents, as friends,

kind of stopped being like reflexive robotics, like based

on our experiences and in the past, and what we think should

happen and start being more just open to listening and seeking to

understand and discovery before we start to move forward.

Thank you.

Dr. Richard Winters: Yeah, cool. Thank you. Thank you. Thanks for

having me. Great meeting you.