doi: 10.1097/ALN.0b013e3182862f4a

In Reply

Scemama, Pascal H. M.D., M.B.A.*; Hull, Jeffrey W. Ph.D.

Free Access
Article Outline
Collapse Box

Author Information

We thank Dr. Dexter for his comments about our recent article.1 We agree with him about the need for effective leadership practices to be rooted in both evidenced-based behavioral and management science.
The efficiency measures presented in our case were selected for illustration purposes but do reflect an aggregate of practices that we understand have been implemented at various institutions, even if some of them may be misguided as highlighted by Dr. Dexter. The reaction of the residents to such efficiency measures is based on discussions by Dr. Scemama with residents at his and other institutions.
Dr. Dexter seems to draw a distinction between behavioral and leadership principles. As discussed in our case scenario, the foundation of leadership is behavioral,1 and effective leadership requires the ability to recognize and to navigate both our own and others’ cognitive, emotional, and relational biases. The successful implementation of process improvement requires both sound management science and effective leadership. We believe that the intersection between effective leadership and management science in anesthesiology is an exciting area for further investigation.
Pascal H. Scemama, M.D., M.B.A.,
Jeffrey W. Hull, Ph.D.
*The Massachusetts General Hospital, Boston, Massachusetts.
Back to Top | Article Outline


1. Scemama PH, Hull JW. Developing leaders in anesthesiology: A practical framework. Anesthesiology. 2012;117:651–6

© 2013 American Society of Anesthesiologists, Inc.

Publication of an advertisement in Anesthesiology Online does not constitute endorsement by the American Society of Anesthesiologists, Inc. or Lippincott Williams & Wilkins, Inc. of the product or service being advertised.

Article Tools