Snap Judgments in Veterinary Medicine
The practice of leadership in medicine should not hang on outcomes alone, and there are lessons to be learned about it elsewhere.
Author’s note: This was originally written in September and edited into October of 2022. Since then we have the benefit of hindsight on the Giants’ season but I kept the tone in its more or less original form. The New York Giants would finish the season 9-7-1 and earn a playoff berth. They would beat the Minnesota Vikings in the Wild Card Round, but lose to the eventual NFC Champion Philadelphia Eagles in the Divisional Round. A very respectable year.
Veterinary medicine is a very small world and we are prone to looking only within to find insight and wisdom. This intentionally narrow worldview limits us, I think, personally and professionally. Most of us have other hobbies and interests that are wholly separate from our profession. In those things we often find more than just recreation, but opportunities for growth and development that enhance our professional selves and our profession.
I’m a veterinarian, sure, but for far longer have I been an avid and insufferable sports fan. And as such I often find metaphors in the happenings of sports for veterinary medicine, leadership, and life. As of the time of this writing, the New York Giants, an American football team, is 5-1 under first year head coach Brian Daboll. Noting the new coach’s success recently, sports journalist Chad Forbes tweeted this week:
"Brian Daboll is going to get other Coaches fired. Owners watching from afar see a 1st Yr Head Coach with a talent deficiency winning games nobody saw possible. Team has even bought in. It’s the best 1st Yr Coaching job I can remember. 4-1 with this roster is just absurd.."
The tweet has more than 7,000 likes, nearly 500 retweets, and made the front page of r/NFL on Reddit. This is all to say that it's getting some attention in the community that cares about such things. A community populated largely by avid and insufferable fans.
And, being an avid and insufferable sports fan, I can't help but reflect on this "hot take" by a journalist. It seems to speak to an urgency for success that isn't always desired and pursued in a healthy or productive fashion. The desperation for immediate returns and results can create a toxic environment that dooms leaders and teams who would otherwise have been wildly successful.
Because I'm an avid sports fan, I had an approximate idea of how a number of successful coaches fared in their first years as head coaches and, insufferably, wanting to make a point, I looked it up.
The following is a list of the four coaches with the most Super Bowl wins in NFL history, the championship of professional football, their first year head coaching records, and their Super Bowl wins:
Bill Belichick: 6-10, 6 Super Bowls
Chuck Noll: 1-13, 4 Super Bowls
Bill Walsh: 2-14, 3 Super Bowls
Joe Gibbs: 8-8, 3 Super Bowls
Two Super Bowl wins as a head coach more or less guarantees you a spot in the Hall of Fame. Three or more is rare air, marking you as an all-time great among all-time greats. These four men account for roughly a third of the championships won in the modern era. For further perspective, of the 516 men who have ever served as NFL head coaches, four account for a third of championships. They are a combined 17-45 in their first seasons, and only one of them even sniffed a winning record in their first season as head coach. While they combined for 17 victories in their first seasons, they now combine for 16 championships in their careers.
I consider this when I think about the praise heaped on Brian Daboll and the dramatic comparisons we so badly want to draw. We may become so results driven that we don't allow time for growth, both personally and organizationally. We want so badly for things to work now that we do not allow processes to develop, plans to mature, or organizations to change. There are any number of trite aphorisms about how we must be patient in the pursuit of achievement, but I'm partial to Emily Dickinson's slant: "The truth must dazzle gradually or every man be blind."
Blinking in the brightness of sudden success, we can still be mindful that not all success is immediate and not all achievement can be measured so cleanly. Do we expect Coach Daboll destined to achieve Hall of Fame success based on what amounts to little more than a great start and a modest sample size? As a fan of an opposing team in Coach Daboll's division, I certainly hope not. But moreover I don't expect his record of wins and losses at this point to be reflective of anything more than how many times his team has scored more points than his opponents.
All of this reflection is, of course, because I suspect that Chad Forbes' tweet is to prove true, as administrators and front offices will evaluate and compare their own coach’s results to those of Coach Daboll. (Matt Rhule, the former Carolina Panthers head coach, was fired this week - uncommon to see a coach fired midseason - after going 11-27 in his first two-and-a-quarter seasons.) As a leader who has felt and failed as, I imagine, Walsh, Belichick, or Noll did in their first seasons, I know the necessity of commitment to principle and unflagging effort in the face of objective failure. I also know the doubt and frustration it brings. Not everything works immediately, and while it’s usually easy to identify what isn’t working, it can be hard to know the difference between what isn’t working yet and what never will. Although, fortunately, in leadership in veterinary medicine we are often afforded the opportunity to let success develop gradually. An opportunity of which we ought to avail ourselves, as I suspect we have even more to learn from those careers and achievements we find analogous to Bill Belichick and his six Super Bowl wins than those we do of Brian Daboll and his first seven games.
As veterinarians, we are expected to observe, assess, diagnose, and treat. Usually within just a few minutes and sometimes even less. How many of us can spot a torn cruciate ligament from 20 yards away? How many of us can hear a single clinical sign from a chatty stranger at the dog park and know the precise course of action to take? Heck, some of us can pull off a technical surgery in a shadowy barn on a winter night and a twitchy gelding and never break the sterile field. We are amazing. We’ve also been trained for that for nearly a decade. Most of us have devoted much of our adult lives to the study and practice of medicine. The work is a wonder but it is no wonder why we’re so good at it.
Leadership and organizational change doesn’t happen with the same speed of a surgery or occur with clarity of a drug concentration. Diagnosis of institutional and systemic issues (usually) can’t be done at 20 yards or in a glance at test results. The interplay of even a dozen people is incredibly complex and we haven’t spent most of our adult lives studying and practicing affecting change at that level. While we must get better at being leaders, I think we also need to get better at evaluating them. Acknowledging that the methods of thinking we’ve trained and have become reliable in reaction to a set of circumstances probably don’t serve us as well in wicked systems where we haven’t learned or practiced quite as long or hard.
The first time I submitted an earlier and admittedly rougher version of this essay to a veterinary industry publication, I was politely dismissed on the stated grounds that it was not “specifically relevant to veterinary medicine.” I’ve had other essays never see publication for similar reasons from other mediums. I’d argue, avidly and insufferably, that leadership, judgment, and performance have everything to do with veterinary medicine and we must be able to find value in more places than those that only pertain to veterinary medicine. And while I took another go at strengthening the analogy in my essay, I worry that the attitude that simply because the subject matter isn’t explicitly and exclusively about vet med, it will continue to be dismissed as unworthy of our industry. Such blinders will not serve us well. There is much to be learned in the rest of the world and it is no secret that our greatest professional and industry deficits do not lie in medicine or surgery. We need to find wisdom in more areas than our profession.
Avidly and insufferably, and feeling as though I’ve justified my analogy, I am meandering my way to an altogether different point: Success may come slowly, and we should not discount or dismiss leadership and its processes simply because it doesn’t fill our aching immediacy.