From leadership to biodiversity: the good of small things
BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l4402 (Published 27 June 2019) Cite this as: BMJ 2019;365:l4402All rapid responses
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Dear Kamran,
I have just read your editor’s choice entry in June 29th edition of the BMJ.
I fully agree with the sentiments therein - and that we should ‘sweat the small stuff’ when it comes to the environment and the planet. However, the BMJ (and other medical journals) that are delivered to me every week still come wrapped in plastic packaging which goes directly to landfill. Not particularly environmentally friendly is it? I also subscribe to ‘Which?’ magazine and they have recently switched to a fully compostable potato starch wrapper after a consultation with their readership. It is a perfectly suitable alternative that I get great satisfaction from when I stuff it into my green bin.
Isn’t it time that our medical journals did the same?
With kindest regards.
Dr Ross Cunningham
GPAiT - Whipps Cross VTS, London
GMC 7406600
Competing interests: No competing interests
The editorial by Kamran Abbasi on Leadership to Biodiversity (1) highlights some principles on the importance of medical leaders attending to minor details in their daily environment whilst focussed strategically on the big picture. There are many lessons that medical leaders can imbibe from the animal kingdom or indeed from our own red cells.
Although Homo sapiens is rightly placed at the evolutionary pinnacle, we should be humble enough to recognise that although the development and growth of the cerebral cortex has enabled us to map the human genome and deliver other major technological advances, we have indeed become orphans of wisdom that was found in abundance amongst our forefathers. Shouldn’t we learn from the work ethic and organisational ability of the ants and the flexibility and adaptation abilities of the amphibians? We could indeed learn from the pack of wolves on a mountainous trail when the leader of the pack is at the back of the trail leaving the elderly and infirm (and the wise) to lead the pack. An excellent example of “leading from behind”.
One could not identify a better role model in leadership than the simple red cell. The red cells do not have a nucleus and as such, they do not possess, what some geneticists label as the Selfish Genes (2) seeking survival at all costs. They come to life, serve every other cell in the body, carrying the vital O2 day in and day out, do not seek immortality, and after 120 days, quietly leave their world with a smile and satisfaction that the job has been well done. Not only a lesson on leadership qualities and selfless service but also of note in an era of technological advances being applied inappropriately in many situations complicating "end of life" related decision making.
The editorial further refers to the reluctance of medical professionals to take on management and leadership positions in the NHS (3). This position is quite different to the roles and career progression of doctors and scientists in the biotechnology and pharmaceutical industries based on my own observation in a previous senior executive role. The development of careers in these industries have been designed to interweave the technocrats into management and leadership roles so that the roles become almost seamless. I recognise that it is easier to do so in organisations without direct clinical responsibilities where the technical role progresses upwards from delivering research to research management. However, the NHS could well benefit from exploring the industry model and see how it could be appropriately applied in the NHS. Technical experts do indeed make great leaders (4)
References:
1) Abbasi K, From leadership to biodiversity: the good of small things BMJ 2019;365:l4402
2) Dawkins R, The Selfish Genes 2006, Oxford University Press ISBN 978-0-19-929115
3) Thornton J, Doctors need to step up – why are there still so few medical chief executives in the NHS, BMJ, 2019;365:l4341.
4) Goodall A. Why technical experts make great leaders. Harvard Bus Rev 2018 Apr 24. https://hbr.org/ideacast/2018/04/why-technical-experts-make-great-leader....
Competing interests: No competing interests
Re: From leadership to biodiversity: the good of small things
Dear Editor,
I will be commenting on the article “From leadership to biodiversity: the good of small things” written by Kamran Abbasi published on June 27,2019. The question was asked by the author … can a leader whether in biodiversity, environmental activism or healthcare afford to keep their eyes fixed on the big picture and leave the details to others?
My response is, they cannot: an effective leader does not disregard small things as he/ she is aware that everything has a purpose and has essential roles in team building. If only 10% of the National Health Service (NHS) chief executives are clinically trained as stated by the author how effective are they? In my opinion, I believe that the 90% of NHS chief executives who are not clinically trained may not be as effective in implementing measures to improve patient care as they may not possess the expertise in clinical settings. In addition, they may not be actively engaged with the staff at various levels to be better able to understand their visions.
Although the author’s focus was about biodiversity, we all need to be mindful of small things that we tend to perceive as insignificant. On numerous occasions we take things for granted, for example, the air that we breathe. Air is everywhere but does not have weight. Have you ever wondered what would happen to our health if we were constantly breathing air of poor quality? The World Health Organization (WHO) (2019) reported that 9 out of 10 people breathe polluted air which kills approximately 7 million individuals yearly. Twenty- four percent of all stroke deaths were associated with air pollution and approximately 1.4 million deaths occur yearly from stoke due to air pollution. Every year air pollution causes 2.4 million deaths due to heart disease. In addition, air pollution is closely linked to the changes in climate which is negatively impacting the ecosystem.
We all have a part to play in preserving the universe. If each day we protect what we deem as the least in the environment it may result in pure air to breathe, clean water to consume, a healthy environment and healthy lives. A significant reduction in diseases and deaths would be evident worldwide if we took the time to care for our environment.
References
Abbasi, K. From leadership to biodiversity: The good of small things. BMJ 2019; 365: l4402. Retrieved from https://www.bmj.com/content/365/bmj.l4402
World Health Organization. (2019). Air pollution. Retrieved from https://www.who.int/airpollution/en/
World Health Organization. (2019). Public Health, Environmental and Social Determinants of Health. Retrieved from https://www.who.int/phe/en/
Competing interests: No competing interests