As a whole generation prepares for retirement, the HTM industry grapples with filling leadership roles, turning to new strategies for training and leadership development to meet the demand.
By Steven Martinez
What does great leadership in HTM look like to you? Running an effective shop that stays on top of equipment repairs and PMs requires skilled technicians and a leader who can rally the team toward a common cause, industry experts agree. But is leadership an innate quality, or can it be taught?
It’s an important question to ask as this current generation of HTM leaders nears retirement, while their replacements wait in the wings.
Trial by Fire
George Reed is the director of clinical engineering for WakeMed Health and Hospitals in Raleigh, N.C. His 40-year career has touched every aspect of HTM, from turning wrenches as a biomed to leading some of the largest health systems on the East Coast. But he says that his first experience of leadership wasn’t something he was prepared for—it was a sink-or-swim situation.
“For me, it was trial by fire,” says Reed. “I’ve had a couple of mentors who taught me about the clinical aspect of the field, but I never had one to really teach me the management aspect. So, a lot of my learning was through fault.”
Reed says that when a director position opened up at his shop, none of the more experienced technicians, including those with management experience, wanted to take it. He recalls the older guys saying, “George will do it,” and being young and naive, Reed agreed to take on the challenge.
Reed had some leadership experience as an NCO in the Army, but the military’s rigid command structure didn’t fully translate to the civilian world. He says that while his mentors taught him a lot about repairing equipment, they had little to offer when it came to managing employees and, just as crucially, managing the higher-ups.
“[My mentors] taught me a lot about the business side, but they did not teach me the people side,” says Reed. “They probably were the worst two for that, because they were the most cantankerous people I’ve ever dealt with.”
Instead, Reed found a new mentor from an outside source: the head of the pharmacy department.
“He is the one who actually said, ’You have absolutely no management experience in healthcare,’“ says Reed. “He coached me on how to communicate with not only my team, but my peers because I never realized that at a director level, you have to communicate with other directors and managers differently than you do with your buddies in the shop. That was a huge learning curve for me.”
Can Anyone Become a Leader?
While nobody is born knowing how to lead, the question is whether everyone is cut out to do it. Dallas Sutton, BS, CRES, LSSGB, manager of clinical engineering for WakeMed, puts it succinctly: “Nope.”
Sutton, who transitioned to HTM from the Air Force, had a similar journey to Reed, needing to unlearn some of the leadership skills he acquired in the military. “People do pushups if they don’t do what you say,” says Sutton. “There was no requirement to be personable or flexible.”
While both Reed and Sutton say their leadership skills were rooted in the military environment, they each had to unlearn and relearn much to become effective leaders in the civilian world.
As they tell it, not only are some people not cut out for leadership, but ignoring this reality could derail a career.
“Over the years, I have watched people who have gotten into leadership roles because they were phenomenal engineers,” says Reed. “But I watched leadership take somebody from here and put them over here, and I have watched their careers go south. And then they got terminated.”
Sutton remembers a young employee who was a great biomed and quickly rose to the top rank. When a unique position opened at a small facility within the company, requiring the young man to run the shop alone, he accepted it. However, as the facility grew, they hired people to work under his supervision, and the situation quickly deteriorated.
“He couldn’t do it,” says Sutton. “He did not like the interaction of having to tell somebody else what to do. He was technically inclined, but when it became a personal interaction, he just wasn’t there.”
The man left the company to work at a different facility and, years later, was rehired by Sutton as a regular biomed.
“It’s a bad analogy, but somebody’s got to dig ditches, right?” says Sutton. “Not everybody is inclined to move to the top of the field, and you still need those people. He is the best from a technical perspective; I can’t touch him. He’s a great guy. But he’s not set up to lead.”
On the opposite end of the spectrum is a leader who has management training but no knowledge of the job they’re asking their employees to do.
“Back when I was a baby biomed, GE started hiring Pizza Hut managers to be HTM directors because they had a degree,” says Sutton. “It’s not about the degree. The degree helps, from a business perspective, but in my opinion, for someone to be a director or manager of a biomed department, you need to be a biomed. You need to have experience in that field to observe processes that are going on with your team and articulate issues that you see with the team.”
The disconnect between managers and their employees can make their directives seem clueless or cruel if, at a basic level, they don’t understand what they’re asking of people.”
“I think what makes a good leader is if you understand what your team is going through,” says Reed. “What makes me different from some of the other leaders who might have gotten out of college with a degree in biomedical engineering and have gone right into management is that they understand the business side, but they don’t understand the clinical side. Coming up through the ranks of being the lowest [person] on the totem pole to being in management, when I’m talking to my team, I can relate to what they’re thinking and or what they’re going through.”
Leading Through Understanding
Reed says that when he enters a new management role at a new company, he drives everyone crazy. And that’s by design.
“For the first 90 days, I don’t do anything,” says Reed. “I observe, watch, and listen. I want to know who they are, what they know, what they are looking for in their profession, and where they think they want to be. I always try to get to know my team on a professional and personal level.”
Reed says he picked up this strategy from a leadership book called, appropriately, The First 90 Days by Michael D. Watkins. During that initial three-month period, Reed learned to hold off on giving directives until after first observing how things operate. In addition to meeting his employees, Reed uses this time to better understand who they are and how to communicate with them.
“You can’t talk to everybody the same way because nobody hears things the same way,” says Reed. “As a leader, that can be frustrating, because you want to get one message out, but sometimes you have to put the message out, and then you have to circle back with those individuals who you know may not have heard what everybody else heard.”
It’s all about building trust with personnel so that when changes are made, they don’t come across as change for the sake of change. After the 90 days, Reed used his observations to suggest a new strategy.
“Go in there and listen, observe, watch, and then come back and say, ‘I observed X. What if we try Y?’ And then watch how that plays out,” says Reed. “Then after the next 90 days, come back and say, all right, this didn’t work, but I think this will, and by your first year there, you will have built that synergy and support model with your team to really be an effective leader.”
Building Up the Next Generation of Leaders
With a shortage of new talent entering the HTM profession, finding and developing the next generation of leaders has become even more critical. Sutton and Reed agree that leaders should come from within the field, but the talent shortage has led to hiring less experienced people. As a result, shops are increasingly needing to invest more in training new biomeds.
“We need to start being creative in our methodologies of who we take,” says Sutton. For instance, he posits, “Do you take someone with a high school diploma and have a formalized internship program that will allow for development?”
One of the companies working to train new biomeds is NVRT Labs. Pronounced “invert”, NVRT offers virtual reality (VR) training on specific equipment, coupling it with learning modules and written materials to help inexperienced technicians quickly get up to speed.
Matthew Bassuk, CEO of NVRT Labs, says that many healthcare organizations are turning to local community colleges, hiring students to fill needed positions. Unfortunately, many community colleges are closing their biomed programs, meaning innovative techniques will be necessary to provide new techs with the training they need
“We see that as a big opportunity, because a lot of ISOs, health systems, and different healthcare facilities are starting to pull technicians from online programs, and they’re coming out and hitting the ground running,” says Bassuk.
NVRT’s VR training uses Oculus Quest headsets loaded with fully virtual versions of common equipment, such as infusion pumps. Users can see and manipulate the devices to learn how to service the components of each piece of equipment, ensuring that when they enter the real world, they already have hands-on experience.
“What’s cool about VR is that it provides users with autonomy to experiment with the device,” says Bassuk. “You can break things and just get comfortable with it. Your brain really starts to fill in some of the gaps and make it feel a lot more real than it is, and it does so very quickly.”
The realism of VR training has led to some unintentional mishaps, such as users trying to lean on tables that aren’t actually there. However, the perceived reality of performing procedures in a 3D environment allows users to familiarize themselves with equipment and protocols in a way that written curricula alone cannot achieve.
Bassuk says that NVRT has even explored the possibility of adding soft skills training, such as dealing with customers or peers, allowing aspects of leadership to be practiced in the same way as repairing a medical device.
Because leadership, experts agree, requires both technical skills and the ability to manage relationships, soft skills training has become essential. For WakeMed’s George Reed, it’s all part of setting yourself up to lead effectively and ensure the growth of future leaders.
“As a leader, you should always be developing your replacement,” says Reed. “If you have not developed your successor, and they have not developed their successor, then you have failed as a leader. So, we’re always looking at development to get people into that next level. Because if you don’t do that, you’ll always be behind the ball.”
