INTERVIEW

Gillian Kernaghan: inspired by the past, but looking to the future

 

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INTERVIEW: Gillian Kernaghan: inspired by the past, but looking to the future

Pat Rich

 

Most women physicians can reference female mentors or colleagues who have inspired them or provided them with guidance as they assumed leadership positions. But few reach back more than 300 years for such inspiration, as does Dr. Gillian Kernaghan, President and CEO of St. Joseph’s Health Care in London, Ontario. As she wrote in Leading from the Front,1 a book on physician leaders published by the Canadian Medical Association, in conjunction with the Canadian Society of Physician Leaders, in 2013:

Most women physicians can reference female mentors or colleagues who have inspired them or provided them with guidance as they assumed leadership positions. But few reach back more than 300 years for such inspiration, as does Dr. Gillian Kernaghan, President and CEO of St. Joseph’s Health Care in London, Ontario. As she wrote in Leading from the Front,1 a book on physician leaders published by the Canadian Medical Association, in conjunction with the Canadian Society of Physician Leaders, in 2013:

 

“It is humbling to realize that many leadership principles described today were articulated and lived in 1650 by rural French women who were the founders of the Sisters of St. Joseph. These courageous risk takers founded what is now St. Joseph’s Health Care in 1869; I am honoured to continue that legacy of care into the future.”

 

In an interview, Dr. Kernaghan said that, having served as the CEO for the faith-based institution since 2010, she continues to reflect on the attitude and work of the Sisters. “I found the principles they reflected are so very true. They were women who really went against the social norm, the religious establishment and the municipal establishment, to step out to do something different: very inspiring in lots of ways.”

 

The Sisters of St. Joseph can be seen as an example of servant leadership, and Dr. Kernaghan says it is heartening to see such publications as the Harvard Business Review2 take up this concept. As articulated by Robert F. Greenleaf and the Robert F. Greenleaf Center for Servant Leadership: “The servant-leader is servant first… It begins with the natural feeling that one wants to serve, to serve first. Servant leadership is a philosophy and set of practices that enriches the lives of individuals, builds better organizations and ultimately creates a more just and caring world.”3

 

Dr. Kernaghan says this concept really resonated for her in reflecting what is important about leadership.

 

As a community family physician, Dr. Kernaghan’s own journey in institutional leadership began in 1993 when she became VP Medical for Parkwood Hospital, a chronic care and rehabilitation establishment that is now part of St. Joseph’s. At a time when few women were holding leadership positions in Canadian health care institutions, Dr. Kernaghan said she was fortunate to have sponsorship from the man who was CEO of the hospital at the time.

 

“I had never been in a formal leadership role before, and my first reaction was, ‘I don’t have the skills to do that’.” However, she says, she was energized by her experiences as a volunteer board member at the hospital and was also able to provide “the gift of time” to her family as the VP position meant she did not have to spend so many hours in clinical work.

 

At the time she accepted the VP position, Dr. Kernaghan says, there was still a sense that taking a full-time administrative role meant a physician had gone over to “the dark side.” “To seek leadership as a career for a male or female physician was not seen as being of value.”

 

Although this move from community medicine to administration was fairly smooth, Dr. Kernaghan says there was more risk involved when Parkwood merged with St. Joseph’s and she was asked to take on the role of VP Medical for the amalgamated centre in 1997. With no women colleagues holding comparable positions to turn to for advice when she applied for this position, Dr. Kernaghan says she spoke to a male colleague who encouraged her to “be who you are and you’ll earn the respect. This really encouraged me to be authentically who I am because I love being a woman and am very comfortable in who I am.” Top

 

“For me that was a big leap,” she says, noting that, at that time, no family doctor held a VP medical position in any Ontario hospital, no other women were in such a role, and she was 15 years younger than anyone else around the physician leadership table at the institution.

As the result of a 360 external performance review held at about this time, Dr. Kernaghan says she realized she was beginning to drift into mimicking the leadership characteristics of a male career leader, and she said this made her “reset” her approach. “That caused me to really think hard about who I am as a leader and to try and be authentic as a leader.”

 

Dr. Kernaghan describes her first year in the new role as being “very rough,” as she experienced paternalism and lack of respect from some male colleagues. When she tackled one of her more outspoken critics about this attitude a couple of years later, she says, the person indicated that he had given her a hard time because he simply did not understand the process issues she was trying to raise.

 

Reflecting on her career in leadership, Dr. Kernaghan prefers not to judge whether any challenges to her leadership may be a result of bias against her simply because she is a woman. “I work hard not to go there. There are times when I have had challenges from people, but I have learned to be very reflective about that and assess how I might have contributed to the situation not going well.” However, she says, during her medical school training she definitely experienced gender bias and “childish” behaviour from a few male teachers.

 

According to Dr. Kernaghan, there still seems to be a culture where the government tends to turn to senior male CEOs for guidance. “What are seen as traditionally more female attributes around leadership — relationship and trust-building, communication, and team work — have not, until fairly recently, been as valued in leadership circles.”

 

Dr. Kernaghan references an international project looking at traditional male and female leadership attributes that found what people are looking for today — regardless of culture — tends to align more with what are traditionally thought of as female leadership attributes.  And she says this skill set encompasses not only the “soft” skills, such as nurturing and team-building, but also a focus on being strategic and getting results. She describes this as a move away from the “heroic” leader toward the collaborative, servant leader.

 

“I do think the health care system is moving in that direction, as is business. This isn’t just a social sector phenomenon.” As a result of this trend, she says, more senior-level health care leadership positions will be held by people — male or female — who have these attributes. Top

 

To encourage more female physicians to take leadership positions, Dr. Kernaghan says she believes a change in culture is required — one that recognizes the leadership attributes of tomorrow rather than those that have brought us to today. This must be combined with a recognition that the skills of women physician leaders are valued.

 

Although women now make up 50% or more of practising physicians in Canada and the new generation of partners is more willing to share responsibilities, Dr. Kernaghan says it is unlikely the health care sector will see a similar percentage of women holding leadership positions in the near future because there are too many other cultural pressures facing them. “The reality is that, as women, we are the ones who have kids. We’re the ones who have to take a break in our careers in order to have a family.” While some supports, such as maternity leave and parental leave, are now more prevalent that in the past, she says, more needs to be done in this area.

 

Barriers must also be removed that discourage female physicians from taking leadership positions at a younger age in a way that does not occur with their male counterparts, she says. “We need to encourage women based on their ability and not on their circumstances.”

 

The challenge for current physician leaders, both male and female, she says, is to convey the satisfaction and “joy” that comes from working in leadership roles. Although leadership roles can involve long hours and financial sacrifices, Dr. Kernaghan says today’s physician leaders must do a better job of expressing the satisfaction that can come from holding such roles.

 

Although she is not very active personally on social media, Dr. Kernaghan voices support for the value of social media networks in supporting women leaders and prospective leaders and giving them a voice and the power of the #MeTooMedicine movement. However, she says, she feels comments should focus on moving forward and building a positive environment for women rather than on negative events and attitudes from the past.

 

Asked what needs to be done to encourage the development of more female physician leaders, Dr. Kernaghan says that, in London, there has been a focus on a talent management model, where potential leaders are identified early and provided with mentoring and opportunities to develop leadership skills.

 

More thought about gender balance by physicians on selection committees for leadership positions is also required, she says, rather than just having this happen by chance. Selection committees must also decide ahead of time what attributes they are seeking for the position, so they can judge a person based on those rather than on other personal characteristics.

 

“We need to be more intentional about this,” she says, not just from a gender but also a generational perspective, so that leaders are recruited who can lead in an intergenerational environment and nurture the new generation of female physician leaders.

 

Leadership is a privilege, and finding a leadership role that allows a person to develop based on their strengths will allow female physicians to excel. This, says Dr. Kernaghan, has been her experience and is a credit to many people on her leadership journey.

 

References

1.Kernaghan G. Redefining a health care brand. In Carruthers C, Lightfoot P (editors). Leading from the front: experiences of Canadian physician leaders. Ottawa: Canadian Medical Association and Canadian Society of Physician Leaders; 2013:36-42.

2.Cable D. How humble leadership really works. Harv Bus Rev 2018;23 April. Available: https://tinyurl.com/yd46bepq

3.Greenleaf RK. What is servant leadership. Atlanta, Ga.: Center for Servant Leadership; n.d. Available: https://tinyurl.com/l6rxutn

 

Author

Pat Rich (@pat_health) is a medical writer and editor.

Correspondence to:

prich5757@gmail.com

 

 

 

Dr. Gillian Kernaghan is the 2018 recipient of the CSPL’s award for Excellence in Physician Leadership. As one of her nominees wrote: “Gillian has demonstrated her absolute commitment to enhancing our leadership as physicians, has provided — regionally, provincially, and nationally — great leadership of our health care system and has helped create the CSPL’s success as the national physician leader organization.”

 

 

“It is humbling to realize that many leadership principles described today were articulated and lived in 1650 by rural French women who were the founders of the Sisters of St. Joseph. These courageous risk takers founded what is now St. Joseph’s Health Care in 1869; I am honoured to continue that legacy of care into the future.”