AAN LEADERSHIP ALUMNI NEWSLETTER SEPTEMBER 2019

LETTER FROM THE EDITOR, Yazmin Odia, md, mS

We welcome you to the 4^th edition of the AAN Leadership Alumni Newsletter.

We again highlight a recent graduate, Dr. Thabele (Bay) M. Leslie-Mazwi, who relays the impact of the Transforming Leader Program (TLP) on a personal, institutional, regional, and even national and international spheres. Despite his “challenging relationship with the concept of leadership,” he has boldly assumed “positions of leadership” in order to transform the system of care limiting access to life saving stroke therapy at his institution and state as his personal TLP project. The 2019 AAN TLP group project also tackled the daunting and increasing gap between the neurology workforce and rising demand for neurologic care. The 2019 AAN TLP group details three key strategies in an upcoming publication, namely by (1) shaping the demand, (2) enhancing the workforce, and (3) advocacy at multiple levels. Stay tuned!

The consultants again provide food for thought for alumni who seek to grow their leadership skills. Laraine Kaminsky reminds us of the ABC biases that threaten career development of neurologists, especially women and those from underrepresented ethnic and racial as well as LGBTQI populations. She cautions all to remain aware of the “unconscious bias…that is built into and replicated in our institutions and processes.” Selena Rezvani challenges us to boldly speak up and be heard, especially during critical meetings. From “using your body,” to calling out interruptions “within the group” and “outside the group,” and finding “an ally,” she provides five tools to avoid feeling “stuck or silenced” and instead  “speak your piece, address the interruption, and move on.”

We highlight the successful translation of two AAN Leadership Program group projects into palpable AAN initiatives and program. The 2013 Emerging Leaders Forum (ELF) fostered the AAN offerings, including the well-received maintenance of certification modules free of charge to its members as a means of engaging junior members. The 2018 Diversity Leadership Program (DLP) project led to the local and AAN Equity, Diversity, and Inclusion (EDI) committees, focused on “improving the climate/culture, enhancing academic development, improving recruitment and retention, and promoting sponsorship of the underrepresented” racial and ethnic groups. We provide updates on the metrics and goals that objectively measure the success and future directions of the AAN leadership programs.

Join us as we recognize and thank our exiting CEO, Catherine M. Rydell, for her 21 years of exceptional leadership at the AAN. She emphasizes listening as a key to growing in leadership and building a successful team. As she highlights, “neurology needs strong, capable, diverse, and confident leaders” that will tackle seemingly insurmountable challenges like the neurology supply-demand mismatch, the underrepresented pipeline deficits, and the ever-changing legislation attempting to contain healthcare cost while ensuring quality care. Catherine M. Rydell, as AAN CEO, served as a great example of such “capable” and “confident” leadership.

Also, let’s celebrate the recent success of alumni of AAN Leadership programs, from new institutional and national positions to new members of the family. We appreciate your contributions!

REMEMBER! Official AAN Leadership Program hashtag #AANleadership

How was your experience with the Transforming Leaders Program (TLP)?

The program was excellent! It taught me leadership strategies such as understanding group dynamics and accomplishing outcomes by consensus building, skills which are not traditionally taught in medical school. The program also focused on personal growth. The professional and peer coaching I received was invaluable.

How has participation in TLP contributed to your professional success?

Some of the skills I have learned through the program include developing a systematic approach to projects, incorporating organizational strategies to achieve my goals, and constructively managing setbacks. Applying these skills has helped me to obtain greater recognition and visibility within my own institution and subspecialty community. The program also helped me to recognize that neurologists are leaders in the future of health care, and it provided valuable insight into the workings of the AAN as a professional society.

What is your greatest achievement since graduating from TLP?

We have a program at Dartmouth-Hitchcock called HOBSCOTCH (Home Based Self-management and Cognitive Training Changes lives) that is designed to help improve memory in patients with epilepsy. HOBSCOTCH is part of the Managing Epilepsy Well (MEW) Network, which has a strong focus on research and public health outreach to improve quality of life. The HOBSCOTCH program has been shown in randomized controlled trials to improve memory in patients with epilepsy, but it has been a challenge to disseminate the program to a large audience and earn recognition as a viable treatment option. My experience in TLP helped me to formulate a strategic plan to elevate HOBSCOTCH and the MEW Network to higher national visibility. We established a greater presence at national meetings, within community organizations such as the Epilepsy Foundation, and in professional societies such as the American Academy of Neurology and the American Epilepsy Society. As a result of these efforts, the HOBSCOTCH program is now offered in three additional states.

What would you say to a colleague who may be considering application to TLP?

I would enthusiastically endorse the TLP. While many other leadership programs are directed to young investigators or junior physicians, the TLP focuses on seasoned neurologists in the mid- to late career. The skills I learned through the program are invaluable, and the diversity of participants was a great asset. I am pleased that the American Academy of Neurology continues to extend this opportunity to other physicians as well.

Updates from Our Alumni

By LEIGH MARIA RAMOS-PLATT, MD

Aarti Sarwal, MD, FNCS, FAAN, medical director of the Neurocritical Care Unit at Wake Forest School of Medicine (ELP class of 2019), was chosen to be the social media editor of Critical Care Medicine, an official publication of the Society of Critical Care Medicine and flagship journal of Society of Critical Care Medicine.

Amy Hessler, DO, FAAN, director of Women’s Neurology at the University of Kentucky School of Medicine (WLN class of 2018), was appointed as chair of the Clerkship Directors’ Committee. She ran her first meeting on July 1.

Graduating from the Palatucci Advocacy Leadership Forum (2016), Jonathan Santoro, MD, has had a busy 2019. He completed his fellowship training pediatric MS and demyelinating disorders at Harvard Medical School. He also joined the faculty at the Children’s Hospital of Los Angeles and has an appointment as an assistant professor of neurology at the University of Southern California’s Keck School of Medicine. He received an AAN advocacy grant to help develop a video component to his disability education project which he developed at the Palatucci Forum and published on his original project in May. Most importantly, he became the proud father of a son, Julian. 

Consultant Corner

Challenging Unconscious Bias

By: Laraine Kaminsky

In 2018 and 2019, I had the privilege of speaking on the impact of bias at the AAN Annual meeting. Many participants shared examples of the conscious bias and overt discrimination they have experienced based on stereotypes and prejudices within the profession and how it has impacted on their performance in an already stressful and challenging profession.

 Fortunately, social norms are changing and most of us have been equipped to recognize and call out overt bias and discrimination. However, this often doesn’t correct for the unconscious bias that operates below the surface and that is built into and replicated in our institutions and processes.

There are many different types of unconscious biases that impact on who gets opportunities and who doesn’t, but the ones I have come across the most, relevant in the career path to leadership, are easily remembered as the ABC’s of bias:

1. Affinity Bias: having an affinity for a person most like you, which frequently results in those like you getting an unearned advantage/privilege. “They remind me of me at that stage in my career.”
2. Benevolent Bias: an effort to be kind results in decision-making on another’s behalf that takes away their choice. “Yes, she is an excellent candidate. She has published some excellent articles, completed stellar research, is a great contributor and patients and colleagues really like her. But she has a young family and this role will add stress to her already very busy life.”

3. Confirmation Bias: favoring information that confirms our bias based on past experience. “We hired someone from that school or hospital five years ago and it was a disaster, we don’t want to do that again.”

Do any of these scenarios sound familiar? They occur often in the workplace and frequently cause women and people from underrepresented ethnic and racial backgrounds to be excluded from the projects, conferences, conversations, and opportunities, which open the doors to leadership positions. They can be demoralizing and discouraging for individuals and limit innovation and engagement in teams and organizations.

All of us need to become more self-aware, advocate for change, and not stand by passively when we observe overt discrimination or unconscious biases built into our processes and systems.

The world is changing, and both our medical student body and patient demography are increasingly diverse and globally connected. We will all benefit from a more diverse and inclusive leadership that challenges the bias and beliefs that do not align with modern values.

 5 Tips When You're Interrupted, Cut Off or Talked Over in Meetings

By: Selena Rezvani

Imagine summoning the courage in a work meeting to share a new idea—one you’ve been researching and percolating for weeks. You start to launch into your idea, and just when you get to the good part, you get cut off by a teammate. The conversation is derailed. Your point gets forgotten.

Utterly infuriating, right?

Having a good comeback in a situation like this can be tricky. Do you make a big deal about it? Interrupt the interrupter? Just let it go? As someone who trains professionals on assertiveness every day, I’m going to share five effective tactics that really work in these situations:

1. Carry right on talking. Particularly with a serial interrupter, it can often be more effective to affirm your position by continuing to speak—rather than stopping and yielding to them. As you carry on speaking, you can also choose to talk louder as a way to regain your command of the room.
2. Use your body. It’s amazing that the same tactic that works with kids when you’re on the phone can apply to a work setting. If you’re being interrupted, carry on talking and raise your index finger. This indicates that you’re not finished, without you having to verbally address the interruption. If you’re presenting seated, you can also try standing up or otherwise making yourself more conspicuous as you’re speaking.
3. Call it out within the group. If you’re on a team that will continually work together, try addressing it in the group. You can make a non-judgmental observation by saying, “That’s the third time you’ve cut me off, Robert” or by issuing a firm verbal warning like “Let me finish.” In this case, you’re citing observable behavior, not guessing at innuendo. This approach gives the person a chance to self-correct in case they’re somehow unaware of their interrupting behavior.
4. Confront it outside the group. For many of us, being criticized is hard enough, but even more upsetting if done in front of an audience. If you want to explore or deescalate the tension with a particular chronic interrupter, consider taking them aside privately. This is especially important if it represents a critical relationship to you. In one real-life case, Sara, who was being chronically interrupted by her manager, addressed it with him privately. She not only received a sincere apology—but her manager chose to bring up his behavior to the entire team and apologize for it.
5. Get an ally: Partner with a teammate or manager to call out not-ok behavior in meetings. Often this is someone who is already motivated to foster an inclusive, collaborative culture. Still, you can build your ally’s awareness by sharing your observations so that they can challenge an interrupter with “You keep interrupting people” or “The way you’re speaking to people is making me uncomfortable.” You can also use these same ally behaviors to support quieter or chronically talked-over teammates yourself, urging that the “mic” is passed around equitably.

It’s not fun to be interrupted. But there’s no reason you should feel stuck or silenced when it happens. Using one or a mix of these tactics lets you speak your piece, address the interruption and move on.

Selena Rezvani is a self-advocacy and leadership speaker and a vice president at Be Leaderly (www.beleaderly.com).

program HIGHLIGHTS

Group Projects to AAN Initiatives 

By WISSAM GEORGES DEEB, MD

The American Academy of Neurology engages with its members and uses the projects developed through the leadership programs to upgrade and improve its services. We will highlight here two projects that were successfully translated from abstract ideas into effective, tangible, and member-driven progress.

Junior members are the future of the AAN. In 2013, the Emerging Leaders Forum (ELF) was tasked with identifying ways to improve the retention of junior members at the Academy. The ELF recommended integration of the American Board of Psychiatry and Neurology requirements of certification with the AAN offerings. This resulted in the AAN offering, among many other changes, the maintenance of certification modules free of charge to its members.

Neurology faces a lack of equity for underrepresented racial and ethnic groups that perpetuates the obstacles facing those groups. According to a 2018 AAN Insights Report, only 2.2 percent of the total United States neurology faculty identifies as Hispanic or Latino, while 18.1 percent of the general US population identifies as such. Similarly, despite representing 13.4 percent of the US population, Black/African American neurologists account for only 2.7 percent of AAN members. Furthermore, a report by the American Association of Medical Colleges published in 2017 has identified that women, American Indian/Alaska Native, Black/African American, Hispanic/Latino, and Native Hawaiian/Pacific Islanders are largely underrepresented in academic neurology. This is even more apparent at higher levels of leadership. Underrepresented racial and ethnic groups face isolation, implicit bias, and lack of sponsors and role models. This results in lower academic achievements, lower involvement in leadership, lower compensation, and decreased professional satisfaction/increased burn out.

In 2018, the Diversity Leadership Program (DLP) addressed this issue. The DLP prioritized the formation of local and AAN Equity, Diversity, and Inclusion (EDI) committees and officers with a goal of improving the climate/culture, enhancing academic development, improving recruitment and retention, and promoting sponsorship of the underrepresented racial and ethnic groups. Using those recommendations, the AAN, under the leadership of President Ralph Sacco, formed an EDI Coordinating Council. Its overarching charge is to coordinate and advance EDI across the organization. The EDI council provides an umbrella coordinating the persistent efforts of multiple committees, subcommittees, and sections at the AAN that have been working on improving access, fairness, and academic success of different underrepresented groups. For instance, the efforts of the diversity leadership subcommittee, the leadership for women subcommittee, and the LGBTQI section (to name a few) can be coordinated and improved.

Whether in providing free modules or in fostering equity, diversity, and inclusion, the recommendations and projects of the leadership programs induce tangible changes. This is consistent with the AAN’s mission of being indispensable to its members.

DLP Class of 2018

Back row: Porter, Testai, Armstrong, Wint, Gutierrez, Williams.

Front row: Ajiboye, Mejia, Sur, Spencer

Metrics & Goals 

By BEAU NAKAMOTO, MD, PHD, MBA, FAAN

A work group under the direction of the Leadership Engagement Subcommittee is responsible for providing guidance on metrics and goals for the AAN Leadership Programs. This work group has created a pre- and post-assessment that all intensive leadership program participants must complete prior to the kick-off of their program and immediately following graduation.

The following metrics have been compiled from the 2018-2019 intensive leadership program application materials and assessments. Intensive leadership programs are identified as follows: Diversity Leadership Program (DLP), Emerging Leaders Program (ELP), Practice Leadership Program (PLP), Transforming Leaders Program (TLP) and Women Leading in Neurology (WLN).

AAN Diversification Strategy

The Leadership Development Committee is working toward ensuring leadership in the AAN is representative of AAN membership at large. This includes making leadership proportionate of member gender, race, and practice setting. The 2018-2019 cohort of leadership programs shows we are taking strides in the right direction.

The AAN recognizes the importance of having leaders that reflect the demographics of its members and the patients they serve. Identification, mentorship, and engagement of AAN members from underrepresented racial and ethnic groups are a crucial aspect of the AAN’s leadership diversification strategy.

The gendercomposition of the leadership participants reflects an intentional effort to help our members tackle gender disparities, create a peer network with other female AAN members and help them advance to the top levels of leadership within their field and within the Academy.

Individuals from solo practice and small and multispecialty neurology groups make up 43 percent of the AAN membership. Thirty-two percent of our 2018-2019 leadership participants were from these practice settings. The AAN continues to identify and engage solo and small practitioners interested in helping shape the future of neurology within the AAN and their communities.

Leadership is a privilege and an honor

Message from AAN Chief Executive Officer Catherine M. Rydell, CAE

You’ve likely heard that I am retiring in May 2020 after more than 21 years as the AAN’s chief executive officer. I can’t believe how quickly the time has passed. When I joined the AAN in 1999, my background included 12 years as a state legislator in North Dakota, executive director of that state’s medical association, and director of women and children’s services as well as surgical services for a regional medical center. I applied the insights and experiences I gained from those positions to my work with the Academy. But I also listened to our board, our members, staff, colleagues in associations inside and outside of the medical field. And I still listen, because that’s how you learn as a leader. There’s a saying I like, “If you’re the smartest person in the room—find another room!”

Any leadership skills I’ve been able to muster have been inspired and strengthened by working with and learning from the most amazing people. Once you pull the right team together, aligned toward the same goal, you’re 90 percent of the way there.

I’ve championed the AAN’s Leadership Programs because the field of neurology needs strong, capable, diverse, and confident leaders, now and in the future. The Academy will also need your skills, experiences, and insights. I have no doubt there are several of you who will someday be members of our board of directors, and you will build upon our current successes and vision to be indispensable to our members.

In the future, the AAN will continue to face many of the same challenges we are confronting today: constant change in the health care environment as lawmakers and regulators wrestle with cost containment and improving quality in care; increasing the numbers of medical students who choose neurology as their specialty to meet the growing numbers of people afflicted with neurological disease; harnessing technology to make the neurologist/care team/patient relationship more efficient, convenient, and comprehensive; and collaborating with academic neurology departments to provide tools and resources that aid them in their mission. The Academy also must continue to grow its membership and diversify its revenue streams to extend its financial stability and keep dues low. And, our members demand gold-standard education opportunities and resources that engage their minds and enhance their knowledge, whether through attendance at the Annual Meeting and regional conferences or via our online education products. We will need to confront these issues with creativity and tenacity, always ensuring our solutions are aligned with our vision and mission.

I’m confident that we will continue to be successful, thanks to our strong, wide-ranging leadership programs, our hundreds of impassioned volunteer members who walk the talk, and our skilled and agile staff. We have a very savvy board of directors and I have no doubt they will select a supremely qualified CEO who understands what we’re all about.

Many of you have experienced that transitioning into a leadership role is exciting and challenging, sometimes even daunting. There are tremendous expectations, much to be absorbed, and decisions that need to be made quickly, yet wisely. I will spend several months working alongside my successor to make this a seamless transition. This will be made all the easier by the AAN’s high member engagement and solid financial footing.

I’m proud of what the AAN has accomplished over the past 20 years, and I will always be excited for its future.

Leadership Development Committee Vision and Mission:
Vision: All members will achieve their leadership potential.
Mission: To cultivate and inspire leaders in neurology and foster their engagement with the AAN

Editorial Team

Editor

Associate Editors

We hope you have enjoyed this issue of the Leadership Newsletter. Join us for the next issue due April 2020!

SUPPORTERS OF THE AAN LEADERSHIP PROGRAM

ACADIA Pharmaceuticals, Inc.

The Allergan Foundation

Allergan, Inc.

Greenwich Biosciences, Inc.

Medtronic

Neurocrine Biosciences

Sanofi Genzyme

Supernus Pharmaceuticals, Inc.

UCB

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