Are you leading your employees? Or are you just managing them through every task?
On this episode of Inside Reproductive Health, Griffin talks to Rita Gruber, President of Gruber Group, LLC, a consulting firm helping people in the medical field become effective leaders in their organizations. She shares with us the change in business management practices over the years, how to empower your employees, and what you can do today to help yourself become a better leader.
Whether you are a physician-owner, an office manager, director of a department, are part of the C-suite, or aspire to be any of the above, this episode is for you!
Mentioned in this episode:
Episode 59 - Michael Alper
Episode 36 - Michael Levy
Episode 46 - Alan Copperman
Start with Why - Simon Sinek
Episode 10 - Jason Franasiak
Episode 15 - Hannah Johnson
To get started on a marketing plan for your company, complete the Goal and Competitive Diagnostic at FertilityBridge.com.
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Welcome to Inside Reproductive Health, the shoptalk of the fertility field. Here, you'll hear authentic and unscripted conversations about practice management, patient relations, and business development from the most forward-thinking experts in our field.
Wall Street and Silicon Valley both want your patients, but there is a plan if you're willing to take action. Visit fertilitybridge.com to learn about the first piece of building a Fertility Marketing System--The Goal and Competitive Diagnostic. Now, here's the founder of Fertility Bridge and the host of Inside Reproductive Health, Griffin Jones.
JONES 0:52
Today on Inside Reproductive Health, I'm joined by Ms. Rita Gruber. Rita has more than 35 years experience as a Senior Executive in Retail and Healthcare Management with 23 of those years being in Human Resources and Operations at Integramed and RMA of New Jersey and is now President of the Gruber Group, LLC. She does consulting work with MedTech For Solutions. They serve REI practices and clinics across the country. She's hired and on boarded executives and staff in all RE disciplines, coached and mentored physicians, managers and staff and leadership and performance competencies and volunteered her experience to help students prepare for their job search and interviews. She really is one of my favorite people in this field. Ms. Gruber, Rita, welcome to Inside Reproductive Health.
GRUBER 1:41
Oh, thank you, Griffin. And again, thank you for this opportunity. And I guess this is a mutual respect and admiration relationship that we have, many generations apart, but I certainly respect all the work that you do, too, Griffin.
JONES 1:58
Well, I think you're one of the original gangsters of practice management in the field and so many people look up to you. And you've touched so many people in different eras of the field and a lot of it has had to do with your development and leadership. And I'd like to steer our conversation today a bit more about that--about developing leaders. And I'm wondering how you came to have that passion and focus in the first place?
GRUBER 2:29
Well, the core issue is all businesses rise and fall on the quality of their leadership. Part of it, since we're talking about my multi-generations in an executive role, a lot of it comes from my personal reformation from the old, commanding control that existed when I first became a boss, as the cliche was, or a manager and the concept of pleasing your boss to the beauty of today's new approach of service, mentorship, and coaching. So my passion lies with the fact that as I'm ending my career, I would like to help others stay who they are and still become effective, influential leaders. Subject matter expertise is critical, whether you're the physician, the nurse, or the finance manager. But “people expertise” is the most critical to be successful and influential. It's personal and, I guess at the same time, it's organizational. Some people are born gifted in building relationships, and others have to work a little bit harder about developing the skill.
JONES 3:55
I wanted to ask if how well that can be learned and how innate it is, but first I want to go back to something you brought up about the older era and that reputation of command and control. I think when we think of management, leadership, bosses, supervisors, the conversation very much is well, a few decades ago very much was command and control, today is more of the--with Jeff Bezos having the Amazon dot love philosophy, whether it's genuine or not is up for debate, but that's very much the ethos of leadership now--service and passion, as you mentioned, previously, reputation had been command and control. Is that exaggerated or was it really like that? Where it was very much I'm the boss, this is the way it is, a few decades ago? And do you really think that is all but gone today?
GRUBER 4:52
Alright, a couple of things. It truly was, as you mentioned, more command and control? Yes. I’m the boss. I know best at this level of my expertise. And I'm going to give you the work to do. Now, you could still be a kind person, you could still be reasonably respectful and caring about the employees reporting to you. But you were not--and I'm going to use this phrase several times through our talk today, Griffin--you weren't sharing the journey. Whatever the business journey was. It was you could have a decent relationship. As I said, you could be kind, you could bring in doughnuts every Friday morning, you could be a good guy. But you were not sharing. They were people who worked for you, you were the person in control. Now, part of the problem, Griffin, and I guess why you and I are talking today. That isn't totally gone. People might object to using the term, are you a command and control manager? And yet they live more by their title or their position, which we'll also hopefully touch on. And they don't realize that that level, the lowest level--and John Maxwell, one of the big leadership gurus, has sort of laid it out for us. I mean, I can go through his five steps if you would like to do that? To keep in line with your--
JONES 6:29
Yeah, let's go through it at a really high level because I think John Maxwell and others are part-- Jim Collins--are part of the reason why this shift has happened. And so I imagine that started in--just based on the era of those guys, I'm imagining this ethos coming into the workplace more in the late 80s, popularizing in the 90s, cementing in the 2000s is the way I'm seeing the timeline, but if you were to recap those at a high level, what is that new type of doctrine that they're bringing in?
GRUBER 7:09
Well, what he would say is like what you and I were just discussing, people lean on their position. They are promoted too often just because they're the best at their job, which does not necessarily mean they should be in management, or that they are leaders. And what they're saying is they have rights. So people just follow them because they have to. But if they don't have the right influence, and mentorship, and coaching, they're going to have turnover in their direct reports. And they really can't stay at that level. They have to move to building relationships and getting results, etc. So that's the Reader's Digest version, but a lot of people still do base their entire influence just on their title rather than trying to make their people better. And having influence, relationships, and service to the people who report to you are core to what we're discussing today.
JONES 8:14
So that's the first. Is that sort of like the basic, the most fundamental form of leadership? Or I guess maybe the most, if you haven't advanced to a more degree, just having the--you're in the position because you're leaning on your technical expertise and people follow you because they have to. How does it advance from there?
GRUBER 8:39
Yeah, okay. Well, again, when hopefully you realize that you do have a turnover or people are not as responsive to you or, cliche, engaged in their work or feeling empowered in their work. And empowered meant, again, is very vague because we can only build our empowerment when we buy--which we will hopefully talk about in a moment--buy into a mission or a purpose or a why. And hopefully this lowest level of management or leadership will learn they have to build a better relationship with their direct reports and with their peers and with those ahead of them in the traditional org chart. It's a 360 relationship building, Griffin. To truly bear influence in the practice, or in any organization and serve the people who report to you. And I'm getting to keep getting back to that term: serve. Because once you become a leader slash manager your primary responsibility, again, is to impact the practice by building up the people who report to you, showing them they're important and helping them do their work better. Again, why do coaches earn so much money when they're speaking at business events? Like NFL coaches or basketball coaches or whatever? Because they never start a day without a playbook. They know what plays they're looking at. They've measured the competition. And they have determined to bring out the best in each one of their players on the field or on the court. And that's what we're expected to do in leadership in every organization.
JONES 10:47
One of the statements that you said has me thinking which was the start to build empowerment mission. When they start to see--I'm paraphrasing--but they're starting to see less of a return from the dictate style. They need to empower people to buy-in to get a greater return. And so I'm wondering how much of it is people changing their leadership style because they know the other model from top down isn't working as well, it isn't returning as much as it used to. How much of it is them changing versus how much of it is that the current style favors a particular personality profile that it didn't before? In other words, the nice gal or guy with other skills is able to win a lot more with their empathetic style, their natural personality than they may have been able to 20-30 years ago. How much of it is changing to accommodate what's working versus just the current style favors personality type now that maybe didn't previously?
GRUBER 11:55
That is a compound, complex question! That is a great question! That could be--just answering that question could be the balance of the hour and touching on all the bullet points I had sitting in front of me. Okay, let's go back to that. Alright, first of all, let's just keep in our world of the reproductive medicine practice or clinic and the top boss is the physician. Okay? So a lot is going to depend on has that physician taken the time to look at him or herself regarding their own leadership style? Now, before you and I formally began this talk, we touched on your prior podcasts. And I'm going to mention three physicians that have spoken with you, Griffin, powerhouses!
JONES 12:56
Wow! You really are a fan of the show if you can rattle off three just like that!
GRUBER 13:01
I can! And they are three of my favorites! Now I don't know Dr. Alper, Mike Alper, as well. We would know each other If we met at ASRM, but I do know his history and he absolutely is a leader. I have not worked directly with Dr. Alper, but I know others who have. You and I know several from ARM. And he is very aware of his leadership style. He's very aware of himself and what he brings to not just to patients, but to his people, and to his growth and development. So that I know and then, two of my favorites that I know personally and have worked with personally are Michael Levy, Dr. Levy from Shady Grove--and they didn't get to be the biggest practice in this country without solid leadership from Dr. Levy, of course, Dr. Segoskin--the two founding partners, and Bob Stillman, again, another phenomenal doctor, who are among the best people leaders, not just patient caregivers, but people leaders in our industry. And I've known them since maybe 1997-98. And then another great guy is Dr. Copperman. And again, the success of RMA of New York is due to Dr. Copperman and his three other founding partners and how they, again, taking care of their patients, their successes, their outcomes, their clinical recognition, their scientific recognition, but the people, the people who work for them, and how they have led them and allowed others to even direct them and lead their people. So it does start with the physician Griffin. And getting back again to your question is, the next thing is a true leader can be always focused on the immediate satisfaction or politics of satisfying their boss. Their success in the practice will be bringing results. And bringing results through people, minimum turnover, their people being their direct reports being engaged, and as you rise on the org chart, your leadership vision. You always look to the horizon and when you get there, there's the next horizon. So you share again, the growth journey with the physicians who are, so to speak, owning and running the practice. So I think we see that with certain groups of our colleagues in ARM, Griffin, that kind of leadership and relationship they have with the physicians running their practice. And their service to the people who are working at the practice at all levels. I think we have also seen managers and practice administrators, etc. struggling because they're focused on pleasing their bosses day by day, instead of everybody getting the big picture. And no way that the physicians can only be as successful as the leaders they bring with them on their journey, whether that's in the laboratory, what has been the clinical arena, or whether that's in the administration arena or department. So I'm hoping I'm answering your question, big picture. What do you think?
JONES 16:56
I'm wondering if though--one point that you make is that it starts from the top or that is to say that the physician is at the top tenet of leadership of people in the practice is not focusing on pleasing the boss in the day to day in sort of every little sense. But I wonder is that still not the fault and/or responsibility of the boss? In other words, I consider everything that happens at Fertility Bridge, my fault. I'm 100% responsible because in my case, I'm the sole proprietor of this company. So even if it's our social media manager that makes a mistake, even if it was someone else that was the creative manager that was supposed to be supervising them for something, if something happens at the end of the day, it's my fault. And I don't mean that in that I need to micromanage everybody because I don't. What I mean by that is if someone doesn't have the tools and/or if they don't have the accountability above them, it's because somewhere in the chain, that gets traced back to me. I didn't put something into place. I didn't hire someone. I didn't invest in something. And so I think that it's my fault and my responsibility. So if there is a culture of having to please the boss at the day-to-day to show--here, boss, here's what I'm doing, see how productive I am! And if that's happening, isn't it the culture from the person at the top, in this case, the physician?
GRUBER 18:19
You are correct in your leadership approach to running your business within your own company and helping other practices. So you are correct. But with the physicians, okay, that is not always correct. Like we joke about physicians all think they're entrepreneurs, but really, you know--Wharton is now part of their medical education. I think what medical schools are starting to focus on more is relationships. You used the term empathy before. Empathy has actually become a critical attribute that we all have, it's just how is it developed? But, okay, the physician too often throughout the country, I have come across physicians who--cliche--when they say jump, all of the management team and I'm using that term deliberately should say how high, boss? And that's not necessarily the case. If accounts receivable falls 100 days behind, they are looking more to blame than to bring in the manager and say, What can we do to fix this? I need you to sit and talk to me and let's say, how do we fix it together? What do we need to do. So from the get go, and this is even important with onboarding and at the hiring level--the founding physician has set the vision and the mission. Okay? Then they need to communicate that from their heart. It was personal to them. That's what happened when they started the practice. It's personal. I have a personal mission. I have a vision for this practice. But then they need to solicit the buy-in from others, from the staff to what eventually becomes their leaders and managers. They need others and again, I'm using the same term, to take the journey with them. They give purpose to the day to day. As Simon Sinek--I'm sure your generation is very familiar with Simon Sinek--I love Simon Sinek!
JONES 20:56
Me too.
GRUBER 20:57
Don’t you?! I love him. I love watching him on YouTube. Now, he wrote the book Why, but he is not the first or the only leadership management guru that uses that term. This physician in the practice, from the founding physicians to every physician, has to set out why to their employees. And then it excites the people. They have a passion, they have a purpose, it pulls them back to the vision, again, the why. And that empowers people and it's a self-motivation. I think Griffin, you've learned, we really can't motivate people. We have to give them a reason to motivate themselves. So all these talks about how do you motivate people? I don't believe we can. But I do believe we can create an environment that empowers the people to motivate themselves. They want to contribute to that physician journey. They will want their work to matter. Again, as corny as it sounds, they also want to be loved in the business sense. So, that “why” that Simon Sinek and so many other people propose, the “Why” is the purpose for the work and that has to come from the physician. The “What” is the vision that the physician is giving everybody. And the “How” then is the strategy. How do we do this as a team? So, no, that's not evident, as widespread as it should be in our field throughout the country. No. And the leaders now that we see and work with and we call colleagues, they have to start learning how to sometimes generate that themselves in this sphere of influence, if in fact, the physician may not be doing it. And again, we see the success. We see the result from IVF Boston, we see the results in Shady Grove. We see the results from RMA of New York. And yeah, I don't think he really had anybody from my old group, RMA of New Jersey, but those three founding partners gave us passion every day.
JONES 23:17
I’ve had Jason Franasiak from RMA of New Jersey--
GRUBER 23:19
Oh, that’s right! I saw that!
JONES 23:20
Richard Scott, if any of your team is listening, your invitation stands to have your founder’s story on! So I think you might have just poked the bear a little bit in a good way, Rita!
GRUBER 23:34
Okay, well, you never know. Actually, they did a beautiful, beautiful video. I was just back for the 20th anniversary of RMA of New Jersey. And of course, just RMA now, it's global. But the videos on the founding were phenomenal. And again, like Shady Grove, like RMA New York, like IVF Boston, they were 25 people including three physicians that started RMA of New Jersey when they left the Institute of Saint Barnabas and Griffin, I would say out of those 25 employees, including, as I said, the three founding physicians, there's probably 18 or 19 left, still there!
JONES 24:21
Wow!
GRUBER 24:22
That's phenomenal. And that's true with the other three practices. I've mentioned their employee retention, because of the passion, the vision, and the strategy those physicians have implemented throughout their practice and throughout their growth is critical. And I would like everybody to learn from these successes. Yes, so that's how important the physician can be. But leaders within the practice, sometimes have to learn how to do that with their groups if this physician is not quite as inspiring or motivating as some of the ones we've discussed here on this talk.
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JONES 27:03
So maybe the founding physician isn't inspiring or motivating, those are personality traits. And if someone is a wonderful scientist and physician, then they shouldn't necessarily have to rely on those traits. But at the very least, if one really is the founding physician of a practice group that is meant to have growth or even sustainability over a decent period of time, doesn't that founding physician have a responsibility to provide safety for those leaders to be able to motivate and inspire in their way or to, at the very least, be able to lead in the functions of the company? I'm thinking of someone that we've worked with recently, and I'm not even going to say what sex they are, what part of the world they are--because I know this individual listens to the show and they're a really good person. I've had the conversation with them, Doc, the reason why you're not getting the results that you want is because we've worked with six different people on your team thus far, meaning they're constantly changing! And I said to this person, I said, Hey, can I just have a conversation with you? Your team tries to screw each other over. And the reason why they do that is because you're constantly changing who's in this position. And the only way they can feel like they're not next on the chopping block is to put someone else's head on it. And I see that mistake when other agencies and other firms go into pitch a new client or when a new client, they'll either put the marketing directors head on the chopping block, they'll put the other agencies head on the chopping block, and I don't do that because all it's really doing, Rita, in my opinion, is pushing someone else out of the way on the chopping block to say, Hey, hurry up, chop their head off. So then you can chop mine off. And I tried to address that. But isn't it the responsibility of the leader of the company to provide a degree of safety to where they feel like they can, you know, make some mistakes have some level of forgiveness at at least within human reason, so that they can be the ones that are motivating or at the very least, managing adequately?
GRUBER 29:28
Oh, absolutely. I mean, every work environment, the leaders have to provide a safety net. And each individual leader--we will consider the leaders in this conversation, the people that run the clinical division, the laboratory division and the administrative division, you know, or who say the head of marketing the head of finance. Okay? Those leaders to be effective, you're correct, have to provide a safety net for their employees to make a mistake, cause we will all make mistakes.
JONES 30:10
Well, I'm up at a level higher than that. I agree with that statement 100%. But even to get to there, to where the leaders can provide the employees with the safety net, doesn't the founding physician or the principal of the company or the chief executive or whoever's at the top in this case, don't they have to provide those leaders with that safety net in order for the leaders to provide it to the employees?
GRUBER 30:36
Oh, absolutely. And then the leaders have to--like, we’ll get back to the example I use, because this is always a hot topic. Marketing and finance are two hot topics, as you know. Day by day in every physician practice, where are my new patients and where is my money? Okay, hot topics, even in the best leadership environment! So if you look at finance and you say, okay, we're 100 days out. First of all, the finance manager has the responsibility to, so to speak, to defend their team, recognize what's falling short, be able to present that to the physician without being cut off at the knees. And the physician being far less than understanding, but then the physician has a right to say to that finance manager, Ok, I would like a report or a spreadsheet. I would like to see your plan. And again, it's not you--let's fix this. Let's get back to 65-70 days outstanding, what might be appropriate for that practice in that state. Let's get back to that. And I would like a plan from you. I would like a timeline. And if it's going to mean an increased cost and staff hours, I would like to know that and I would like to have an opportunity to approve it. So now you can be disciplined as a physician, but you can also be respectful and appropriate and give the top leadership a chance to fix the situation. Is that what you're sort of getting at Griffin?
JONES 32:26
Yeah, as opposed to just sort of letting whatever is new and shiny take the place of someone who's currently trying. And you know, it could be we're not getting this result in a very short unrealistic period of time, so I'm going to move to the next one, and then I'm going to move to the next one. And as opposed to I think what you're talking about is having a plan, having key performance indicators, allowing someone to push back so they can provide a realistic option because I think the alternative just breeds--well, I know that all I'm gonna really be able to do here is buy myself some more time by throwing someone else under the bus and I think that sabotages the entire organization. I see it sabotage many organizations.
GRUBER 33:12
Oh, yes. If we're getting into the marketing field, I can see if this physician does not feel their getting enough patients referred. I mean, that's the bread and butter, correct? That's the bread and butter business, those referring physicians, and is very unhappy with the marketing manager or director and threatens their job. That puts him or her into survival mode. And then that means the people out in the field--now I'm used to calling into physician liaisons--out in the field. They all feel their job is in jeopardy, is that correct?
JONES 33:51
Yes, that's right. And to everyone listening, this is why I don't talk to your marketing director in the initial conversations and I try to be very delicate about that, but I just say, Listen, I'm going to talk to the principal or our company is just not going to engage with yours. That's just the way that it has to be. And part of the reason is because the relationship is very different. And one of those reasons is because when the relationship has started with the marketing director, it's very much a place where they feel threatened. And I don't want that to happen. We don't come in and say your marketing director is doing a lousy job or your PLs are doing a lousy job. That's rarely the case where we say that and it's never the case where we say it immediately. And part of that reason is because we want that stability coming from the top. We don't want jumping from one solution to another or passing the buck and that really needs to be assigned to the person at the top but we don't say, Hey, these people are doing a lousy job, we say, if there's a hard conversation to have, let's have it now. Because otherwise, when something inevitably doesn't work, then it's people throwing each other under the bus. And I think that that is damaging in all organizations.
GRUBER 35:19
Oh, yes, it's lethal. You're correct. And what usually happens in that kind of a culture is the good people, the star performers are the first ones to put their resume out there. Yeah, they're the ones that jump ship first say, Oh, I can't work in this kind of a culture where every other month I'm worried about the axe falling on my boss or I'm getting blamed for his or her deficiencies. And the good employees can always find jobs. And then what you're left with, very often the second string players if the good people start leaving. Have you found that to happen?
JONES 36:04
I’ve lived that! I've been that person in the corporate world. And it's part of the reason why I wanted to start my own company because I noticed--I worked in radio advertising and sales for my first real job and did that for half a decade. And I noticed that the people that were excellent, that brought the most value to the company, were treated the same as the people who were cancer cells within the company. In fact, sometimes they were treated worse because they didn't complain. And sometimes the people that were the cancer cells were the squeaky wheel and got more attention. And it really made for an organization that wasn't high growth, that wasn't forward thinking, that wasn't adapting to change. And I thought it would just be so much better if the good people were rewarded, the middle people were mentored to perform more like the great people and then the lousy people, if they really are sabotaging, are let go immediately.
GRUBER 37:07
Well that’s correct. Absolutely correct. So, you know, again, that's you could have another podcast--seriously--just on performance management and talent development within a practice because, yes, time and time again, if you have physician leadership that isn't paying attention, and you have department managers or leadership that are not listening appropriately, even to the silences, you start losing the good employees who say, you know, what, am I stupid? You know, I do my work and her work to get the same amount of money, no recognition, and she's still here getting an average performance evaluation. I don't think this is the culture for me to succeed and grow. So we're back to the mindsets, starting with the founding physicians down throughout the practice. That service and developing others is a key ingredient to patient success and good patient outcomes and the growth and the financial success of the practice. So, again, you know, this is what we have to develop and this is why it's become such a passion. I mean, people are talking about emotional intelligence, which is a subset that I'm also very passionate about and that brings in self-awareness and empathy, etc. with patients and with each other and with the employees to report to you. But yes, a practice cannot, cannot sustain good patient outcomes, good patient volume, good reputation in the community and growth and financial success unless they decide to achieve good leadership skills. Now, nobody's going to be the perfect leader. But that good physician leader will learn how to depend on others to share the journey. And usually that could be the CEO, the executive director if they're still part of the Integramed network, or possibly a CEO as these big companies, Shady Grove and IVF Boston or RMA of New York and New Jersey have their CEO. Learn how to depend on these people and their expertise. Learn how to depend on your clinical manager and her expertise, etc. And that's good leadership. Also admit what you don't know and don't have time to learn, so I’ll depend on your expertise. And then as you see the successes, you will trust these people more and more. And respect and trust and influence are all critical in a good leadership culture.
JONES 40:29
With this depend on others theme that you just brought up, it really touches on what I have posited has been part of the reason for moving towards consolidation and corporate interest in the field and larger fertility networks and business structure coming in on the back of venture capital and private equity of depending on others. And I'm not saying that everyone has to do it in that way, but the skill set that you're describing of leadership, it's not an easy one to come by, it's not easy to come by as a natural, God-given or universe-given talent set to have. And I think in many cases, it's very, very unreasonable to expect someone to have that talent set, and to have the talent set of being a brilliant clinician and scientist and physician and then expecting them to have the time and focus to be able to develop both. I think there's just very few people that can do that. And there really are amazing physician leaders that can do both. I think many people are going to be better at one or the other. And for that reason, I feel like the consolidation that's happened, the larger fertility networks has been a response to the shift and I think in the mid-20th century, for example, where this general practice model sort of come from, it was the command and control, didn't have to necessarily be a leader with all of the skills that a leader has to have today. We've established that leaders today do have a much different skill set. And to have both, to be an REI and to be able to lead a company, especially one scaling with several dozen, several hundred, over 1000 employees is exceptionally rare. And so I wonder if you see that. If you think that having CEOs now, where we didn't have those in practices 40 years ago, outside of just really large health systems, and having that type of structure and executive director and consequently, the private equity and venture capital that comes with it, is a response to this void of the founding physician often not being able to do all of these things a leader has to do today especially at scale?
GRUBER 43:09
Again, you throw out these phenomenal questions. And again, each one of them can be its own podcast! There are many reasons today, yes, that you have these amalgamations, these integrations, the venture capital--and that’s huge in healthcare today, through all disciplines of healthcare--because one of the core reasons is finances because it's very hard to be a classic one or two physician practice and make money with what insurance companies are reimbursing, Still in our field, so many states do not mandate reproductive care, etc, etc. So, bottom line is one of the driving forces for these major amalgamations and seeking better capital and diversification of your practice. Whether you open a surgery center or you start investing in a pharmacy, so many of our physicians are also diversifying the types of businesses they're in. The other thing is, you are correct, absolutely correct, you're not going to find a physician who is thoroughly focused on the clinical and scientific aspects of his chosen vocation: help patients become a family. Okay? That's going to have John Maxwell's 21 attributes of leadership? Not going to happen. But what we are looking at as a leader is what I just spoke about a while ago, is even if you're not ready for these amalgamations, or you just want to have monster growth on your own, recognize, again, other people's expertise. Listen. Stay open to advice. Stay open to change and rely a little bit on other people. And getting back to a few minutes ago, allow them to occasionally make a mistake and then regroup and regroup quickly. You can regroup from a mistake. So again, I agree that the great clinical and scientific mind in our field, predominantly those who are physicians, are not going to have every top leadership skill. Impossible. That's not their focus, but they can develop and learn better people skills. Getting back to some of your experiences, sometimes if I'm in a client practice, just teaching a physician to say thank you is huge. You don't have to have donut day, make your own ice cream sundaes. Sometimes just to walk up to the front desk and say it was a tough day today, thank you. You saw us through. It was as smooth as smooth could be under the circumstances. I just want to say thank you. That's huge, huge respect, recognizing a job well done. And while you're taking your growth journey, reward as you go along and sometimes the reward is just a thank you. I don't know that it appears to be agreeing with you Griffin, but I do see your point. But still the physician has to develop, very deliberately, better people skills. And sometimes the managers have to say that you know what, don't walk out and go out to lunch and look like you're angry at the world, even if you are. Just walk through smiling and if you pass somebody just nod or say hello, and go out and calm down. We're all humans, we all have a wide range of emotions. Emotions, again, aren’t wrong, it's how we demonstrate those emotions that become either right or wrong. So just disciplining your emotion as you're walking through the practice to go out to lunch, or go off to the hospital for surgery can speak volumes because everybody's looking at the leaders, starting with the physicians down and the mood and the attitude they're demonstrating on any given day. Have you been to a practice, Griffin, that people just say Okay, Dr. So-and-so is in the building. What mood is he or she in today?
JONES 48:06
Yes, I have!
GRUBER 48:07
Yeah. So again, it does not require the full gamut of leadership skills that you would expect in other areas of the practice, but people skills would be critical. You could have had a horrible disagreement with your spouse at home before you left and when you come in the building, does it go away? Of course it doesn't go away. But try not to have your body language take that aggravation because people take it personally. They don't say, Oh Dr. So-and-so must have had a disagreement with his spouse or had a bad drive he experienced in his commute to work. They personalize it. Oh, what is he mad about here today? What is she disgusted with today? Or disappointed in today? Must have been on the phone on her way to work. And you have to be aware how you're being perceived by the people who work in the practice.
JONES 49:12
Why do you think that you've embraced this so much, Rita, that you've been so interested in, adapting to the new style--and not just adapting but really embracing it. Because I see people that are a lot, if I can be frank, that are a lot closer to my age than yours, that behave much, much older in their mentality of these kids now--I see people now that I'm in my mid-30s, complaining about the new generation of people in their early 20s entering the workforce, and I think, do you not remember us going through this just 12 years ago? And whereas you yourself have really always invested in learning new things and embracing new people and it's one of the reasons why I just got attached to you because you were one of the first people to see potential in me, I think. And you always encouraged me to take on leadership positions and you encouraged me to reach out to other people. And I part of it, I see it as you being--that's maintained cultural relevance and I want to have the same thing. I want to be rocking for a long career. And I think part of doing that involves bringing people up, but also I, you know, if I can pay you the compliment, I call you the youngest person in the field. And I remember two years ago, I think it was we were in Atlanta, and we were having lunch together. And you said, Griffin, I want to talk about blockchain. And I thought Rita, you're so freaking cool. Because you're constantly adapting and learning and a lot of people get old before they're even 30. And stay kind of in a mentality of an idealized version of things that may or may not have been and you're constantly adapting and I think it's probably a lot of work and takes a lot of bandwidth and I wonder why you do it.
GRUBER 51:05
Okay. Well, first of all, I truly love people and I love to learn from people. I love to learn, okay? And the more serious end of that is, I truly think I failed my leadership role in retailing. I was doing retailing for just about 15 years. I was fortunate I was part of the female experience--I’m from that generation that I have scars from hitting the glass ceiling. So in my world of New York retailing, in administration, buying offices were always different. In New York retailing, I was the second woman to change history that was promoted to what we called then an Executive Director in one of the stores. I was the only one to survive that role for more than a year and other promotions up to that level, I was either the first or second woman. And again, the only woman who survived and I had a personal reason to do that. I was raising three daughters alone, and I certainly wanted a career and good financial stability. But I think I spent more time focused on the numbers and pleasing the bosses, Griffin, than on the people. And yet I was very fortunate I became what they call their “best closer.” We were in the process of closing down and the chain really almost shut down when our current President bought them. But that said, I was a good closer and because we had minimum shortage and shortage comes more from employees and outside and the employees stayed until the doors were locked. So there was a part of me who, liking people came through in walking the floor and talking with them and talking with them personally, it was part of my persona and that came through, but yet on a business and it was sort of schizophrenic. I was about money square footage, making the numbers, saving the budget, etc, etc, and getting promoted to a bigger store. So when I left retailing and was choosing my new career, my new career sort of found me and that was the IVF America at the time, before it even became Integramed. That was when I decided I wanted to bring to my career more of who I am and develop better leadership skilsl. And that was another journey of 15 years, truthfully, Griffin. And I say by the time I left RMA of New Jersey, consistently learning, learning our business, learning what's happening in the business and learning in health care, not just human resources or performance management or business strategy, I was able to integrate my true caring for people and still live within a lot of the regulatory framework of HR. We were almost 400 employees when I left RMA, they’re now almost 700 employees, and still bring compassion and your employer cares about you to my every day. And I say if I annoyed any group, it was above me, rather than my peers or below me. But other than that, I just think you have to keep evolving as a person, Griffin, and I'm facing another birthday soon and I don't want to stop what I'm doing even on this part time consulting basis. And I love it. I have grandchildren that are your contemporaries, and I learned from them all the time, Griffin. And that keeps my grandma connection very special and very special to those young people. I'm never going to show them how to bake cookies because I don't bake cookies. So maybe from the Pillsbury tube, but when they're putting together a resume or they're having a problem on the job or whatever, they give grandma a call or send a text, Are you available or they send me an email, can you look this over, Grandma? And I love that relationship. I just do. Well, they'll talk about maybe a dating relationship or something else that's personal. So your generation and the generation now that's following you are so interesting, and so different. That shame on anybody who does not want to get in tune with what you have to teach us. And we still have a lot to teach you. And by the way, you know what's going to the Supreme Court? The term, “Okay, Boomer.” Did you know that?
JONES 56:18
I think it's an ageist term, I think it harkens back to--what you're talking about right now, Rita, is the other side of a conversation I had on the podcast last year with Hannah Johnson from Vios about the you know, the Millennial/Boomer divide is is not just a generational management issue, but it's also an ageist issue, and it goes both ways. And I see my generation now that we are in our mid 30s, now that we do have some powers and in executive director roles, owning companies starting to say well, to heck with these guys that didn't cut us in on the deal for the last 12 or 15 years. And I think that's a mistake and I don't like the term “Okay, Boomer” because I don't like anyone being discounted for their age. One of the reasons I like about your style is that I think I'm a lot more eager to learn from you--I'm always eager to learn from people in general--but it makes it very easy because it's a two way conversation. And I think people would be really remiss not to realize that there's always something more to learn and the wealth of experience that older generations have is really compounded in a beneficial way with the youth and a little bit of naivete and ingenuity of younger generations. And so I don't want to, you know, interrupt your point too much, but I would feel remiss concluding the show without adding that.
GRUBER 57:50
Oh, no, I appreciate it. And you're right. I mean, I hope we have a relationship that even becomes personal when I'm not doing any business anymore. As much as it might not be professional for this podcast but I always joke I have a granddaughter for you. So I laugh about that because you could ask my daughters, I've said that more than once. She's in New York now and she's actually in sales. She's actually in healthcare sales! But all of that said, all kidding aside, I think, again, we get back to the culture of the work environment. So if that 60-something employee is so afraid that the younger team now is out to get the job or demean them in any way, they get defensive, they're not open to change, etc, etc. And it becomes again a toxic environment. The them against us, the young against old, and somehow whether it's intended or not, discriminatory behavior can sort of seep in that environment and unfortunately, become litigious to the practice, unfortunately, and that's not where it was all intended in the first place. So again, it's how do you introduce things that I can--I remember one day, Dr. Bergh called another colleague of mine into his office, and they were about to promote somebody, and certainly much younger than me, not necessarily my colleague, and he brought her into the room. And he said, so and so you know, Rita and he said, they are a font of information for you to help you succeed. So I'd like you to spend time with them and I'm going to help create that time. And I want you to start today by going out to lunch. Just ask them questions. They'll share with you, they will be a resource to you. Now, that was a good start! You know what I'm saying? For her and for us in building this relationship. And again, just have some common sense on how you put a millennial in charge of a 60 year old. It can be done and it can be done successfully. The other side of that is if you haven't continued to develop your employee, especially in the world of technology, that puts the older employee at a tremendous disadvantage.
JONES 60:41
Yeah.
GRUBER 60:42
And that's where they get so defensive. Because it isn't just about the new EMR anymore, you know, it's about One Note, it's about all sorts of communication within the practice--what they're using, and that older employee if they haven't been brought along with the technology ,immediately goes defensive and it can, unfortunately, cost them the job. So that's also part of a culture, you know, keep developing people, keep giving them new skills or find a niche where they can succeed. And I think that's critical. So it's interesting, I have a quote, if you were getting ready to end the podcast about elitist credibility?
JONES 61:35
I'd love to hear it.
GRUBER 61:36
It's elitist credibility begins with personal success. The people only follow you truly if you come across as the true success, but it ends with helping others achieve their personal success. And I think that to someone. Whether you're ever a manager, whether your name is on the org chart in the top echelon, whether, to use the corporate term, you're in the C-suite, you can be a person of influence. You can be a leader to other people, in your family, in the community, and with those that work with you.
JONES 62:12
Well said. And I think that perfectly encapsulates what you shared with us today, which is leadership principles that I think would have been successful three or four decades ago, even if they weren't common that are successful today that I think are going to be successful three or four decades from now. And I've really enjoyed the conversation that we've had and I hope that you share it with your grandkids so that they drop me an email so that I can tell them how cool you are. It's been such a pleasure. Miss Rita Gruber, thank you for coming on Inside Reproductive Health.
GRUBER 1:02:43
Thank you, Griffin. Bye-bye now.
***
You’ve been listening to the Inside Reproductive Health Podcast with Griffin Jones. If you're ready to take action to make sure that your practice drives beyond the revolutionary changes that are happening in our field and in society, visit fertiltybridge.com to begin the first piece of the Fertility Marketing System, the Goal and Competitive Diagnostic. Thank you for listening to Inside Reproductive Health.