The Informative Brief

How can we effectively brief our bosses, our peers, and other stakeholders to educate them on important issues, and in the end, achieve our goals? 

A senior civilian official in the military health system was at a surgical conference with a young Navy colleague. They chatted, and in the course of their conversation the Navy surgeon mentioned some exciting things that he was doing in his clinic to improve access, operating room utilization and quality of care.  The civilian official asked the younger man to prepare a talk to present to a group of senior leaders. Eventually word of this arrangement spread throughout the levels of command and my team was tasked with making sure that the brief accomplished its purpose.

The Navy surgeon was smart, industrious, and enthusiastic about his team’s accomplishments. Their record was impressive, providing more patient care with better outcomes, higher satisfaction and fewer resources than before. Operating room utilization improved, and the surgical fellowship, threatened by poor case mix and volume, was on firmer ground.

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DOTMLPF-P Analysis for War and Peace

A comprehensive and highly useful military model for analyzing and addressing problems that does well in non-military settings as well. From medicine to business to non-profit work, DOTMLPF-P covers all aspects of common difficulties. 

By Mark D. Harris

My staff and I were meeting at the end of a long day. As representatives of the regional headquarters they had been working with their counterparts at our subordinate medical facilities on an important project with a tight suspense, and they had met resistance. One exasperated lady at a hospital said, “Tell your boss that we have full time jobs already!” Another one said, “This regional initiative just isn’t my top priority right now”, and one of my staff said “Sir, there just aren’t enough hours in the day.” Everyone who has worked long in leadership and management has heard these complaints time and again.

There is always a temptation to ignore such concerns and keep pushing, but that is rarely the right thing to do. One concern from my staff is that they did not feel as though their counterparts in the clinics and hospitals considered them value added. They wanted cooperation on these vital projects but did not perceive that they had much to give in return. This is a perpetual problem and when I worked in a hospital, I felt the same way about the regional staff.

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Jonathan Potts – American Revolutionary Physician

Military physicians, just like all soldiers and military officers, should read military history. We will be better if we do.

By Mark D. Harris

Napoleon suggested “Read over and over again the campaigns of Alexander, Hannibal, Caesar, Gustavus, Turenne, Eugene and Frederic. … This is the only way to become a great general and master the secrets of the art of war. …” As true as this maxim is for line officers, it is also true for leaders in the Army medical department. By studying the struggles, victories and defeats of our forebears we can better surmount the obstacles we face today.

Dr. Jonathan Potts is a medical officer worth studying. He was born in Popodickon, Pennsylvania in 1747 and, with Dr. Benjamin Rush, attended the famous medical school in Edinburgh, Scotland. He returned to the colonies on learning of the illness of his fiancé, Miss Grace Richardson. Potts married her in May 1767 and completed his Doctor of Medicine at the College of Philadelphia, the first institution to grant medical degrees in America, in 1771. He began a private practice in Reading, PA, but responded to the call of independence, seeking assignment with the Continental Hospital Department, comprised of Northern, Middle and Eastern Departments.

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Briefing Senior Leaders

How to brief (make a presentation to) your boss

By Mark D. Harris

One of the most daunting tasks faced by junior officers in the military, and subordinates in any organization, is how to formally communicate with their boss and other senior leaders. Some senior leaders are easy to communicate with; they welcome open discussion and make those briefing them comfortable. Others are hard to communicate with, and as people progress up the ranks they find that senior leaders become harder and harder to brief.

This is not because senior leaders are bad people morally, they are certainly not worse than others on average. It is not because they are stupid or lazy; senior leaders have to be relatively intelligent and ambitious or they wouldn’t make it to senior levels. Rather it is because they are very busy people who don’t have time for the unprepared, the uninterested, the verbose, and the comic. They expect their subordinates to bring them trustworthy information, problems and solutions. Such leaders don’t have the time or the ability to double the information they are given, and they can’t fix everything, regardless of their position.

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The Dance of the Headquarters

Individual units of large organizations and higher headquarters always misunderstand each other. Front line personnel feel like their leaders are detached and sometimes incompetent, while higher level leaders have pressures that small unit personnel do not understand. How do we bring them together?

In Iraq in late 2003 a draft recommendation came to the Task Force 1st Armored Division Headquarters from our higher headquarters, the Combined Joint Task Force Headquarters. It referenced tuberculosis in Iraq and proposed aggressive use of preventive measures against the disease, citing huge numbers of new cases per year. As the Task Force Preventive Medicine Officer and Deputy Division Surgeon, I was responsible to review all public health and other medical recommendations coming from outside. The math didn’t seem right and I went to the World Health Organization website to check the incidence and prevalence of tuberculosis in Iraq. Suddenly I realized that whoever had made the recommendation had badly overestimated the incidence of new tuberculosis cases. To our medical team it was just another example of trouble from our higher headquarters.

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