Episode Transcript
Interviewer: All right. We're podcasting live at the AAMC Learn Serve Lead 2025 in San Antonio. We’re at the Pathways booth for University of Utah Health and the Spencer Fox Eccles School of Medicine talking about some of the most critical aspects of academic medicine, whether it's leading or whether it's serving patients.
Today, in this particular conversation, we're going talk about trust. Trust is critical in everything we do in order to motivate people to participate. Especially with patients, you want to instill trust. It's a skillset, and you can actually develop that skillset.
Now we're going to find out who's behind the microphone. Who do we have right here?
Robert Brodell: This is Bob Brodell, and I'm the chairman of the Department of Pathology and former chair of the Department of Dermatology at the University of Mississippi Medical Center, Ole Miss.
Kristina Callis Duffin: Hi, I am Kristina Duffin, I am the interim dean at the Spencer Fox Eccles School of Medicine and the current chair of the Department of Dermatology.
Interviewer: And how do you two know each other?
Robert Brodell: Well, in dermatology, we're a very small field, and we all know each other well.
Interviewer: Okay. In addition to having a shared career interest in dermatology, you have a shared interest in culture and what culture can do for an institution. Let's go to you, Kristina, and find out what culture is all about.
Kristina Callis Duffin: Culture is probably the most important thing that a leader can work on when they are at an institution.
Interviewer: And what is this thing we call culture?
Kristina Callis Duffin: It's really hard to define, isn't it? People always say, oh, “You know it when you see it.” But Bob and I agree that the most important aspect of culture that makes people feel like they are in an excellent culture or a good workforce is trust.
Interviewer: Bob, do you agree with that?
Robert Brodell: I absolutely do agree with that. What happened to me was I developed a Department of Dermatology where there was none in Mississippi. When I did that, I thought, “I'm a nice person. Things are really working out pretty well.” And then we got our AAMC survey results back, and we were less than 50th percentile compared to other departments.
So we hired a culture guru expert, a fellow named Gustavo Gradnitzky, who wrote the book “Culture Trumps Everything.” He taught leaders in my department a skillset related to culture, and lo and behold, we came in above 90% on the next survey of our department related to measurable aspects that relate to culture.
Interviewer: What did the survey tell you, and how did you know culture was the answer to solving that problem?
Robert Brodell: Well, it's an engagement survey, and it's taken by 36 different universities around the country, and you answer about 120 questions. And the results were hurtful to me. I took it personally. What we learned was that if you learn a skillset that makes it so that people around you think you're reliable, that is a very important component. It's not just, “You're reliable!” You have to look for ways to demonstrate that you're reliable.
So for instance, anytime there's an award at the University of Mississippi, I latch onto that as an opportunity to stand for my faculty and put one or two of them forward for that award.
Interviewer: In your discussions, have you both talked about culture together?
Robert Brodell: Not so much, actually. This is kind of the first time this has happened.
Kristina Callis Duffin: We're figuring this out on the fly—and isn't that fun?
Interviewer: Okay. So explain that to me, Kristina, how you're figuring this out on the fly.
Kristina Callis Duffin: Well, we were just at a session where Bob was on the panel. And we in the audience were asked to submit a question in a poll about, “What's the most important thing that you can work on as a leader in your institution?” I thought about three answers.
The first one was culture, the second was change, and the third was parking. But culture was top of mind for Bob.
Interviewer: Right. What did that make you think or feel?
Kristina Callis Duffin: “Dermatologists are so good at this, right?” No, I think a lot of people agreed that culture is the top thing.
Interviewer: All right. What did you take away from the session, Kristina?
Kristina Callis Duffin: The session was talking about, what do faculty think of leadership? How should leadership, deans, CEOs, and faculty be interacting and working together? What are the things that faculty care about when it comes to those conversations, beyond funds and money? So much of it is about setting the tone, having trust, being reliable, and doing the things that you say you're going to do, right? Following through, collaborating, communicating, reducing ambiguity—all those things make up a good culture.
Robert Brodell: The University of Utah has a great culture, but one thing I would think is it could be better. So it's not just the dean's job. This is a job of everyone at the university to be reliable for every group they're interacting with—in their clinic, in their department, wherever it is. And it's more than just reliability. It's openness. That means the door needs to be open. People know that they can contact Kristina Duffin—they can get to her to make their ideas known and stir the pot a little bit.
So reliability, openness, then there's competence. I would contend that at a medical center, even though competence is hard, it's actually the easiest one of these things we're going to talk about. And the last one is concern. Again, it's not just that you have a dean that is obviously a wonderful human being and is concerned about people. We need to show that we're concerned, every opportunity we can find. Every department head, every clinic director, every head nurse needs to be trying to work on reliability, openness, competence, and concern.
Interviewer: If you start looking at things through that lens, I would imagine you see opportunities to do that in ways you hadn't before.
Robert Brodell: Opportunities abound, right? When you're looking for them.
Interviewer: Kristina, did you have any other questions that you wanted to ask him based on that session? Here you don't even have to raise your hand and wait.
Kristina Callis Duffin: Well, I wanted to hear more about this survey, and can you give us an example of something that hurt your heart that you then feel like you changed things within the culture to fix that?
Robert Brodell: Well, my faculty suggested in the survey that I didn't care about them as much as the 50th percentile of other faculty in answering these various questions.
Interviewer: No wonder his heart was hurt, Kristina. You're grimacing over there for your friend.
Robert Brodell: I love my faculty, and I see them as my family. I always thought it wasn't so much a dysfunctional family until I realized that there was more work to be done. We actually had a culture guru come in and work with the chairs for eight weeks. Every Monday we got an assignment and learned about some aspect of culture, and then on Friday we talked about how it went.
So for instance, one assignment would be to go to the front receptionist and find out something about their family. I had never done that. I was missing the boat. It was an opportunity for them to learn. I did care about them as people.
Interviewer: Did it feel a little weird doing it that first time? Like, “I'm doing this for a purpose beyond just being interested.”
Robert Brodell: It was more than weird, and some of the faculty members actually complained to me that they're never going to get that hour back that they wasted doing this. But we went from the 40th percentile to above the 90th percentile by working through these things and showing people that we were concerned, making ourselves open, showing that we cared, and proving that we were reliable and they could count on us.
Kristina Callis Duffin: One of the things that my predecessor did in 2014 is he said, we need to have a culture of leaders. We need more people willing to step in to lead. And that takes a lot of development, right? Leadership development, professional development. So I think having a culture of willingness to step in to lead is super important. So I'm curious, how have you done that, Bob? How have you empowered faculty to step in and lead?
Robert Brodell: Well, leadership is also a learned skill, and you have to dive in and swim, and sometimes you sink. When you fail, you learn more about leadership than you do when you are swimming in the lead.
Interviewer: But it hurts a little bit when you fail.
Robert Brodell: One time, I was with my faculty in a faculty meeting and the executive administrative person we had was in the meeting. At the end of the meeting she said something like, “Dr. Bob, you threw me under the bus.” I said, “What? I didn't mean to throw you under the bus.” I was trying to defend my faculty about a certain issue, but it was interpreted by my executive administrative assistant that I threw her under the bus. I spent three months working very hard, doing everything I could think of to try to make her realize I didn't mean to, and I understand how she feels, and I'm sorry, and I'm never going to do it again. But if I do, she's got to tell me right away so that I can come back and grovel and let her know how sorry I am that it came across that way.
Interviewer: Do you feel what you did there was showing an example of leadership?
Robert Brodell: Well, it was. It's also another example of the many errors I have made in my life, right? I live in the South, and I once kidded someone about saying, “Y'all.” That was a very bad thing from somebody coming from Ohio that was hurtful to them. I made the mistake, and again, I worked my way out of it.
Interviewer: Kristina, I have to wonder if what happened to Bob there actually maybe was a blessing in disguise, because it seems like a lot of trust was built right there. This person admitted something to you that was probably hard for them to do. So you apologized. You work very hard over the course of those next few months to make up for that. What do you think about that?
Kristina Callis Duffin: I think it's the true sign of a leader that there's humility. There's humanity. There's a willingness to be vulnerable that allowed that person who was hurt to be vulnerable with you, to show you the way to how you can make up.
Robert Brodell: And thank goodness Peg came to me and didn't let it chew at her inside, right? If I would've learned about it three months later when it might've been too late.
Kristina Callis Duffin: And that is trust.
Interviewer: Perfect. Kristina, anything else that you would like to say? Did you get a tip on how you could be a better leader? What's something you're going to do as soon as you get back to your institution?
Kristina Callis Duffin: I think we learn these lessons over and over again. That idea of having that open door and being accessible is so important, and that's feedback that I've gotten in the past: “You're not accessible enough, you're too busy, you're running too fast.” So it’s important to slow down, listen, be vulnerable, be willing to listen, and be humble. We all know what these lessons are—we just have to be reminded all the time to practice them. It's a practice, right? Medicine's a practice. Leadership's a practice. We're always learning.
Robert Brodell: I love that. And when I grow up, I want to be like Kristina Duffin.
Interviewer: All right, last question. Leadership is a skill that you can develop. Some people might be born with it inherently, but for most of us, we have to learn it. Kristina, give us a resource that has been helpful for you to learn that skill of leadership. And I'm going to ask the same thing of Bob afterwards.
Kristina Callis Duffin: I have a whole bookshelf! I've had a lot of coaches who have said, “Read the pages in those books.” The Executive Leadership and Academic Medicine program (ELAM) was instrumental in my leadership development. Our prior chair brought coaches in for leadership development. And then of course, for mentors, we are continually learning how to do this by talking to people and learning lessons. You have to make it a priority and then talk to people about that priority.
Robert Brodell: The dean at Wharton Business School, Adam Grant, wrote a book called “Give and Take.” It's a wonderful quick read—in about two hours, you can read it. But the take-home message, or the secret of hyper-successful individuals, is that helping others. That had a big impact on me.
Interviewer: Thank you very much for being here and talking about the importance of leadership and culture.