Josh Hartzell: A Doctor’s Prescription for Leadership Excellence

Episode recap: 

Marcel and Josh explored the intersection of healthcare, leadership, and well-being, drawing on Josh’s experience as a physician and retired army colonel. They discussed the transition from clinical practice to leadership development, the importance of compassionate leadership, and the need for consistent, evidence-based approaches to improve both staff retention and patient outcomes. Themes included self-awareness, aligning leadership with personal values, listening deeply, and shaping culture intentionally. Josh emphasized making a business case for investing in healthcare worker well-being and caring for teams as a core leadership responsibility. The conversation also touched on humility, resilience, unity, and lifelong learning, with Josh sharing insights from his book A Prescription for Caring in Healthcare Leadership and personal reflections on resilience, humor, and values.

Bio:

Joshua D. Hartzell, MD, MS-HPEd, FACP, FIDSA, is a retired Army Colonel who spent 25 years in military medicine. He deployed as a Battalion Surgeon with the 82nd Airborne Division to Afghanistan. Dr. Hartzell has held numerous leadership positions throughout his career, including being Program Director for the Internal Medicine Residency and Assistant Chief of Graduate Medical Education at Walter Reed National Military Medical Center and Assistant Dean for Faculty Development at the Uniformed Services University. Dr. Hartzell is also a faculty member at the MGH Institute of Health Professions, where he teaches leadership development. A practicing Internal Medicine and Infectious Diseases Physician, he has devoted the last decade to developing leaders, training and teaching thousands of students, residents, and faculty within healthcare. 

Quotes 

• “If we can improve leadership, that’s not only going to improve the lives of the people providing the care, it’s going to improve patient care.” 
• “Listening is your bridge to growth as an individual and as an organization.” 

 Takeaways 

• Make leadership development a priority in healthcare education and organizations. 
• Practice evidence-based self-care to lead with clarity and resilience. 
• Anchor decisions in values and balance care with accountability. 

Timestamp 

[00:00] Marcel’s personal story of toxic leadership in healthcare 

[04:30] Dr. Hartzell’s military and medical background 

[16:20] Burnout, turnover, and the cost of poor leadership 

[20:15] Leadership training in medicine today 

[42:10] The role of feedback in shaping culture 

[47:25] Building a caring culture for the future of healthcare 

Conclusion 

Dr. Joshua Hartzell makes it clear that healthcare doesn’t have a medical problem, it has a leadership problem. Developing leaders who care deeply for their people is not optional, it is essential for patient safety, staff well-being, and long-term organizational health. His call is simple but urgent: invest in leadership early, practice self-care as a foundation, and create cultures where listening and accountability thrive. The future of healthcare depends on leaders who choose to care. 

Links Mentioned 

1. Dr. Joshua Hartzell on LinkedIn 
2. A Prescription for Caring in Healthcare Leadership (Amazon, Barnes & Noble, major booksellers) 
3. Marcel Schwantes’ website:  marcelschwantes.com

Website - https://joshuahartzellmd.com/   

Transcript

Marcel Schwantes   0:00   

Here we go. Hey gang, welcome back. Glad you are here, and really appreciate that you chose us to tune in and listen to this episode. I know there's a lot of podcasts out there, so we are glad that you are here. Okay, today we are going to have a discussion about healthcare leadership can not a topic that we talk enough about. And so any of you listening that work in hospitals, clinics, treatment facilities, hospices, this episode is, is, is for you. But hold on, though, even if you don't work in these places, you're going to get enough wisdom, strategies and insights to bring back and apply to your own workplaces. So here's what I know about healthcare leadership, because I worked in one for a few years and well, unfortunately, it was also one of the most toxic environments for me during one of my hospital stays as a high level HR person. And the whole reason I say it was one of the most toxic places is because because of the lack of good leadership. And by the way, you can find that story in the introduction of my own book. If you're curious, humane leadership, check it out. So, these healthcare settings, you know, they're, they're full of brilliant clinicians, administrators, doctors, nurses, but they're often, they often fall short on leadership. Okay, too many hospitals rely on on these high level people, these these doctors really by default, without ever giving them the training, the tools, or even teaching them the mindset needed to truly guide their teams. So, what's the result of all that? A lot of stuff, burnout for not only the physician in charge, perhaps, but also for the people that report to those people disengagement, and I'm thinking of a system that struggles to care for the very people tasked with caring for the patient community. Okay, so if we want healthier organizations and then better outcomes. We need more than just great physicians and and great administrators that are brilliant on strategy and and drive and innovation and charisma. No, no. Okay, no. You know, nothing wrong with all of that, but we need great leaders to serve others at the highest levels of health care. So today's guest knows all of this firsthand. Dr Joshua Hartzell is a retired Army colonel who spent 25 years in military medicine. He's lived and led at the intersection of medicine and leadership, and he's here to share why developing leaders in healthcare isn't optional. Optional anymore. It's this is really mission critical. Dr Hartzell is now a practicing internal medicine and infectious diseases physician. He has devoted the last decade to developing future leaders training and teaching 1000s of students and medical residents and faculty within the healthcare sector. Dr Hartzell is a sought after speaker and coach on leadership development. He brings all of these leadership lessons that he has earned and learned really throughout his career, to readers of his brand new book, by the way, which is entitled A Prescription For Caring In Healthcare Leadership. I'm telling you, this is a a page turner that is full of awesome insight strategies and and you're going to get to learn firsthand that the lessons straight from the author today in this very episode, and speaking of Dr Josh Hartzell, now joins us. Welcome to the love in action podcast. 

Joshua Hartzell   4:25   

Well, Marcel, thanks for having me, and thank you for that very kind introduction. It's really when I saw your podcast initially and then read your book, I was like, wow, this is someone whose voice is first off, so incredibly needed, not only in healthcare and beyond, but really resonates with many of the thoughts and ideas that I have. So, I'm excited to be here and talk with you. 

Marcel Schwantes   4:46   

Yeah, I'm excited to talk to you too. I mean, I alluded to it that I think I have a special place in my heart for those in healthcare settings, because I was in that setting and saw the worst of humanity. See when you know when it comes to leading, leading other, other people. So, yeah, I'm glad, I'm glad you're here. We have to have these, more of these comments conversations. So, all right, so we start like this. You ready?  

Joshua Hartzell   

Do it. 

Joshua Hartzell   

What's your story? 

Joshua Hartzell   5:17   

So, it's really an evolving story, and you actually touched on, I think, some of it during your intro. So for the majority of my adult life, or actually all of my adult life, until recently, I was in Army Medicine. I spent the first 25 years of my sort of career as a physician in the US Army, and the first part of that was focused on being a really good clinician. So, I was an infectious disease and internal medicine doctor. I did a lot of clinical patient care, and that was my focus. And then after a few years, I really, I think, honestly, if I wasn't a physician, I would probably be a teacher. I sort of gravitated toward doing medical education and helping to train future medical students and residents who were in graduate medical education, and I did that for several years. And during both of those processes, what became apparent to me was that the real challenges that we faced at work were not the clinical ones. And I don't want to discount, like, the complexity of clinical care, like, it's really hard, and people spend a lot of time, you know, developing those skills to be really good at their work, which we're all grateful for. But what I noticed is that the most of the real challenges we had were actually leadership challenges. And in order for us to be effective as clinicians, physicians, nurses, physical therapists, we really needed to figure out how to lead more effectively so that ultimately, through that leading more effectively, we could deliver patient care more effectively. So, as you mentioned, I spent the last 10 years or so of my career really dedicated to helping both trainees, medicals and students, as well as our faculty, think about and become more effective leaders. And then as I was transitioning from the from my army job to my sort of my new civilian role, I had some time, and I've always been a huge, avid reader, and I wanted to sort of capture those lessons and put them in the book. And boy, that was a process, as I I know you're aware of, but I'm really excited about, like, the ideas and the thoughts and and how through your work, my work, others work, we can really start reshaping the culture of medicine so that we can take care of the people delivering the care, as you mentioned. Yeah. 

Marcel Schwantes   7:39   

Well, yeah, okay, so there's a lot of rabbit holes I want to go down there, but I thought I'd choose this one maybe to as a kick start. You know, in medicine, as far as I know, and you can correct me if I'm wrong, medical school graduates in those white coat ceremonies, they make some form of public oath or pledge about, you know, what it means to be a physician. I know some of them borrow from the historical, you know, Hippocratic oath. I don't know how relevant that is today, or even if it is relevant or not, but you know, a lot of them make their own personal declaration right of doing no harm, respecting patients, upholding integrity, etc, etc. So right at the start of your book, you make a different kind of pledge, the healthcare leadership pledge. I have never heard of any physician having a healthcare leadership pledge. So, in essence, tell us what it is. And why did you feel you had to include that in your book? 

Joshua Hartzell   8:46   

Yeah, the real impetus for it was one most people. Almost everyone in healthcare is super busy. So, the idea behind the pledge was to capture the essence of the book in a very short, summarized format, with the goal that people could go back to it or look at it and say, Okay, here's the behaviors that I can take if I want to take care of my people. And I just outlined them, like top to bottom. You know, here's a list of behaviors. Put it on your desk, post it on your wall if I want to be more effective at taking care of the healthcare team. Let me do these behaviors. And the idea behind the pledge was also sort of about, look, I'm going to pledge to do this like I took the Hippocratic oath to take care of my patients. Yeah, I'm going to similarly take this healthcare leadership pledge to take care of the people, taking care of the patients. 

Marcel Schwantes   9:37   

Yeah. I just wish that we saw them more of as a as a tradition for those because a lot of physicians are going to move up the ranks into leadership and management roles, but they don't take that pledge. Is which is why we have such enormous suffering in in the people that take care of patients, right? Eight when you talk about employee satisfaction, healthcare settings have very low scores in employee satisfaction and so anyway. So, I thought that was interesting, that you made that, that oath from leadership standpoint, to take care of the people, not the patients. Because, you know, by design, you have to make an oath as a physician to it's your whole world is to treat the patient. So, you know, in full integrity, that's your Hippocratic Oath or your personal declaration. But then what happens when you move up to a leadership role who is taking that oath? So, I really appreciate that. I mean, right off the bat, you start to book with that, yeah, 

Joshua Hartzell   10:44   

and I'm hoping that, I mean again, because a lot of physicians, particularly, are familiar with the Hippocratic Oath of this is what we're supposed to do to take care of patients that the pledge is will resonate with them and help them. You know, just give them a sense of ownership of the leadership that they can provide to others, yeah, and tangible, tangible ways to do it. Yeah. 

Marcel Schwantes   11:05   

Let's talk a little bit about those leadership themes that that flow to the surface. So you interviewed so many great physicians. I recognized a few of them, couple that have also come to the podcast, and so many of them from the armed forces, high ranking officers, retired colonels, major generals, etc. So boil that down all of your interviews with all these people, what would you say are some common themes about leadership from your conversations with with these healthcare execs? 

Joshua Hartzell   11:41   

Yeah. One common theme, and actually, I'll give you two, because I think they're related, is it was very clear interviewing all of these folks, so I'm very grateful for, I mean, their time and their interest in this topic, but they all cared really deeply for the people that they led, I mean, and to the point that many of them, you know, their stories and examples, I mean, they're, they're just very powerful. And it's, it was obvious how much they cared about their people. And the second part of that was within that caring for their people, they cared about whatever the mission was. And that's, you know, easy to say when you're part of the military, as part of our job, is like complete the mission. But I also think for all of the you know, others outside of the military that I interviewed, they were very mission focused, but they understood the key point, which is for us to ultimately be able to be the most successful, we have to take care of our people, because they're the front line who are going to ultimately be able to accomplish that mission. And I would say, I mean, part of it's probably the questions I asked, but all of them to a T. I mean, they just talked about it, mission and people, and how they're not separated, how you have to have both, but it starts with taking care of the people. 

Marcel Schwantes   12:59   

And let's go one step further. You and I were laughing offline, because this, this question comes up a lot, and and this, and here it is, the business case for caring leadership, right? Fuzzy term. So make the business make the business case for it, especially in healthcare. 

Joshua Hartzell   13:20   

Yeah, yeah, it's, it's, it's, we were joking before, like, why we have to keep saying this message. But I think that's why I like this podcast and your book, my book, other books are so important, is because there is a business case for it. One of the things that that I think about, if we just look at burnout, for example, in healthcare, we know that burnout is a driver of worse patient outcomes, increased patient safety, errors, physician nursing, turnover, all of those things lead to increased costs, like without question, if we look at retention, which is a huge issue currently, the amount of money it costs to replace, or, you know, replace a physician who leaves an organization is estimated to be between 500,000 to a million dollars. The estimated cost to replace one nurse is somewhere between, I don't know, 60 to $100,000 if we just took 25% of that money for one person like and think of an organization that maybe has many physicians and nurses that are turning over, and we invested that into proactive initiatives to support the people providing the care, we would save money, and that's just from the retention standpoint, if we looked at it from the patient safety standpoint, again, if you invest that money up Front into their provider well being. It leads to better patient outcomes. It leads to better patient satisfaction scores. There's a great quote by Angela Costa, who I interviewed. She said, You know what makes happy patients happy nurses, right? And it's true. Like, if you take care of the nurses, they feel empowered. Or they feel respected, then they're going to do an amazing job, and even more amazing job, because I think they already do an amazing job, but they're working in a system that doesn't always support them. But how do we be more proactive about this, and actually, again, invest some of these these funds instead of playing catch up? Let's be proactive. The thing I've been talking about recently is, you know, we often talk about secondary prevention in healthcare, right? It's like, if you've had a heart attack, here are the things we do. So, I've been trying to tell this to other healthcare leaders, like, instead of playing secondary prevention with leadership, how can we play primary prevention? What are the strategies and things we can do up front to prevent that heart attack, to prevent that burnout, to prevent people leaving our organization. So, we really need to move towards primary prevention. And to answer your initial question, yeah, that's ultimately not only good for patients and the people providing the care. It's good for the business model as well. Yeah, yeah. 

Marcel Schwantes   15:58   

Okay, so we made a case as we you and I, again, we keep banging on this drum right to make the case, and yet we still see a deficiency in leadership. So that leads me to this question, and level with us, what's the current state of leadership development in medicine today. 

Joshua Hartzell   16:25   

Yeah, it's not where it needs to be. It's very complicated. Look, I'll admit, I work, you know, in a medical school. I've worked in graduate medical education for years, and I've trained hundreds of faculty on leadership. We have a lot of things we're trying to do and need to do. And I think the biggest problem I've seen is that leadership then becomes pushed to the side, and it's always sort of this, oh, you'll get that later, you'll get that later, and then ultimately, what that ends up in is you just don't get it, or you haven't had enough of it. I mean, if you look at the data medical schools in the country, it's very inconsistent what leadership development they provide when you get to graduate medical education training, which is sort of your next step. It's very similar. Some programs don't do any leadership development, yeah, some do a little bit, but having like, a longitudinal, ongoing leadership development program for our trainees and is, is is pretty low. I do think there are organizations that do this really well, but I would say collectively, nationally and even internationally, like my colleagues I work with in other countries, this is definitely an area that that we can improve on. And the reason why I think this is so important is it goes back to some of the introduction is, if we can improve the leadership, that's not only going to improve the lives of the people providing the care, it's going to improve medical education. It's going to make our training better, and then ultimately, what it's going to do is improve patient care. So, our investment in leadership development is really an investment in patient care, both from a time and resource standpoint, 

Marcel Schwantes   18:05   

yeah, yeah, absolutely. All right, let's pull back. I want to pull back and put the focus back on the individual as a leader. Okay, you start Chapter Four with this line, and I quote, you can't lead others effectively if you are not well yourself. End quote, so are you speaking of self care, or is there more to that? 

Joshua Hartzell   18:29   

I think there's, there's more to it, probably, but primarily, primarily self care, you know, I think, and I'm not very good at this look for when I retired from the army, I think I had like, one or two primary care visits my entire army career. So, I'm speaking from a position of, don't do as I did, but try to do better. One of the things I do talk about in the book, though, is I had undiagnosed sleep apnea for years, and I didn't realize the impact that was having on probably my work, the way I showed up at work, in terms of maybe my attentiveness, maybe my emotional response to certain things at times, and just potentially my ability to think it was also definitely impacting some of my stuff at home, because I would be at home and just tired and falling asleep in in when I got treated. I think one of the big things like, and it shouldn't take this to make it an eye opening thing for a physician. But I was like, wow. Like, I really wish I would have done this earlier. I really wish I would have been, you know, taking care of myself more effectively. And I think the other thing that I've seen over time, both when I was doing residency training, but also faculty, is almost everyone in healthcare puts off their own healthcare. And you know, if you're struggling with a physical issue or a mental issue. You that's going to impact your work, like there's just no way to say that. It's not even if it means that you're just not coming in and performing optimally. So, I really think we need to do a better job of taking care of ourselves, and that that includes not only the health that I just mentioned, but also, look the badge of honor of not sleeping. Yeah, we know the data. We know the data on sleeping like, it's just like, if you sleep better and get more sleep, you're like, your cognition is improved, likely your mood is improved. You know, if you're getting exercise, we know what that does for you. I really think that we need to think about the way our health actually impacts our leadership. And one of the things I talk about in the book is evidence based leadership. You know, trying to convince healthcare providers, or really anyone, how to do something is is a challenge, but we talk about evidence based medicine, so one of the things that I'm trying to do is say, Look, this is evidence based leadership. You need. You need sleep. It's not my opinion, but here's the data you need to make sure that you get your exercise. Because, hey, listen, some high intensity exercise actually improves your creativeness, actually improves your ability to think strategically. Right? These are evidence based strategies on how to lead more effectively, and it all starts with, how do I take care of myself as a leader? 

Marcel Schwantes   21:25   

Yeah, I love that. And you know, I was gonna also suggest maybe that some of us haven't really tapped into what holds us back mentally or emotionally as a way to take care of ourselves. There are people listening right now that may have unresolved issues, for example, trauma. They may have unresolved issues that have led to shame, and so they cover up their shame with pride and ego and being this, this person that that operates out of extreme insecurity, right? And so, all these other be, all these other bad behaviors come up and and they're not really leading from from their inner self. So maybe let's, let's banter back and forth about about this. You know, this understanding of sometimes leadership is a journey of building self- awareness to evolve from where we have been, maybe stuck in the past, or perhaps because of family of origin issues, because of our shame, etc, right? And, and, and sometimes it's even because we're not clear on what our values are, right, we don't fully understand what drives us. So, I think we're talking about our inner world. And you have a, you have this, this big thing in your book, about about if you're going to be an effective leader, you know, it starts with that. Starts with kind of, like, understanding ourselves at a deeper level so we can better serve others, so unpack that for us. 

Joshua Hartzell   23:16   

Yeah, I and I know you're a coach as well, and I think one of the things that I've been doing recently with coaches is helping people unpack some of those issues and try to figure out, you know, what is your life story and how is that impacting you as a leader? What? What are the things that, as you mentioned, you're holding on to, that you know are shaping some of the decisions or actions that that you take? So I totally agree with that. I think coaching, actually, for me personally, has been really helpful, and I hope for some of the people that I've coached, it's been helpful to work through some of those issues. And you know your point about values? Boy, I think you pick up any leadership book and there's a chapter or a couple chapters on what are your values? And for me, this has been critical. And really, over the last, I mean, five years as I've had to make some challenging decisions, both at work and other places. And you know, if you're if you're clear on your values and what is important to you, they become your compass about the decisions you make, yeah, right. And if you don't know your values, and then you're faced with these really challenging decisions, what are you using to guide to make those decisions? So, I think the more clear you are on your values, it just it gives you a system or a process to hopefully make better informed decisions, or certainly decisions that you're going to be comfortable with, because you've you've run them through your sort of value lens as to, yeah, you know what? That aligns with my values. So that's the decision I'm going to make. 

Marcel Schwantes   24:54   

Yeah, it's I'm learning a lot about congruence, like you don't want to be. Incongruent, right? So congruence means that your inner world aligns with your you know your outer world or your the way you drive results, the things you want to accomplish, but all that has to align with who you are inside, and that a lot of it speaks to knowing your values. Okay? So chapter eight, you asked this, this question. Here it is, can you care too much? So this is similar to the vulnerability question, like, can you be too vulnerable? So what would you say to that? I mean, is there a line that we must draw when it comes to caring as a leader. Can we care too much? 

Joshua Hartzell   25:43   

You can always do something too much. I actually, I actually just saw a post on this on LinkedIn the other day. So, you know, I think, generally speaking, it's really hard to care too much. There are times, though, where you have to be aware that you're caring for an individual. You know, what is the right decision for that individual, for the organization? And sometimes, you know, this is challenging, right? Like, if we feel like this person, we've given them the feedback, we've invested in them, they're just not doing the job we need them to do despite all of these things. One One could argue, well, if you really, if you care too much, you're not going to hold them accountable. I would actually argue that the caring act is to hold them accountable, and you may have to let them go, because otherwise you let them sort of continue in this space of, Oh, I must be doing okay, or must be, must be good enough, if they're really not holding me accountable. So, I think it's a real challenge to care too much, and I would argue that I'll take my chances with having an organization where people care too much than one where they don't care enough. 

Marcel Schwantes   26:58   

Yeah, Josh, you have so many powerful nuggets of wisdom throughout the book. It's all over the pages. And I mean, it's folks, this is the kind of book where you're going to be scribbling on this, on the on the side sidebar, and putting sticky notes on it, highlighting it that it's that kind of book, because it's just, it's not theory, it's so practical and things that you can apply immediately. So, you write and I quote, again, listening is your bridge to growth as an individual and as an organization. End quote, so let's get into listening as as a really, as a leadership powerhouse skill. I think so, what have you seen in healthcare settings? First of all, I mean, is there a deficit in listening? 

Joshua Hartzell   27:43   

Yeah, I would say twofold. And one is like, as you mentioned, as an individual, and in the second is as a as an organization, yeah, I think as an individual, you know, particularly, we need to be more effective at listening. There's actually a study. I don't remember the exact data, but when you go and see your go and see your physician, they generally only listen for a few seconds before then they interrupt and they start right, asking more pointed questions, right? That's sort of the classic, we don't listen well studies, you know, I think part of it is I can't learn if I'm not listening. So, I can't learn as an individual, but I also can't, like we can't learn as an organization if we're not listening. So as a leader, you really need to spend more time listening and really listening. For me, this is a lesson I learned during my career. I was not good at this. I would often be multitasking on my computer, you know, on my phone, sort of listening, but not really listening, so really just giving someone your full attention and making sure you're listening. And the second part of that is listening with curiosity, to really understand their perspective, trying to, you know, almost challenge your own perspective. Like, what am I missing that they might know something about that will help me better understand the situation. And often, when we clinically, we do this like I might be consulting on a different patient from a different service, maybe the orthopedic surgeons and I need to listen to them, because, look, they're in the or operating room. They're the ones who did the procedure. They have a different lens and perspective than I do, so I really need to be able to listen to them to make the best clinical decision. Similarly, you could take that and put it in a boardroom or a conference room, and as we're thinking about maybe a quality improvement project for a hospital or a new strategic initiative, I need to listen to everyone at that table to get their input for a couple reasons. One is someone at that table probably has a much better idea than I do. That's one. Two, listening, just listening to people is a huge way to show value and respect, right? When I listen to. To, you know, nurses or physical therapists, because they're giving me advice, either clinically or for something else we're doing. It shows that I value and respect you. Yeah, and then I would say, you know, at the end, you know that that listening gives you the best ideas, it allows you to think about, okay, what have I heard? What have I learned? And then, what from this, can I use? And the last key, I think, for for leaders in particular, is, as soon as you start talking, you shift the conversation, right? If you're in charge, and you start giving your ideas, your solutions, you may have just prevented somebody else at the table or someone else in the room from being willing to speak up. So I always think for us, it's important, if you're in a leadership role, to listen first talk later. Yeah, right. Get get that input from others. 

Marcel Schwantes  30:55   

Yeah, this is a great feedback or segue. 

Marcel Schwantes  31:03   

This is a great segue for your chapter 13, which is, is about receiving feedback. And I know as as leaders, we like to give feedback, right? But getting feedback is a different story. And by the way, giving feedback is a is a chapter also in your book, but I want to, I want to touch on the receiving part of feedback. So how do we get to that point where we care enough to want to receive feedback? What do you recommend? 

Joshua Hartzell   31:32   

Yeah, the first thing is, what you just said is that we we actually care enough to want to. This was a real eye opener for me several years ago, and I put this story in the book, but I was in a meeting, and someone gave us some feedback, pretty lengthy email feedback about our internal medicine residency program at the time. And my initial response was, Wow, they're they're really complaining. And one of my sort of bosses at the time, Lou pangaro, who's a very prominent medical educator, he said, so they're not they're not complaining. They still care enough to give us this feedback. And I mean, it was like he hit me over the side of the head with a book. I was like, that. That's a lesson that I need to really take to heart, right? So, when people are giving us feedback. They're giving us that feedback because they still care enough about either us personally or us as an organization to give us that feedback. So our response should be one of caring should be thank like thanking them for that feedback. And to me, this is really a key point, right? So, when somebody gives you that feedback, be open to it. Listen. Thank them for it. If you want to create a culture where people are going to be willing to speak up and give more feedback, point it out, right? Hey, Marcel, I just want to thank you for giving me that feedback, and I also want to thank you for being willing to say something counter to what everyone else in the everyone else in the group has been saying. Like, that's the kind of feedback we need. So I think we need to point it out. We need to thank people for it, those cues, then allow people to see, like, oh, they really do want our feedback. And then the final piece of this really is, like, you get this feedback, what do I do with it? Right? Like, we've all been to town halls. Or, you know, we have the anonymous people, we give all this feedback and, like, Okay, well, what? What happened to it? Like, did it just go into the, like, dark space of the feedback universe? Or no here? And I think this is the closing the loop, right? You get that feedback, here's what I heard, here's what changes we're going to make, or here's what I heard, and here's why we can't make changes, but being transparent and really communicating what you are or are not doing with it, because again, I think that creates an environment where people feel valued, they feel respected, and they feel empowered to continue to deliver that 

Marcel Schwantes   34:01   

feedback. Yeah, yeah. And, yeah. And you mentioned, you know, these are elements that shape a great company culture, whatever your industry. So, let's, let's piggyback on the culture piece for a minute here. Okay, how do we, and this is probably a higher level conversation. When you're talking about shaping culture, it's those that are at the top that have to create the environment necessary, the necessary elements for that to happen. So address that. How do we shape a great work culture? What are the building blocks? What's the starting point? 

Joshua Hartzell   34:37   

Yeah, I want to push back a little bit on the last statement about it starts at the top, because I get, I get this a lot, where people work in organizations and they don't feel supported by their leaders, and, you know, they almost sort of have this helpless stance of, well, what, what can I do? I'm not, quote, unquote, in charge. And so. The challenge that I like to give to people is think about your own sphere of influence. Think about the people you work closest with. That might be two or three people, it might be 10, might be 20, might be 50 or 100 depending on the size of your your organization. But how can you impact your culture for those people? Yeah, because that, yeah, sure, there are conditions from above that are going to impact that, but you have a choice every day how you build the culture with the people you work closest with. So I think that's one key lesson, is be intentional about what you do right to build the culture, but also be intentional about what you don't do every you know James clear, who wrote atomic habits, if you've read it. I love that book. But basically he says, Every action is a is a vote for against the person you want to be. I would argue that every action is a vote for against the culture you want to have in your in your organization. And that can be the smallest level, which we all have an ability to influence. Yeah, getting to the to the larger thing, you know, how can an organization do this? I do think clarity of values, right? What are your values as the top, top leaders, and then specifically, what are the intentional steps that you do to get people in your organization to live out those values? Because all too often we see the values, they're printed on the wall, or they're on the internet banner, and no one really knows them, or they know they're there, but everyone is like, yeah, those are the values, right? But it's not actually what happens in the halls of the the organization. And I think for leaders, you know, the way you can do that is you need to empower every leader below you to live out those values, and you need to actually have discussions about it, and you need to ask them, Hey, what are you doing to make listening a priority for our organization? Tell me what you're doing in your department that is encouraging a listening environment that is encouraging psychological safety. What are you doing in your environment, to invest in your people? What are you doing in your department? Right? So it starts at the top, but then there's an intentional effort by these leaders to make sure that each leader level below them is actually carrying out those values, and the values should drive their behavior. 

Marcel Schwantes  37:21   

Yeah, I'm glad you pushed back, because you were 100% correct. It reminds me of a keynote I did. I did a keynote on servant leadership, and then I get off stage and it's woman comes rushing to me and said, Hey, Marcel, I I am a servant leader, but my executives are not. How do I, you know, shift the environment around me. It says, Well, it starts with you. You're a servant leader. Then, you know, you do? You influence your team, yeah, okay. Well, be a servant leader to them. Don't wait for the people at the top to catch up. They may never aspire to be servant leaders. But start with, like you said, your your sphere of influence, and then, by the way, and I told her, I said that there are clients in the past that they started with their own department team of, you know, five to 10, and then their engagement scores went through the roof. And then those at the top wanted to know what is, you know, Missy or Joanne doing that is outperforming her her colleagues in engagement scores and employee satisfaction. So anyway, so there you go. That's, that was. It's a good starting point to shift those at the top to lead up. Yeah, love it. Love it. And it spreads. Yeah, yeah, absolutely. Okay. I want to ask you to speak to the CEO tasked with shaping this company culture that you spoke, that we're speaking about, to bring out all the elements of care. Okay, how do I start this journey, 

Joshua Hartzell   39:03   

I would ask them, probably two questions. One is, what is your what is your primary mission? What do you? What do you really want to accomplish? And then I would say, how are you supporting your people to accomplish that mission? What are the what are the tangible steps you're doing to best support your people to accomplish that mission. And the reason why, I think, is, like most people, are very clear on the mission, here's what we want to do. But when you start getting granular about, okay, what are the actual things I'm doing to support my people to meet that mission? Sometimes there's a there's a disconnect, right? So trying to just get them to think about that, and then, you know, depending on the organization and what you do, I think it becomes clear, like, what your people need, these are smart people, right? You don't get into these leadership positions without being really smart gifted. But what we want them to do is become. Intentional about supporting their workforce to accomplish their mission. It's better. It's good for them, right? Like they get the results they want, and it's good for the people they're leading. You know, there's, there's so many examples of this within the business industry and within medicine, but yet people still don't put their people first. So I would ask them those two questions, and then we would talk about, okay, what is it going to look like to better support our people, to better reach your mission? 

Marcel Schwantes   40:30   

Yeah, that's great. Okay. As we wind down here, is there anything that we have not covered that our listeners absolutely must know before we transition? 

Joshua Hartzell    40:41   

Yeah, yeah, I guess the only thing, and it's a little bit of a jump on that last point about, you know, investing in your people. So for me, when I think about the most effective leaders I've ever worked with, or the leaders that I respected the most, I knew that each and every one of them was invested in me, personally and professionally. So I think as a leader, what I try to do is, when I if I'm meeting with Marcel, when I'm going into that meeting, I'm asking myself, what can I do to help Marcel with his career, or what could I do for Marcel to help him? Because I know he has these family issues, how can I better support Marcel? And you know, sometimes that's just a simple question of like, hey, Marcel, you've been here for six months. You've been here for six years. What could we do to better support your role here? What would make what would make your work easier? Or, what, what would allow you to be more effective? Right? Because I think most people in an organization, they know what those things are. Or, hey, Marcel, like you've been here for six years. Like, what are your goals or aspirations? Like, are you interested in moving up? Are you interested? You know, I always ask that question because I had a colleague, Rachelle Corrado. I love her. She's like, you know, not everyone wants to move up, so I think understanding what they want is helpful, but then investing in them. So every person you meet with as a leader, just ask yourself, How can I invest in this person, individually, personally and professionally? 

Marcel Schwantes   42:09   

Yeah, that's great. All right, strap on your seat belt. We have arrived at the speed round. Okay, here we go. Josh, a good book you would recommend, 

Joshua Hartzell   42:22 

Culture Code. I love the book Culture Code by Daniel Coyle. I've probably gifted it  

a hundred times. It's just a terrific, phenomenal book well written and it talks about Navy SEALs I mean they could have talked about Army Rangers probably would have been a slightly better twist now I'm kidding. San Antonio Spurs Pixar it's just a phenomenal book I think anyone who's interested in leadership should read it.  

Marcel Schwantes   42:44 

One of the greatest lessons you've learned in life. 

Joshua Hartzell      42:49 

Yeah this this goes back to the book and it goes back to what my parents taught me and it's just take care of other people. You know, I think growing up, I saw my parents do this day in and day out. And I saw the impact they had on other people's lives. And I've seen this with leaders. And, you know, people will do anything for a leader that really cares about them. So just taking care of people. 

Marcel Schwantes   43:18 

 Someone who inspires you right now.  

Joshua Hartzell      43:25 

Someone who inspires me right now. Um, I would actually say, and this is maybe a little, I don't know, personal, but I would say my kids, you  know, I don't, I don't think it's easy to be a kid. Yeah. And, you know, I see them face adversity. And what's inspiring about it is how they just kind of roll with it. they roll with it, they learn, they grow. And I think sometimes as adults, we, we struggle with that. We struggle with 

adversity. And I'm not saying that, you know, kids don't, but, you know, the lessons I've learned from them is like, just embrace it. And it's part of the process. So I would say my kids right now.  

Marcel Schwantes   44:01 

That's really interesting. I got a 12 year old and I see him in his most Resilient form right now because he just started middle school and it's like every day He hears or sees something different and some of it just just kind of floors him Right and he's being exposed to different things and  

you got eighth graders with sixth graders I just came out of elementary school and these are eighth graders or next year will be high school students It's a weird dynamic, but I see Resilience in him and man, I'm proud of that kid so much. 

Marcel Schwantes   44:39 

Yeah, I look up to him. All right good for him a Quirk a habit or something that you're known for that people are gonna say. Yep. That's Josh 

Joshua Hartzell   44:56   

Probably sarcasm, I don't know if I should really say that, but I definitely have. 

A sort of a dry, little dry sense of humor and sarcasm, even to the point where my wife will frequently remind me she's like, you know, people, they don't get that. They don't realize that sarcasm. So I've had to almost sign post that at times that, hey, I'm being a little bit sarcastic. But yes, I have a touch of sarcasm that exists. 

Marcel Schwantes   45:24   

All right. This is a pop culture question. I don't know if it applies to you or not. Favorite superhero movie or character? 

Joshua Hartzell   45:34   

Yeah, I would actually have to say, like, I'm a big fan. We actually watched all the Marvel movies over over, covid, we hadn't had we hadn't watched any of them. So we just sort of, let's start at the beginning. I pick one, I guess it would be Thor. I don't know why. I just really enjoyed those movies, and something about thunder and lightning and control seems interesting to me,  

Marcel Schwantes   46:00   

And the fact that only he can pick up his own hand, hammer, nobody else can. So I don't know there's something there. Okay, name a person dead or alive that you would like to have dinner with? 

Joshua Hartzell   46:13   

Yeah, this would be Theodore Roosevelt. I am a huge, uh, Teddy Roosevelt fan. I've read several of the books on him, and I just find him fascinating. I mean, when you look at like, all the different things he did, you know, politics, military writer, athlete, rancher, I mean, just he literally led sort of a movie esque life, but he was a real person. And, you know, speaking of quotes, I mean, he has so many quotes that are just powerful and impactful. He also seemed to be someone who was not afraid to live out his values. I think it'd be very interesting to see him in, like, the current sort of world and environment, because he was pretty much his own person and just That's who he was. But yeah, I would love to have dinner with him and just ask a bunch of questions. 

Marcel Schwantes   47:10   

Your biggest hope for humanity moving forward, 

Joshua Hartzell    47:15   

less separation, more unity. You know, we live in a very divided world, and I think somehow we have to get past the things that separate us and get back to the things that unite us. Before I deployed to Afghanistan, I deployed with the 82nd Airborne Division, someone told me, they said, hey, look, you know, like the people of Afghanistan, like they want the same things that that you want. Like, they want their kids to do better than they did. They want their families to have opportunities. They want to have, you know, the basic necessities, those types of things. And it was just a good reminder for me that despite, like, living worlds apart, it was very true. Like, you know, we, I think we all want things that are good for our families, good for our kids, our neighbors, but we've become so isolated. And my hope for humanity would be that we don't focus on all the differences, but somehow we come together and focus on the things that would allow us to, you know, all be better and take care of each other. 

Marcel Schwantes   48:21   

Well stated, and you have survived the speed round. All right, Josh, we bring it home with two questions, as we do with every guest. The first one is, you know, we've been talking about principles of love and care throughout this conversation. Pick one though, how do, how do we lead with more actionable, practical love and care? Which what floats to the surface for you? 

Joshua Hartzell   48:48   

Yeah, I think for me, like I've already mentioned a couple, we've talked about listening, and we talked about investing in others. And I will say investing in others is generally my, my go to but I'm going to go with humility, because we really didn't touch too much on humility. And I think, again, a lot of the problems we have now is that we have a we have leaders at all levels, right? You know, small unit individuals, that we just need to be humble and ask ourselves, what don't I know? Or what do I think I know that actually might be wrong, and how can I learn from the people I work with or the people around me? So I just think like having a sense of humility allows us to be lifelong learners and change and adapt and shift to meet the challenges that we need. So I would say Humility is a big one. 

Marcel Schwantes   49:38   

That's great. That's great. All right, Josh, bring us home. What's that one thing that will you want us? You want to really stick with us? 

Joshua Hartzell    49:47   

Yeah, it would be this, every day, every interaction we have, we have the opportunity to positively impact someone's life. And that could be at work, where. I take the time to listen to somebody and show value or respect. It could be taking the time to mentor or coach somebody. It could be outside of work where I have a neighbor who needs something. It could be at a restaurant where instead of being rude to a waiter or waitress, I decide to be positive and give them maybe a little feedback and thank them for the work they're doing. I think if we all started looking at these micro interactions as ways to positively impact the lives of others, I think we'd be in a much better place and a happier place. 

Marcel Schwantes   50:34   

Yeah, well stated gang the book, again, is called a prescription for caring in healthcare leadership by Joshua Hartzell. MD, hey, get this book, whether you're in healthcare or not, and especially if you're in healthcare, get this book, Josh where can people go to learn more about you and connect with you? 

Joshua Hartzell   50:58   

Yeah, so certainly you can follow me on LinkedIn. It's probably the best place, as I post there and put out new ideas. You can also go to my website, or you can you can buy the book at Barnes and Nobles, Amazon, any major bookseller will have it. 

Marcel Schwantes   51:15   

Yeah, I'll make sure that all that stuff is in the show notes. Hey, it's been a long time coming. Glad we did this. I know that we've been chasing each other for a while. I follow your stuff. You follow mine. Let's keep it going. Let's keep that conversation going. It's been such an honor to finally chat with you. I know my audience is going to be blessed by it. 

Joshua Hartzell   51:34   

Well, thanks so much, Marcel. I appreciate your work and your voice and having the opportunity to do this. 

Marcel Schwantes   51:39   

Yeah, thank you and gang, use the hashtag love in action podcast on social media if you want to keep the conversation going. And like I said, look for my show notes on my website. You're going to find a YouTube link to this very episode. 

Marcel Schwantes   52:00   

And all of that can be found on my website, marcelschantis.com for Dr Hartzell and yours truly. Remember in the end, love wins, we'll see you next time you.