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Coaching, critical to my success in life, art, politics, advocacy. Still need to do my own work & make choices. Listen to a session with one of my coaches, Jan Oldenburg.
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Contents with Time-Stamped Headings
to listen where you want to listen or read where you want to read (heading. time on podcast xx:xx. page # on the transcript)
The start of a business relationship 03:19. 2
Managing the swirl of me 05:50. 2
Coaching as a parent of a teen 07:21. 3
Advice, reflection, self-reflection, shades of grey 09:56. 3
New position, new relationships, new levers 12:51. 4
Measurable outcomes of a strategic plan 16:24. 4
Changing roles at PCORI 17:02. 5
Vanilla management training. No nuts 20:08. 5
Clarifying personal mission, priorities, goals 24:26. 6
Staying in touch with, leveraging, advancing my constituency 26:27. 6
Capable of a delicate balance? 29:22. 7
Rare Disease as an inequity 30:15. 7
Keeping a pulse on Board effectiveness 32:23. 7
Leadership role on the Board 34:00. 8
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The views and opinions presented in this podcast and publication are solely the responsibility of the author, Danny van Leeuwen, and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute® (PCORI®), its Board of Governors or Methodology Committee.
Music by permission from Joey van Leeuwen, Drummer, Composer, Arranger
Web and Social Media Coach Kayla Nelson @lifeoflesion
Rumours of Light image used by permission from Sue Heatherington @theWaterside Quiet Disruptors
Inspired by and grateful to: Christine Goertz, Sharon Levine, Nakela Cook, Mike Herndon, Tanisha Carino, Kara Ayers, Connie Hwang, Luc Pelletier, Caryl Carpenter, Dorothy Cucinelli, Peter Tetrault, Tim Sullivan, Cynthia Meyer
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About the Show
Welcome to Health Hats, learning on the journey toward best health. I am Danny van Leeuwen, a two-legged, old, cisgender, white man with privilege, living in a food oasis, who can afford many hats and knows a little about a lot of healthcare and a lot about very little. Most people wear hats one at a time, but I wear them all at once. We will listen and learn about what it takes to adjust to life’s realities in the awesome circus of healthcare. Let’s make some sense of all this.
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The material found on this website created by me is Open Source and licensed under Creative Commons Attribution. Anyone may use the material (written, audio, or video) freely at no charge. Please cite the source as: ‘From Danny van Leeuwen, Health Hats. (including the link to my website). I welcome edits and improvements. Please let me know. firstname.lastname@example.org. The material on this site created by others is theirs and use follows their guidelines.
Want to be a fly on the wall of a year-end session with my professional coach, Jan Oldenburg? You can hear the good, the bad, and the ugly of my process to hone and strategize my professional and personal work. Why would I share a coaching session? Is this TMI (Too much information) too private? Does it make me vulnerable? In last week’s podcast, Matthew Hudson emphasized that you reveal something about yourself with the questions you ask, the problems you try to solve. Frankly, I am a bit anxious about sharing this, but you already know that I have little guile. I wear my life on my sleeve. I try not to say stuff I wouldn’t want on a billboard, but I’m not perfect at that. I reveal this session so you might sense how important coaching can be anytime in your life. Early in a career, as a leader, in health, art. I’ve been fortunate to have many coaches over the years, some paid, some pro-bono. Here are a few: Lynn Hubbard, Caryl Carpenter, Luc Pelletier, Dorothy Cuccinelli, Tim Sullivan, Peter Tetrault, and my current coaches, Jan Oldenburg, Jeff Harrington, and Kayla Nelson. As you’ll hear in the conversation with Jan, the output of coaching is up to me. I need to do the work. The choices are mine. This session is audio and video recorded with a transcript. You can find the video of this episode on YouTube with links on my website show notes. By the way, I thought this would be the least edited episode I’ve ever produced. True for the audio and video, not so much for the transcript.
The start of a business relationship
Danny van Leeuwen: Jan Oldenburg, you know that I love you.
Jan Oldenburg: I love you, too, Danny.
Danny van Leeuwen: I appreciate our relationship as it’s developed over the years. At first, we were human curious, and then we started doing projects, sat on teams together, provided counsel to each other, and strategized in several different forums. It was always rich. When I was appointed to be on the PCORI Board of Governors, I was both full of myself enough and smart enough to know that I was the right person to be selected. I’m good at what I do. There was no way I would reach my potential without help and regular counsel. I immediately thought of you.
Jan Oldenburg: I’m honored.
Danny van Leeuwen: Thank you. So, we developed, and I insisted that you were very generous and excited and would have done this work pro bono for me, with me. I insisted that we have a business relationship. Part of that is because you got to walk the talk. We insist that people need to be paid for their work. And then there was another not so noble motivation: people with whom you have a business relationship will naturally be more responsive because they have a business relationship. I wanted that. So, we’ve met over fifteen months, pretty much monthly. And for me, I think the most important thing that’s happened is recognizing that I needed a filter between my brain and my mouth.
Jan Oldenburg: I have that problem, too, actually. So, I really understand that.
Managing the swirl of me
Danny van Leeuwen: It’s good to say, okay, wait a minute, before I go off half-cocked, let’s just chew on this with somebody else, with Jan and clarify, clean it up, focus. Yeah. And so that’s good. And then I think it’s bringing all of the various threads that I’m involved in. So, just as I am not multiple sclerosis, I am not PCORI board. I am Danny van Leeuwen, and I have my fingers in many pies and am working on lining that stuff up with life pace. How much energy do I want to be putting out in total, in what buckets and what issues, and balancing all that? So, that’s my introduction. What I’d like to do here are two things. I would like to give you a chance to just talk about coaching and your feelings, approaches, and philosophy, and if you want to apply any of that, you can say anything – the good, bad, and the ugly about me is fine. And then let’s do a year in review.
Coaching as a parent of a teen
Jan Oldenburg: Perfect. Coaching is an interesting role for me. I hope this won’t offend you, but I think this applies whether it’s coaching you or coaching my adult children. One of the things that has been a critical lesson for me in building a relationship with my adult children is figuring out that they don’t want me to fix their problems. They want me to be a sounding board. And whatever advice I am trying to give them, it’s not the point of the exercise. The point is about helping them figure out what they want to do, their instincts, and where they want to go. I bring that, frankly, hard-won lesson, and they will tell you; I still struggle with it. But that’s one of the things I’ve tried to bring into this relationship that this isn’t about it. If I’m doing the job well, it’s not about collaborating to solve the problem. It’s really about my being an echo and a witness and a sounding board for you to figure out where you want to go. And that’s not the easiest part of it for me, quite honestly. Cause I also like to solve the same kinds of problems. But it has been wonderful for me to be able to watch you. And frankly, your focus and resilience in approaching who and what Danny is at this moment in time. And his roles and, if anything, helping you to hone that a little bit more or tune it up, or think about the ways, what you really want to accomplish in each of these forums and how you can best accomplish that. And I hope that’s how it’s felt to you.
Advice, reflection, self-reflection, shades of grey
Danny van Leeuwen: Yeah. It does. I think that being a reflection is important. So, hearing back, you do a lot of, ‘this is what I’m hearing you say,’ Sometimes it sounds right. And sometimes it doesn’t. I do like your opinions or advice, ‘if it were me, I would do, I might do this.’ I find that helpful. I, in no way, feel like that’s okay, then I’m going to do it. Cause I’m just not like that. I think we are people who are not black and white. We are people with many grays, and that gray is in and of itself gray has so many tones, and it’s where to try next.
First, build trust
Danny van Leeuwen: I feel like another thing that happens is the follow-up of okay, what did we start with? We started with trust, building trust with my new colleagues. I was in a new role. I wasn’t a merit reviewer. I wasn’t chairing or co-chairing an advisory panel. I was a board member, and that is a very different seat, and it has different power, obligations, and leavers. And I felt like that setting the first task of building trust. I remember the first management job I ever had was as a nurse manager of an ICU. I was an ER nurse and paramedic, and the ICU Manager left. The nurses came to me and knew me because of the advanced cardiac life support course I set up and taught. They came to me and said, we want you to be our manager. I’m like, you guys are crazy. I’ve never been a manager. I never worked in the ICU. Like how silly can that be? And they said we’ll teach you the ICU and you’ll be a fine manager.
Jan Oldenburg: What a gift, actually.
Danny van Leeuwen: So, I went to my boss, the chief nurse, and told her what happened. She said, ‘put your hat in the ring.’ So, I did, and I got the job, and oh my God, it was different.
New position, new relationships, new levers
Danny van Leeuwen: I’ll tell you two stories about how it was different. The first story was that within the first week, I realized that there were a lot of urinary tract infections amongst the staff. They weren’t taking a break to go to the toilet. There was one other male nurse, and the rest were females. And I was like, folks, we are smart people. We can figure out how to take breaks to go to the bathroom. I know we’re busy, but we are smart, and we can do this. And I went to my boss and said, I can’t believe this was my first management problem.
Jan Oldenburg: No kidding. So many layers of kind of irony about that, right.
Danny van Leeuwen: Yeah. And then the second was that I unilaterally ended visiting hours because it just made no sense to me that people, family members, could only come and see their family from seven to nine pm. Like where did that come from? But, being full of myself, I just did it, and, oh, they were so regretful that they had sponsored my elevation to this position. They thought I was nuts. And thankfully, the medical director was a hundred percent behind me. And my boss, who got lots of complaints, was very helpful strategizing, okay, now what are you going to do? How are you going to handle this? Do you want to back off and whatever? Which I didn’t. And we figured it out.
Jan Oldenburg: Question for you, Danny. The next time you were presented with something similar where you knew there would be staff and patient impact in opposite directions, perhaps it happened right away. Of course. So how did you handle it?
Danny van Leeuwen: I introduced it; I built the coalition. We figured out how to do it together. The next thing was that every physician had their own equipment. We had to maintain a stock of all sorts of brands of the same thing. When I got hired, the ICU was a loss leader. I said to the CEO, rather the chief nurse, which probably got me the job, that there is no way I am leading a loss leader unit. Forget it. It doesn’t have to be that way. So not only did we end up with one line of everything, but we also upgraded all the invasive technology, all the monitors, everything. And we broke even. That just took two years. Thankfully, I had a wonderful medical director because I couldn’t do it by myself, I couldn’t have done any of that, but anyway, I don’t know why we got down this thread.
Measurable outcomes of a strategic plan
Danny van Leeuwen: Okay. Those were some pretty formidable accomplishments: elimination of urinary tract infections, visiting hours, equipment and monitors, breaking even like that. I don’t know if I ever have had those kinds of outcomes. Those are dramatic.
Jan Oldenburg: Those are dramatic. They’re clear, and they’re measurable. They are both human-centered and good for the organization. They hit all the chimes.
Changing roles at PCORI
Danny van Leeuwen: If I think about this first year of PCORI, being on the Board, I don’t know that I can say those kinds of things. On the other hand, I feel like we started with trust, and I think part of the trust I was managing was that I was no longer a detail person in the role. I was not that much of an opinion person. But the role is different, and I’m not in operations. And even though I had relationships with many people at PCORI through my doing. I did all sorts of reviews because being Health Hats, they could check off all kinds of boxes with me and, and depending on what they needed, I’ve worked across the continuum of care, behavioral health, physical health, so I have expertise in a lot so that they could use me a lot. I met many people. And then, I led an advisory panel for four years, and then I was on another one for a year. I knew a lot of people, and I had relationships with those people, and I would communicate with them very occasionally. It’s not like I worked in the same office with them. We spoke monthly or every couple of months – quite a bit. Being on a board is really different. So, I felt like the first part of trust was making it clear that I appreciate the dilemma, the change, the difference. I think some of the stuff we talked about was that I had this long-standing, regular communication with X. That’s just not that appropriate, maybe with her boss, maybe at the director level. Then just being free to have calls with the chair or the executive director and saying, this is interesting or concerning me. Here’s what I would do left to my own devices. And I just want to make sure. Let’s talk about the right way to do this in my role on the Board, that’s supportive of you and the staff and not becoming an additional problem.
Vanilla management training. No nuts
Jan Oldenburg: And I think we talked about that a lot. And I think it reflects on your story about going from being a staff nurse to being the manager. There are changes at each level along the way. So, I got a lot of management training when I first started, but I didn’t get training on how to be a middle manager,
Danny van Leeuwen: which is like night and day difference.
Jan Oldenburg: Even being a manager, it took a long time for me to start appreciating. That, that it wasn’t me getting the compliments. It was my staff getting the compliments, and I got the shit.
Danny van Leeuwen: And that’s the job. You have to own it.
Jan Oldenburg: And that’s the job. You have to figure out how to take pleasure from that. And then when you go from management at whatever level, to be on the Board, it’s the same kind of a sea change. And you have to do precisely those same kinds of thoughtful pondering about is this appropriate or not? How far, how deep can I go? How much of this is my role? And I think you did that thoughtfully and frankly enlisted the support—the rest of the Board, not just the leadership of the Board, but your colleagues.
Danny van Leeuwen: Yeah. I had a mentor on the Board who I made good use of. I’m thinking about when I had a C-suite job, which is very different from middle management, which has served me well here because, frankly, I didn’t do too well in it. I had excellent staff, and the team did outstanding work, so the function that I was leading was mature. But dealing with the culture of the C’s, the various chiefs; oh, my goodness, I was not that good. Eventually, I got canned, which also made me realize how different I see the Board job. I served the Board, which taught me how much work it is for staff to serve a Board. I do know that I am heard on these board meetings. We’ve talked about this. Like, how do you recognize being heard? I feel like it isn’t two or three meetings, sometimes one where something I said or commented on has a life. Now I think some of it had been worked on for quite a while, but I speculate it gave it a little more juice.
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Clarifying personal mission, priorities, goals
Jan Oldenburg: Well, Danny, one of the things I think I have been impressed with, as I have looked at, what you’ve been doing over the course of this time is that. You were very clear when you started about the set of goals you had for being on the Board, and you do a check-in with yourself very regularly. And with me on, how am I doing against those goals? How do I know if I’m doing enough, the right things, if they’re moving forward at an appropriate pace? I think you maintain that laser-like focus on what really matters about your role in this particular institution and what you want to make sure it happens as a result. And I strongly believe it’s one of the reasons you are effective and being heard.
Danny van Leeuwen: If I were to think about those things, it has to do with equity in the research process. Not so much research on equity because other people are going to take care of that. Yes. To me, it’s that there’s equity in the research process. I think it’s. Community partnerships with researchers and the caregiver focus. It isn’t just patients; it’s patients and caregivers—attention to caregivers needs to be there. There isn’t a constituency for caregivers. There is for providers like there is for patients.
Staying in touch with, leveraging, advancing my constituency
Danny van Leeuwen: And then I think leveraging the existing PCORI resources, like the Ambassadors and the Advisory Panels, are diamonds for PCORI. And so, I attend as many of those as I can because I want them to know that somebody on the Board cares about what they’re doing is essential and a little tangent. So, one of the things that you and I talk about and appreciate in the coaching is that I’m really aware that I’m this person with limited mobility sitting in this tiny little eight-by-ten entryway of my flat, which has turned into my office. And I’m losing my train of thought. How, what are the levers, what do I have here? I feel like I have a friend who is completely chair bound has mostly mouth head neck, and she’s an engineer, and she designed her chair. She can do amazing stuff in her chair but take her out of the chair, and she’s a fish out of water. I don’t know if that’s an appropriate thing to say, but you get the meaning. I’m aware that I still have levers, and I feel like you have to use them. And one of them is an appreciation since I came up in PCORI as a patient-caregiver stakeholder. I know the benefit of the advisory panels and the ambassadors. And I think about how do I, we elevate that voice. I’m very fortunate; I think we’re very fortunate that the staff, the people who staff those panels, are pretty darn good at bringing the panels’ thoughts forward and incorporating that in their design thinking. They are focus groups. It’s very powerful. But I think, I don’t know, but I think the Board should just so appreciate this. I’m not sure they do.
Capable of a delicate balance?
Jan Oldenburg: But, yeah, I think it’s also one of the interesting things for you that you’ve managed well, but it’s also part of the value that you bring, which is for, first of all, the delicate balance is attending those meetings without being intrusive on their process without having…
Danny van Leeuwen: Keeping my mouth shut.
Jan Oldenburg: Getting in the way of work that they’re doing. I have a great appreciation for how difficult that can be. But you do it well. And then, part of your role is to amplify what they are doing and amplify it in the context of board decision-making and strategy.
Rare Disease as an inequity
Danny van Leeuwen: Exactly. An example from this week is the Rare Disease Advisory Panel. Somebody said, I think it was the co-chair, that rare disease is a community of disparity. I am not saying that right, but we tend to believe that there are disparities with people of color. There are disparities; inner city, homeless, rural, Native American when we think about the universe of disparities, so I don’t know the word for it. Communities of disparity are not the right words, but they want PCORI to be thinking about rare diseases as those kinds of communities. You and I have had conversations where I try to introduce that if we’re thinking about disparities and equity, my barometer is what are we doing with the homeless and the incarcerated populations? Like those are my barometers. I’m going to add rare diseases because of that discussion with the rare disease panel. I thought it was a brilliant frame.
Jan Oldenburg: Yes. And it’s certainly clear that there are communities that have even between rare diseases. They’re in disparities in how much attention they get in whether they have a celebrity that’s helping them, helping raise awareness. How much money is devoted to it, and how much pharma thinks they can profit from it? All of those things create unevenness is right,
Danny van Leeuwen: not a word, but right. Yeah. Whatever. It works. It might not pass in Scrabble, but it works.
Keeping a pulse on Board effectiveness
Danny van Leeuwen: The other thing, the last area I would say is that I, when you and I first met, we talked about trust and then, where I put my energy and that, the requirement was that I am one board committee. I’m on three, and one of them is governance, which is not considered a sexy committee, and there are only three board members on it. And I think it’s a vital committee. And I know you agree because one of the projects we did together was a governance project, and we learned quite a bit in that project. And so, I marry my quality management background and think that the board needs a dashboard of themselves, of their work, and a dashboard that’s related to the national priorities. At this point, I am ready to do the work to figure it out, to be part of figuring it out. And I say that because I’m a board member. And I say that because this has been my life work. So, I’m good at it. If I wasn’t a board member, you could hire me to do this, and you would get what you want. But I’m a board member.
Leadership role on the Board
Danny van Leeuwen: And so it’s I’m, I’m looking forward to a conversation scheduled next month with that I’m having with the board chair and co-chair, and I think they’re going around in there just having their periodic checking in which I appreciate that they’re doing. And, as you and I do, we think about what two things I want to accomplish in whatever meeting I’m prepping. And so this is one, and so everybody who’s listening, here’s the inside track on Danny’s coaching and thinking about PCORI and those of you who are in PCORI and thinking about this, you’re like, getting this view into Danny’s brain. Enjoy. I think about growing into more leadership roles on the PCORI Board, in a committee or workgroup, or whatever. I’m good at leading, love PCORI, and am committed to it. And I have the time. That’s a pretty nice offer.
Jan Oldenburg: Where would you want to take it?
Danny van Leeuwen: As when I’m first thinking about introducing myself. I have interests, which I try to be clear about. On the other hand, I tell the Board Chair and the Executive Director that I am their pawn. I’m a Renaissance person. I wear a lot of hats. I can do a lot of stuff. So, they should use me. That’s the most important thing. They should use me where they need me. Now, if they don’t know or want to think about it, I would like to be in a leadership role in the EDIC (the Engagement, Dissemination, and Implementation Committee) because that’s where my heart and soul are. That’s what I’m doing there. But the Board is rich with experience and skill and politic, so there’s not a wrong decision they can make. They have a lot of talent to use, and they know more about people’s experiences, time, and interests. I feel like my thing is just to be out there that I’m available. And here’s what I’m interested in. I can tell you have a thought here.
Jan Oldenburg: One of the challenges of being a Renaissance person is that you can do nearly anything. Part of it is choosing where you want to expend your precious energy. You’re correct to say I am your agent; use me as you will. That has been important to building trust. But you also are a limited resource. And so, balancing that with thinking about how you have the impact that you want in the areas you wish to is delicate, but I think you’ve established enough trust that you can be at least somewhat more forceful about the places where you think you’d be more effective or where your goals most converged with the organization’s goals.
Danny van Leeuwen: I’ll say two things to that. One of them is that if I were to have picked the three places to be, it would be the three places they put me. So that’s number one. So, kudos to the chair and co-chair. The second is that we’re in a place where I’m not sure where we’re going and how we’re reorganized. And what we’ll be like, permanent groups, what will be temporary workgroups. And I don’t know what they’re thinking about. I sit at the tables where strategy and governance come up. So, I have something to say about them, and I’m in touch, but I was going to say I’m not a decision-maker. But, I am. Anyway.
The rest of my life
Danny van Leeuwen: I want to shift before we end. I want to shift because one of the things that I think is important about you and my relationship as coach and coachee is because we don’t just talk about my career life. I’m surprised isn’t the right word. I’m grateful that you pretty much every time we talk, you make sure that there are a few minutes about the rest of my life. I have some consulting gigs, my podcast, and play music. And I’m a person with disabilities who has work to do to stay mobile. That’s a lot. I appreciate that you bring that up. One of the things that we’ve accomplished this year is that even though I went through a period of way more disability for two and a half months, being a mess and not being able to play music just killed me. No, it didn’t just kill me; it was really annoying. I had some hopeless moments.
Jan Oldenburg: Yeah. It was heartbreaking.
Danny van Leeuwen: To think that I wasn’t going to be able to play anymore. Oh man, that was a bitter pill, but now I am playing more than ever and loving it. I’ve made some adjustments. I have declined some work. One of the things we’ve talked about is the alignment of everything, and especially the alignment of PCORI, podcasting, and my consulting gigs. As a result, I’m doing very little pro bono work because, hey, people are paying me. I’m buying the equipment I need and having more time to play music, which I enjoy. Plus, my rule has always been when my wife says she wants to do something, the answer is always, ‘yes, give me a minute. I’ll be with you.’ That’s really important, a key to my happiness.
Jan Oldenburg: I’m so glad that you brought this piece up, Danny, because one of the things that I have been, I have watched in awe I think this year is your personal resilience in the face of the challenges that your health has brought. And your continuing problem solving around how to do it, how to do it. And. Yeah, again, it comes in part with clarity of focus about what brings you joy and what you need to maintain that. But it’s also about the mindset that says I’ll take till I get this. And it’s, it’s part of the way that you are always positive. You’re always seeing a way through, or when you are feeling negative, you don’t let it be the permanent home you live in. But it’s also a mindset. That’s so much about possibilities and faith that there are possibilities, which then part help part link creates them. And that’s been a joy to watch and, and then honor to be a witness to because you are amazing.
Danny van Leeuwen: Thank you. This went longer than I expected, but this is our usual session length, everybody. This is usual. We book an hour; we take an hour. We don’t do it that often. As I said, we do monthly, and it feels like enough. And it helps me. Again, continue focus. Self-reflection is so critical. My podcast episode with Matthew Hudson is about the embedded researcher. Matt ends with, I asked him, what do you want to leave people with? And he ends with the importance of self-reflection and then supporting each other with our blind spots and strengths. It’s brilliant, just brilliant. I love that ending. Anyway, Happy New Year. I am so grateful to you and our personal and business relationship. I look forward to the possibilities. I gave you no opportunity to talk about yourself. Someday we’ll do that.
Jan Oldenburg: We’ll talk about legacy someday.
Danny van Leeuwen: Okay. Good. I would do that. All right. I’m delighted that I don’t think I need to edit this. I think I will just do a one-minute introduction and an ending and just put it out there. The funnest thing we’ll be thinking about is the title.
Jan Oldenburg: Oh yes, absolutely. And I’m dying to know what you end up with. So, it’s been my pleasure, Danny, not just this hour, but the time we spend together, it’s a high point of my month.
Danny van Leeuwen: All is well, great. Thank you so much.
Jan Oldenburg: Happy holidays to you, too.
What did you think? Was it curious, boring, enlightening, motivating? Frankly, I was a bit anxious about sharing this with my PCORI colleagues. But if not them, who? I am who I am. Huge thanks to Jan Oldenburg for going along for the ride. Happy holidays, dear listeners and readers. I appreciate you and your contributions. I’m grateful for your support. I look forward to another eventful year, although a little boredom would be great at this point. Onward.