Improv and the Surgeon: The Practical Side of the Woo-Woo Art Form (Part 3 of 5)

By April 23, 2020Blog

William Tseng for BIBy Ali Davis

Welcome to Day 3 of Ali Davis’s talk with Dr. William Tseng, an internationally recognized expert in liposarcoma surgery, on how the principles of improvisation apply to his work.

Find times when you can flatten the hierarchy.

There’s one important way that a surgical team is much more like a business unit than an improv group. (OK, there are several ways, but one that’s relevant here.) An improv group has a deliberately flat structure, so any player can jump in and do anything. Surgical teams have a rigid hierarchy, with an expert attending surgeon like Tseng at the top. That’s crucial during an operation, when Tseng has to know that his commands will be followed immediately.

But anyone who has worked in the world of business knows that the hierarchy can also stop people lower down on the ladder from speaking up when they have a good idea – or when they have spotted a problem.

Tseng flattens the hierarchy by throwing huddles where his team can chat informally and bring up any issues. That includes behind-the-scenes team members like physician assistants, schedulers, and insurance authorization specialists. He also makes sure to maintain good relationships with the surgical residents and students who study under him. “I don’t think I come across as intimidating,” he said, “But it’s a good idea to make sure they feel empowered to say something if they need to.”

That time, space, and informality is key. As is the fact that Tseng himself works to make conversations happen. I love to tell my students about the vice president at a company I worked for who only flew in for major strategy planning and layoffs. Every time, she would send a chipper e-mail letting people know that her door was always open if anyone wanted to chat. How many people below her in the organization do you think took her up on it?[1]

Being willing to flatten the hierarchy – in other words, to let go of your own high position for a bit – is a vital part of making sure you have all the information and the best ideas. When I’m teaching a creativity workshop, I know that I walk in with high status as a teacher, and I know that I make people nervous because my skill set is so different and they don’t know what I’m going to ask them to do. To get the best results, I immediately do several things to drop my status, including jumping in to play games with my students and making sure I look silly when I do. The less intimidating I am, the more comfortable they are with asking a question.

There’s a secret advantage there, too: The fact that I’m willing to drop my status in the short run actually raises my prestige in the long run. A leader who won’t drop status is revealing weakness. A strong leader isn’t worried about temporarily dropping status, because she knows she’ll be able to get it back.

[1] Zero. The answer is zero.