Civility: The Most Important Clinical Leadership Trait

Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.

-Viktor Frankl

For more than 20 years, I have served as a leader in a myriad of clinical environments: rural emergency departments, Level 1 trauma centers, urgent care centers, paramedicine programs, and so on. Across the board, I can attribute my success in establishing high-functioning, engaged teams to one powerful technique—and it’s not setting aligned goals or scheduling monthly meetings. Those things are undeniably important, but they fall flat without one simple thing:  civility.

Civility is defined as, “formal politeness and courtesy in behavior or speech.”

The reality is, the culture of healthcare today does not necessarily foster formality, politeness, or courtesy as a default reaction. We face increasing patient volumes and dwindling reimbursement, higher performance obligations and a shortage of quality providers, and pressure to carefully manage patient care across the continuum all while juggling competing egos and priorities among departments. All of this adds up to exhaustion, stress, and burnout. Not exactly a winning recipe for prioritizing small pleasantries. However, consistently, I have found that taking time to do the small things like smiling, saying hello, and genuinely listening pays great dividends in the long run.  

Being a more civil leader starts with your everyday actions. Every single small interaction adds up to how you are perceived as a leader and how much your team members feel you respect and value them. It also affects how they treat one another. Kindness is contagious, and unkindness is perhaps even more contagious. The ripple effect of the culture of your team—the way you treat one another—touches every single aspect of your business from physician retention and patient experience, to operational efficiency and patient outcomes.   

I am not alone in the belief that how you treat people directly effects your bottom line and your effectiveness as a leader. In fact, a study of more than 20,000 employees around the world shows that no other leadership behavior has a larger effect on employee outcomes than civility. In the study, respect outweighed the importance of recognition, appreciation, communicating an inspiring vision, providing useful feedback, and even providing opportunities for learning, growth, and career development.

These are a few ways you can boost your civility quotient to improve department performance and inspire a more productive, focused, engaged team:

Ask, “How can I make your life easier?”

No matter who I interact with, whether it is a hospital administration team at the outset of a consulting engagement, an emergency department physician, or a nursing director—I always start by asking specific questions about how I can better serve them and make their life easier. I find that this simple question garners powerful, useful feedback. Often, the smallest logistical issues spark lasting tensions that can be diffused by simply asking the question, truly listening to the answer, and most importantly—taking action to address the concern.

Take time to say, “Thank you” and “I appreciate you.”

As a leader, you likely have hundreds of small interactions with various people every single day. Taking the time to simply say “Thank you” or “I appreciate you” at the close of a conversation goes a long way to make your team members and everyone you interface with more engaged and invested in their work. Employees who feel respected are healthier, more focused, and more likely to stay. Even nonverbal signs of appreciation can help, such as a wave, nod, or smile when passing in the hallway.

Seek feedback and accountability

Everyone has shortcomings, even leaders. Although we always strive to lead by example, there are times we fail. Being vulnerable to your team and asking for candid feedback is critical to being perceived as a warm, trustworthy, and competent leader. We conduct regular “360 evaluations” that give team members to opportunity to give anonymous honest feedback on our leadership style. It is worth emphasizing here that although simply posing that opportunity is valuable, it is absolutely critical that you apply the feedback you receive. One way to show you have taken the feedback to heart is to write the suggestions down, thank your team for the feedback, communicate specific ways you plan to improve, and establish a regular opportunity for your team to give you feedback on your progress.

Becoming a more civil leader will increase your effectiveness and the effectiveness and engagement of your entire team. It all starts with increasing self-awareness, making small changes to your everyday interactions, and inspiring others to do the same.