Stephen Nakada, MD, FACS, FRCS (Glasg.) is the Chairman of the Department of Urology at the University of Wisconsin. Dr. Nakada is well-recognized as a leader in academic endourology but also lectures extensively on leadership and leadership cultivation. He is also the editor of Navigating Organized Urology, a text offering practical guidance to developing a successful career in urology (and surgery). (Music Credit: Sunshine, Simon Jomphe Lepine.)
Stephen Nakada, MD, FACS, FRCS (Glasg.) is the Chairman of the Department of Urology at the University of Wisconsin. Dr. Nakada is well-recognized as a leader in academic endourology but also lectures extensively on leadership and leadership cultivation. He is also the editor of Navigating Organized Urology, a text offering practical guidance to developing a successful career in urology (and surgery). (Music Credit: Sunshine, Simon Jomphe Lepine.)
My name is Phil Pierorazio and I'm a urologic oncologist, a surgeon. Like many of you, I absolutely love what I do, and I would not choose another profession. But I've struggled professional identity practice efficiency and wellness over the years. operate with Zen is a podcast designed to explore a mindful approach to surgery and to being a surgeon. By discussing these struggles and mindful solutions, I hope together we can create a community of strong and healthy surgeons enjoy. And welcome to operate with Zen. In today's episode, we have the great pleasure of being joined by Dr. Steven Nakada. And we're going to be talking about leadership and mindful leadership. Dr. Nakada, welcome. Please introduce yourself.
Stephen Nakada:Yeah. Hi, my name is Steven Nakada. I'm the current chair at the University of Wisconsin's department Urology. I also am the Chief Administrative physician of the practice plan here at the UW Medical Foundation.
Phillip Pierorazio:Wonderful. Well, thank you so much for being here. You know, I've interacted with you many, many times over the last several years. And some of it's been through endo urology realms and seeing the great work you've done there. And some of it's been through leadership and seeing the great kind of talks and advice you've giving young and growing urologists and physicians. And so that's kind of where I wanted to start today. I wanted to start with your personal leadership story, if you don't mind. When did you make the transition from just being a urologist to being a leader and being a really effective
Stephen Nakada:leader? Yeah, so I, I did my residency in neurology at the University of Rochester, upstate New York, great program. And I did my fellowship at Washington University, under Bill Catalonia, Ralph claim, and actually Ralph Clayman Bill Kelowna, and came to Wisconsin in 1995, is an assistant professor. And, you know, pretty much on short order, our chairman was nearing retirement, which I sort of knew. So in 2000 2001, he made the move to step down and retire. So I became a candidate. And, you know, through, you know, the circumstances I was selected, and that really was, you know, the first leadership opportunity I had now, the real question is, when did I become a better leader. And, you know, it might not have been at that moment in 2001. Because I think it is a big step. But certainly, when I took over, what I demonstrated was my ability to lead a small group, and more importantly, my ability to be successful, both clinically, and academically, you know, including research. So I think, the areas of leadership that that really, you know, take more time and experience, you know, are involve larger, more diverse groups of folks, not just urologist, but people outside of the medical field even, I think the other, you know, key point is, you know, understanding how important every word is that you say, and how important every interaction is. And, and most importantly, I think, to create, you know, sort of the vision, and the optimism, and, you know, be the magnet for, you know, other top young people to want to join you. And that's a big step from where I was sitting in 2001. And I think that's a journey that took time. And as we grew as a division, you know, my feeling was, it was simple. Our goal was to become a department. And we were supposed to do that in 10 years. And and I think, early on, that made my job easier, because every critical decision that came in front of my desk or in front of our team, we would say, Well, is this going to help us towards our departmental goal or not? And if it was, we would do it? If it wasn't we wouldn't. And we studied what other departments did in the medical center. And so we said, well, we're going to act like other departments. So we're going to populate committees across the health system, you know, we're going to seek to market the importance of urologic disease and treatment of urology, and all that ultimately led to an opportunity in 2008. As our chair surgery stepped down, and as we got a new dean to become a department, and I think at that stage, we had developed sort of a good enough portfolio, you know, to pursue this. And so I was excited. One of my colleagues, Dave Gerard, who's sort of been my right hand, man, for just 25 years, we agreed this was the approach and, and then I remember the new dean said, I asked for a meeting with the dean to talk about this, and the new dean said, I'm happy to meet with you. But I tell you, Steve, you know, we're not going to make you a department, that's just not something we're going to do. You know, my goal was not to increase the number of department chairs, you know, if you want to be the head of surgery, I recommend you put your CV in the hat, you'd be qualified, but I'm not going to do it. So, you know, I went back to Dave and our team and said, Boy, he's negative. And the team said, Listen, you know, we've done it, all right, you know, I say, you go and present, and see what he says. So I did that. And after a 45 minute meeting, you know, he, he agreed. And, and that was sort of the beginning for us, in the beginning for me to be a department chair, which is at that time was substantively different. And that at that time, also, it was unusual for a division to become a department without a leadership change within the department with, you know, the neurologist per se. So, so that was a big part of the journey. I would say the other part of the journey for me, has been leading, you know, other organizations, it started with the Wisconsin urologic society, which there they were at the time, you volunteer to be the president. Now, it's actually quite competitive. And then I became involved with the north central section. So I was the president, eventually, Secretary and President in north central section. I've also been the President, Secretary General and President of the endo urological society. And I've been a trustee and President America for urology, so I end the SAU for that matter. But I've done a lot of that work. And I think there are many lessons there that are very similar to the lessons of being a departmental leader, and, and a leader in general. And I think the lesson that, to me is the most important is you have to take a very careful and good look at the organization you're leading, and the people you're leading, try to understand, you know, where they are, and then identify, you know, what should be the best next steps? And, and I think, once you've established that, then you bring you bring everyone along on that journey. And and I think where many people struggle is when they come into a position, they say, well, here's my agenda, or these are the things I want to do. And, you know, that may just not fit. So it doesn't matter who's in charge, you're just not going to convince all these people that to carry out your agenda. And sure, I started by saying, we became a division, I took over the division, we wanted to be a department. I mean, I obviously asked, and I think all but you know, the majority of the folks wanted sort of to have our own autonomy, maybe one or two, sort of like being attached to surgery, and we had those conversations. And ultimately, one of the things that came to our attention was if we became a department, our paymate, come down, you know, our salaries may come down. And everyone agreed, eventually that that would be okay. And then in the end, our salaries went up, because there were just other things we just didn't know about in terms of funding. But But I guess what I'm getting at is, you know, you have to sort of take the temperature of the people you're leading, you have to figure out how to do that. And the good news is, that's a good process. You know, because people love it. When the boss says, Well, what do you think we should do? And I think it's one thing to ask, and then it's another thing to mean it right. And I think in some ways, leadership is really, you know, sort of servant leadership to use a term that you know, well, I mean, I'm here to help everybody else, frankly. And if we're successful, then I'm successful in that might sound simple, but it's not, as you will know. So, you know, that's my opening gambit on this thing.
Phillip Pierorazio:That's great. Thanks for sharing. There's, there's a ton to unpack there. And I've been jotting some feverish notes and things I want to talk to you about. And I'm sure our audience wants to know. But let's segue right into, you know, you talked about people kind of understanding the culture you're leading. And I think that's a point where people can fail miserably, but is by trying to impart themselves too soon, and not understanding the culture. But to some degree to be successful and impart your your agenda. You do have to change culture. And sometimes that's a little change. And sometimes, that's a big change. How have you kind of approached cultural changes within within your group? Or, you know, other groups?
Stephen Nakada:Yeah, generally, culture change is big. You know, even though you can say it's small, but usually, if it's tangible, it's it's bigger. But I think, you know, one truth is, your goal when you're changing culture is it's sort of like, if you're on a ship, you know, if you're on a cruise line, you want to change the direction of the ship without anyone noticing. Right? I mean, ultimately, that's the best goal. But I do think, you know, the first thing you do with culture is you have to lead by example. I mean, there's no question. And I think how you conduct yourself, you know, and how you as the leader, listen, and ask questions, you know, that's culture changing, usually, from the get go, frankly, and, and that's probably one of the hardest skills for leaders to attain. And, you know, myself included, and one of the reasons it's a harder skill is because, you know, to get into the position to become a leader, to some degree, you don't listen, you you do what you think you need to do, and you use all your resources to get there. And then suddenly, when you're there, now you have to lead people, so you have to figure out what it is the group will succeed with. And, and I think that's something I learned relatively early, that that it's great to listen. And I can tell in my own team, you know, which, which folks really get it, and are going to go quickly up the ladder and others who need help. And ultimately, that's an important truth, too. I mean, I think, you know, part of changing culture, is the concept that you're there to help, you know, your colleagues and your team mates, you know, achieve their goals. So you're not going to really know what their goals are. Without listening, and, and, you know, and I think you know, this well, too, is that, it's just, it takes a while for people to tell you the truth. And that's okay, too.
Phillip Pierorazio:Yeah, I think, you know, obviously, this podcast focuses a little bit on mindful approaches. And one of the big things that's really hard for surgeons is to be a good listener, we're so good at picking the exact pathway we want and dictating that pathway. And sometimes when we're interacting with a colleague, it's really hard to not interject kind of our expert thoughts and our expert mind onto them. And sitting back and being a good listener is a really important skill, as you not necessarily even climb the leader ladder of leadership, but just to be a good colleague, is to learn how to be a good listener. Yeah,
Stephen Nakada:no, absolutely. And I think it's like this. There's, there's this concept or verbage, of ship of leaders, you know, and I think, you know, truthfully, ultimately, that's what we all want to do. And I found working in small groups, you know, is great, so the idea of, you know, having sections within a department divisions within a department, these are great. You know, opportunities, just like in sports, where they have pots, you know, have players that are like minded or not like minded that you put together so that they can communicate, and I do see, one of the challenges in this sort of lead and listen approach is it's a numbers game, right? I mean, we have 24 faculty now. So, you know, I can't sit down every month and meet with all 24 for 30 minutes. So, you know, we we need to do things in small group, knowing that, you know, everyone has their chance to, to, you know, give their position, speak and so on.
Phillip Pierorazio:So, I'm assuming when you started, you had a handful of faculty now 24, you said, so you've obviously recruited and you talked about being a magnet for talent before. So how do you how do you judge that talent? How do you try and magnetize them? How do you bring them And who are you looking for?
Stephen Nakada:Yeah, I mean, I think to some degree in academic urology, you know, it's a small community. So, you know, I think people tend to look at places in programs where people younger people have been successful. So, so to some degree, it's self fulfilling. In that regard, I think the harder part of that question is, how do you make the right choices? And that's hard, you know, and I'd make the case, you know, we, we've done better than most, maybe, but, you know, it's, it's not easy. And I think, to me, and I've spoken with chairs about this, usually a good recruit, is a two way street. And by that, I mean, it's, if you're recruiting somebody that you really want, and then they really want to be here, for some reason. You know, that's, that's a winner. You know, and, and that's kind of, you know, you're sort of a plus recruit, and then everything else falls off from there. You know, and I think, you know, there are circumstances sure that, you know, certain specialties are very hard to recruit, and then you're suddenly looking into different pool of candidates or a smaller pool of candidates. I think, you know, Madison over the years, and the 25 years I've been here has become a much, much more appreciated destination, then I think, in 1995, and even in 2001, I was, remember in trying to attract some top faculty, and, you know, meeting him at this snow laden airport, you know, here in Madison thinking, why would these people come here? And, and I think I've learned since then, number one, don't necessarily have your interviews in February. But, but more importantly, I think the town in the area has gotten much easier to live in. And it's a great experience for the for the right people. So, you know, there's a lot to that. And I think, truthfully, a lot of it is effort. You know, I think how, you know how hard you look at the CV, you know, how you do your homework, how you kind of assess the interviewer is key. And truthfully, I'm not necessarily I try and identify people that aren't as good. I'm just trying to identify people that I don't think are going to be as successful here. You know, knowing our own culture. And I've gotten better, we've gotten better over time, because we understand our culture better. Yeah, so
Phillip Pierorazio:that's great. But I visited Madison in February, it depends on the right person. I stay on the lake. The Capitol was behind me. I thought it was absolutely gorgeous. But it was also my first kid right person. Yeah, yeah, it was also my first kind of Lake experience. And you got to see the the cars drive out and deliver pizzas to the guys and girls ice fishing in the middle of the lake. So that was a, it was definitely interesting. And I found it cold but intriguing. Oh, good. Yeah. So as we're on kind of the topic of Faculty Development, you know, we're talking about leadership today. So how do you recognize leaders? How do you develop leaders? Are these born qualities? Are these developed qualities? You know, how does that work?
Stephen Nakada:I think definitely, the, these are not born qualities you're not innately born to lead, I think you need two elements to lead. One is you need to want to do it. And I don't know that you're born to want something, you know, so So I would say you have to have the passion to lead. And then you have to be sort of negotiable with yourself in terms of understanding that you need to prepare to lead. And, and, obviously, you know, we've been over this for years that historically that the attributes that make you chairman or make you a leader, are not necessarily the attributes that you need to be a great a good leader, a great leader, right? I mean, you know, having a great academic career, being a great surgeon, those are usually the things that get you into the leadership seat, but in point of fact, you know, when you're the leader, if you do more surgery and do more research on your own, you're going to be alone. So I think sort of this emotional intelligence, you know, the idea that, you know, you can inspire others and help others, you know, that, that's, that's the key and people have to figure out how to do that. And then ultimately, you have to figure out how to negotiate right and you have to communicate and usually communicating and negotiating go hand in hand. So So I think, if those are weak areas for you, you can learn what you know, there. You can take courses. You can learn from others, I think There's no doubt, education, you know, can take take a role, like I think, you know, I don't have a degree like an mha, or an mmm or an MBA. But those degrees help you, because you'll learn all of those skills as part of as part of probably gaining those degrees. But But I think, again, adaptation and flexibility are the keys, particularly to long term success and leadership. And I think everybody wants to do it long term to some degree. And, you know, we're learning every day, there's no doubt.
Phillip Pierorazio:One of the things you brought up there was having a passion for leadership and in your book, and if the audience isn't aware, navigating organized urology, you're the editor, and obviously, write a fair amount of the book, you talk about strategies for career success, and I believe it's performance, purpose leads to passion, and the things you're really good at, and the things you really see. So how do you help cultivate that in your faculty in your residents in the people you're leading?
Stephen Nakada:Yeah, so thanks for, you know, propping up the book. I appreciate it. But But yeah, I mean, I think, again, this is, the first thing is you got to ask the question, you know, that's, that's the biggest thing, I think, is sort of what do you want to do? You know, and why do you want to do it? And, you know, there's an interesting study, and not to, quote The Mayo Clinic, because, because, you know, I don't want to saddle them with this. But, you know, one of the things that was presented from the Mayo Clinic was, if you work five days a week, you know, the best approach is, for job satisfaction is that 20% of that time, you're doing what you want to do passionate about. And and, you know, they thought this was a fairly cogent, you know, forward thinking approach. And my immediate thought was, boy, I don't want to work there, because that means 80% of the time, I'm going to be doing something I don't want to do. So. So I think you have to, you know, kind of identify what gets you going, and then, you know, just seek to get to that end. And, you know, I I'm comfortable having those discussions with folks. And sure you have to put the brakes on to an extent. But, you know, if you want to be the best urologic oncologist on Earth, you know, there are things you clearly have to do that others don't have to do. So are you prepared to do that. And I think sort of the frankness of feedback is the key. And, you know, I recently gave a brief leadership talk at the young neurologist, a UA, and one of the slides that got the most interest was the one on giving negative feedback. Because I think that's critical, you just have to try to figure out a way to give it and not be demeaning or insulting or too demanding. So one of my favorite lines is, you know, that's good, but it's not great. You know, if you want to be great, this is what you needed to do, you know, this gets you your certification. But that's about it. You know, and I think it's good to, you know, have those, you know, given feedback, the hardest thing we do, and and, you know, ironically, it's probably underappreciated, and I remember, when I was program director, you know, before I had someone else do it. You know, it was always a chore to do all the evaluations, right? Of the residents, and then for the residents to evaluate the faculty. But in the end, that's the most important exercise we do. And so I think the calcification, cultivating rather the three P's. A lot of that is just, you know, every day talking about how we're doing things, what could be better, and how to be better.
Phillip Pierorazio:I think that's a really important point. You talked very early on in leadership, how important every word and interaction you have, can be. And I was wondering if you wouldn't mind expanding on that a little bit. Tony, tell us what you mean by the importance of every word and interaction?
Stephen Nakada:Well, a great example is when I first became division chair, one of my good colleagues, who was older than me, you know, we would, he's a very bright guy, and we would talk about cases. And so like, if I wasn't sure, I saw an interesting case, I want to talk to him, you know, I'd have to find him. So I paid him. And then after about a month, he said, Steve, you got to stop paying me. And I go, why? Because because every time I see your office number, I panic. He's gone. I assume I've done something wrong. So that was me just not being self aware that now that I'm the Chairman, if I paid you it's different than if your colleague pages you. So. Yes, you have to be self aware of all the things you say And, you know, I think that comes with experience, it's just a challenge to to be perfect, but I do think I try to explain what I see in a positive way. And using humor is not a bad thing. But I think you have to be able to carefully give, you know, feedback. And again, good, but not great is one, you know, I heard one recently, which I thought was really good, or someone just said, you know, you're too important to this organization to be making mistakes like this, you know, so that's, I think, a fair way to say it. Right. And, and, and I think if you never say it, then you can't fix it. And part of my job is to direct people, you know, towards their strengths. And, and so I think hard. And so one thing I do, and I talked about this, I think in the book is he sort of just like with surgery, so getting to this end piece, right, you know, great surgeons think about the operation, right? And think about how you can do it better. Ralph Clayman used to look at the videotape of his laparoscopic nephrectomies, you know, early and early on in that experience to figure out how to do the operation better. You know, I thought that was brilliant. And so I tried to visualize a lot of things, from surgery to what I say to a faculty member, and even potentially how I'll present a topic, because it can be seen differently. And in point of fact, certain things that I bring to the faculty, I will show to a few select people who I know will just give me real feedback. And say, Steve, you know, this is BS, and you have to just say it this way. And I think a good general rule is like, whenever I walk into a room, I assume I'm in the bottom quartile and intelligence in that room, and it's probably right, right. I mean, if I, you know, I'm speaking to you now, I'm sure your your IQ is higher than mine. And, you know, you're just, you know, listening, you know, to get the information to your audience. And I think that's an important truth. In that, yeah, you got to get the feedback, and then get it right yourself, too, since that's what you're teaching.
Phillip Pierorazio:And I think you'd be surprised at how dumb I am, occasionally. But I think it's a great point you bring up about presence and self awareness, and kind of understanding how you fit into a room. I think one of the great examples you give in the book as well is Tiger Woods, during the tiger slam, how he knew he was not a good sand player, and kind of was very self aware. And you said, yeah, he could have worked on a sand game and improved his weaknesses. But in that short time course, where he had the last major coming up, really focused his game on staying out of sand traps and being successful that way. I think that's a great analogy. And there are a lot of great sports and surgery analogies, but I thought that was a great one you brought forth?
Stephen Nakada:Yeah, well, thank you. I mean, I think like it, you know, the biggest thing, I think, in the long run for for leadership and and for success is sort of to understanding team dynamics, you know, and, and understanding sort of, you know, as our department, I'll use our department as an example. I mean, at some point, you know, we, as a group, sort of began to realize, not everyone can have an NIH funded lab, not everyone, you know, is going to travel and speak at meetings. And so you have to begin to have role everyone plays a role and role players and, and again, I think the great teams do that as well. You know, you have, you know, your your people that rebound, like Dennis Rodman, then you have Michael Jordan on that same team, you know, and you put all these people together, and then you have something that's irresistible. Others have said to me, when I brought that vision in the past, say, well, urology isn't the NBA, or isn't the PGA Tour, but urology is still about people. You know, and I think, you know, to, to a large extent, understanding the dynamics of, of your team, you know, is is important, and today more than ever, you know, Google's a good example. I mean, they, they understand, you know, all the team members, and if everyone's not speaking or people are inhibited from speaking, you know, you know, that's a problem of the team. It's a group problem on individual problem, which I wouldn't have said 10 years ago, frankly.
Phillip Pierorazio:Yeah, no, that's a great point. And I love the the bowls analogy. I was a Knicks fan growing up in New York and had a lot of heartbreak watching the draft watching the bulls win. But you know, I think where people get into the problem is where they think Michael Jordan is more valuable than Dennis Rodman. Right, they have a different skill set and and Michael Jordan would not have been as successful without Dennis Rodman, the team would not have been successful without Scottie Pippen, you needed all of those players to come together and play their roles and do the things they do well. And I think we see the same thing in surgery, right? Our surgeries aren't successful if we don't have a good nursing staff or a good tech team, right? Or it could be more successful with with good teams, and doesn't mean the surgeons better than the nurse or the anesthesiologist, no, we're all part of the same organization and the same structure with the same goals.
Stephen Nakada:And I think COVID has been an example. It's a really testing example. You know, because now you, I mean, we're coming out of it, somewhat now. But a lot of the interactions you have to have in critical moments are virtual. And I think that's where, you know, a lot of it's luck of the draw, I mean, if you already have a strong team assembled, you could make the case you'll do better, you know, because you'll have all your faculty at every meeting, because you just have to turn on your computer. On the other hand, if you're a new chair, and you're building a team, you know, I think that provides or causes unique challenges. But But ultimately, you know, I think, you know, the leader, you know, what do leaders have to do? And basically, you know, my boss said it best is three, three things, right. Chairman or leaders have to master logistics. Right, that's the first thing. You know, and so that's the basics organization balance the budget, you know, prepare the Department report. The second is manage crises. You know, and I think a crisis, you know, really tells you who the leader is, right? I mean, I think, and, and COVID was a great example. And I think nationally, we got great evidence of which departments and programs and Institute's were prepared, you know, for this crisis, and could manage it and create data, create educational programs, and others that good. So crisis definitely separates it out. And then finally, the third is common sense. You know, if you can do the first two things and have common sense, then you have the whole package. Because I think at times, when you're mastering logistics, and you're in a crisis, sometimes common sense is lost. So I think the top people can sit down and say, Well, you know, we're just not, at some point, you know, going to continue X, Y, or Z. And in the case of COVID, you know, there had to be a point where you had to, you know, either change how you were doing things or, you know, secede to the health system. But anyway.
Phillip Pierorazio:So, we're, we've been talking for a while we're getting towards the end, we've talked a ton about leadership successes, if you wouldn't mind, take us through leadership failures and how you manage the other side. Yeah,
Stephen Nakada:I mean, I think, you know, the first truth is, you know, if you've been a leader, a time and you say, you've never had a failure, you know, you're either lying, or it's time to write the book, you know, and I'm interested in, I think, it's pretty simple in terms of management of a failure. And that's, you have to admit to it. I mean, I think, in the end, there's nothing more powerful than saying, you know, you made a mistake. And, you know, you take full responsibility for it. And, you know, you'll do your best to make amends for it. And I think most leaders make mistakes. And the key is the great ones. I'm not saying I'm a great one, but a great leader, will have many more many, many more successes than failures, right? And, you know, one of my attendings used to say, every time we had a complication, because we got to learn from this in and we got to have a lot of cases go well, before, you know, we kind of exonerate ourselves from from this, and I think that's true. So, so that's my thought on how you manage it, you know, personal failures. I'm trying to decide what would be appropriate to talk about, but I would say, for the most part, the biggest thing that I see as an area of improvement for myself is, you know, at some point, if you see someone has talent, but they don't necessarily want to use it. You know, I have to be quicker to accept that And I think I can see certain folks that I work with that have so much ability, yet, it's just not a priority. So I have to sort of come to grips more quickly with the concept to say, that's okay. You know, you know, I get that, you know, for you, this is eight to five. And, and obviously, the work you do is outstanding, and we're just lucky to have you. And I find it hard to, to not, you know, move that person forward. But maybe those are areas and, and, and circumstances they just don't want to be in because their personal lives are more important. And I think to some degree COVID kind of shows us this too, right? In the sense that people do begin to, you know, reevaluate and reassess, with all that's happening. And to me, what's interesting, in terms of all the conversations I've had, is a lot of the people that I view as, as you know, leaders in our field, are even more invigorated, you know, because of the crisis we've been through. And so that's kind of a true stamp. So maybe, to me, the not seeing the same degree of engagement that I might have myself is hard, and I gotta let that go. So there you have it.
Phillip Pierorazio:Yeah, I used to call it the, you know, Dr. Walsh, used to give us a use of called the spider man talk, you know, with great, with great power comes great responsibility. And some people take that one direction, and it washes over some people, as well.
Stephen Nakada:Yeah, I've heard the spider man talk story and my thought on, you know, Phil, and I think it's an important question. I mean, I think, you know, Do do you give the spider man talk anymore? In 2021? You know, I think it's almost better that you don't, because you might, you know, trick someone into the wrong thing. And more way for them to ask you, you know, ask you about the blue and red suit.
Phillip Pierorazio:You know, no, I think I think you're right, as you said, kind of before, you know, you have to want to fill that role, right? And you have to negotiate with yourself and be willing to, to make the sacrifices to get there and, and forcing that on somebody is mistaken for both people,
Stephen Nakada:then, let me tell you a quick story of mine. I remember, I was a junior faculty at the time, which wasn't for very long, as you know, probably six years. But in that period, we had this really outstanding resident. And my boss said, Hey, listen, you know, you got to talk Dr. X into going into academics, you know, cuz he wants to go into private practice. And I think, you know, you can convince it, you're a great role model for this, you can convince him I said, of course, so, I call him into my office, and we start talking, and again, here in the IQ, the IQ scale, he's, he's got more, you know, so I'm just listening. And he's telling me, Well, you know, he's got all these plans, and you can join this practice. And, and so because so what do you think? And I said, shoot, that sounds good to me. You know, you're exactly where you want to be, you know, and, and so anyway, I, he leaves my office and my boss comes down the hall, he goes, Well, how'd it go? And I said, Well, I think he's in great shape. And he goes, so he'll go into academics. I said, No, he's going into private practice. And he goes, What did you do? And I said, Well, this is a guy who actually knows exactly what he wants to do and why. And he's more than qualified to do it. So why would we interfere with that? You know, he's given us five years or six years of his life to learn urology, and we've taught it to him, even though he doesn't really need all the lessons we've given him. You know, we pat him on the back, and he's gonna make us proud. And isn't that okay? And the chair kind of shook his head and walked out. So
Phillip Pierorazio:in all fairness, right, he achieved his his three P's right, performance, purpose, passion, and it wasn't necessarily aligned with what you or I do, but he achieved his successes. And and that's wonderful. I mean, that's all you could hope for people you care about, right? Yeah, you got it. Good. So, at this point, I'll kind of summarize some of the things we went through, of course, and then ask you if you know if you have anything else you want to talk about, but you know, I think you gave some really nice tangible advice for people considering leadership. You talked about taking on leadership roles outside of your institution to kind of build experience, whether it's in your section or your your society or whatever that may be. You talked about leading by example. You talked about knowing your audience and being a good listener. And some of the kind of mindful strategies you brought through throughout the talk, were being self aware, knowing the people in the room and one of the hints you you gave for doing that was assume you're in the lowest quartile of intelligence. And, and, and that, that brings about humility, right, which is another mindful approach. And it's humility, being a good listener. And you also talked about how you know, you're ready for leadership. And the three skills you said a good leader has, they can master logistics, manage crises, but also have common sense, or emotional intelligence, they can kind of assess the situation. But more importantly, you have to have a passion for it, this is something you want to do, because there are going to be sacrifices you need to make. And so I thought was a really thoughtful conversation today, and just want to give you the opportunity, if there's anything else you want to talk about, or questions you want to pose, we're still going?
Stephen Nakada:Well, I think, you know, that was a brilliant review. So thanks for that. And I think the podcast is outstanding. So congratulations, on all your efforts in doing this, you know, and and all I can say is, you know, kudos to the effort. And I do think it's a tremendous medium. You know, I listen to podcasts and daily messages, you know, and you kind of filter out, you know, what's, what is relevant to you and what's not, and what, what excites you? And what doesn't, and I think that's the key, you know, there's this old adage, you know, in the, on the research world, it would be more data is always good, right? And in the sports world, more practice is always good. And, and, and, you know, I think, or more instruction is always better. I do think it's great to hear a lot of stuff. But I think the real sweet spot is is, you know, there's always going to be the one or two things in a podcast that really flipped the switch, and you write those down and make a list. And I have that on my phone, some of the some of the best things. You know, I've heard. And I think that's kind of, that's just a great part of doing what we do.
Phillip Pierorazio:Thanks for your support. And thanks for all your input and conversation today. Thanks again, Dr. Steven micarta.
Stephen Nakada:Yeah, thank you.
Phillip Pierorazio:Thanks to the audience. Well, we'll see you next time.