Pharmacy & Therapeutics- August 2008 - (Page 438) EDITORIAL The Four-Way Win David B. Nash, MD, MBA I am confident that many readers of P&T are pulled in multiple directions each day. Not only are our readers busy in the work world, but everyone has competing priorities on the home front as well. We know that when one sphere causes stress, it results in poor performance in the other sphere. I am always looking for ways to help balance the work and home–life continuum. Like many working professionals with a family, I find that it is an ongoing struggle to keep that proverbial balance in check and to stay focused on what is really important in the long run, namely the family unit. As a result of my ongoing search, I was happy to come upon yet another worthwhile Harvard Business Review article about a concept called “total leadership.”1 As the brainchild of Stewart D. Friedman, PhD, total leadership refers to a focus on the whole person. It is about creating sustainable changes to benefit not just ourselves but also the most important people around us. Dr. Friedman, Practice Professor of Management and Director of the Wharton Work/Life Integration Project at the University of Pennsylvania in Philadelphia, believes that we can achieve what he calls a “four-way win”—not trading off one thing for another but finding mutual value among all of life’s domains: work, home, community, and self (mind, body and spirit). Exactly how would one go about scoring this four-way win? We can start by visualizing what we want from, and can contribute to, each domain of our lives now and in the future, with “thoughtful consideration of the people who matter most” to us and the expectations we have for each other. Through his writings, lectures, and workshops, Dr. Friedman helps individuals design and implement a carefully crafted experiment; that is, they do something new for a short period to see how it affects the four domains. These experiments give people an opportunity to score a small win, to see whether the plan is working, and to readjust their strategy. The total leadership concept rests on three principles: (1) being real: acting with authenticity by clarifying what’s important; (2) being whole: acting with integrity by respecting the whole person; and (3) being innovative: acting with creativity by experimenting with how things get done. In his workshops, Dr. Friedman leads participants through a process whereby they consult with and write to peer coaches to identify core values and a vision of leadership and to evaluate how well these align with one’s actions and values. Peer coaching can be very valuable in clarifying what is important to people. The insights that result from peer coaching create opportunities for attendees to focus their attention more intelligently, ideally spurring innovative action. From these efforts comes the design of the experiment. For example, by running in a company-sponsored marathon, employees can simultaneously improve their health, contribute to the work environment, and gain more energy for home responsibilities and other activities. Even by running in a half-marathon with children, participants can create a four-way win that accrues direct and indirect benefits at home. At first blush, these benefits might seem self-evident, but the Friedman system has been tested in hundreds of seminars in the U.S. with all kinds of people with many different professional backgrounds. Dr. Friedman asks: “How does one know if the experiment is working?” To derive an answer, he creates a detailed scorecard with each domain (work, home, community, and self). He asks all workshop attendees to write out their goals and how they will measure success against the stated goal. He then helps them create steps to implement these goals. All of this material is available at his Web site, www.totalleadership.org. Among the areas that might be candidates for experimentation in one’s life include activities like tracking and reflecting or focusing and concentrating. For example, under tracking and reflecting, one could record visits to the gym and note any change in energy levels to help predict the best time for using the gym. Under focusing and concentrating, one might agree with a partner to turn off all digital communication devices at home at a certain time every day and to set aside time to focus on one topic, activity, or a family member’s needs. Most psychologists, I think would agree, that scheduling time with family members is a key step toward building trust and ameliorating inevitable family squabbles. I especially like the fact that workshop participants report the use of all kinds of metrics to assess whether their four-way win is working. These metrics include cost savings from reduced unnecessary work-related travel, avoidance of misunderstandings resulting from e-mail communication, the degree of satisfaction with family time, and the hours spent volunteering (e.g., at a teen center). As a veteran diarist, I certainly appreciate Dr. Friedman’s call for a daily entry in an “energy diar y” that can help predict which activities create or drain energy. Dr. Friedman also is a realist. He knows that not everyone will be able to adopt the four-way win mentality, but he believes that his program can help people become more true to themselves and more innovative and that they will be able to perform better, feel better in all domains, and foster greater harmony by increasing the resources available to themselves. I believe that every P&T committee member would benefit from attempting to achieve a four-way win in life. Imagine how much more productive our meetings would be, how much less contention we’d have to tolerate, and how much more we might be able to accomplish for our patients each day. As always, I’d like to hear your views. My e-mail address is david.nash@ jefferson.edu. My blog is http://department ofhealthpolicy.blogspot.com. REFERENCE 1. Friedman SD. Be a better leader, have a richer life. Harvard Business Review 2008; 86(4):112–118, 138. I 438 P&T® • August 2008 • Vol. 33 No. 8 http://departmentofhealthpolicy.blogspot.com http://www.totalleadership.org http://departmentofhealthpolicy.blogspot.com
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