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About good leadership

Interview with Tobias Nordin


The big award, it came unexpectedly. In 2014, Tobias Nordin, then 42-years old and chief of a large psychiatric clinic, received an award from the Queen and was named the “Healthcare leader of the future”. In the follow-up of this achievement, Tobias Nordin was offered several senior managerial positions, none of which he accepted. Instead, he chose to continue working to further develop his clinic. And three years later when he had achieved these goals, to everyone’s surprise, he decided to step down.

The idea with this interview was to query a well-recognized leader and chief in order to find out the secrets behind a successful leadership. Given the fact that Tobias had chosen to end his career as chief I initially found it hard to know where to begin. What was it like leading a huge organization – and why did he stop?

As with so many other meetings these days, even this interview was conducted over video link. Tobias has just come home from Aalborg, where he works as a physician at a clinic for bipolar disorders. Our conversation alternates between then and now. In our dialog, I notice that Tobias is a man who has reflected over his existence. His answers are precise, well formulated and anything but stereotypical.

Becoming the head of a large clinic was never a thought or plan of mine, says Tobias. However, as a resident in psychiatry he often noticed how much his coworkers would complain about leadership. This did inspire his curiosity about what it would be like to lead an organization and if this could be done in a successful and effective way. Tobias’ interest grew stronger and after completing his residency in 2006 he was appointed medical director and chief physician at a psychiatric department, at the age of just 33. Three years later he became chief of the whole clinic.

You became the head of the entire clinic at the age of 36.

It was quite challenging and exciting from the very beginning. I wanted to make a difference in order to change the way psychiatry worked. From the beginning, I realized the importance of creating a strong team around myself. This is partly done by getting to know each other properly, and giving colleagues the right conditions to perform their work. To show understanding for peoples differing personal and professional capacities is crucial to achieve a well-functioning work environment with a common goal to strive for the best outcome. And also by conveying enthusiasm and inspiration.

What traits according to you characterize good leadership?

Showing care for others is indeed a foundation in a good leadership. You must have the ability to put yourself in the situation of others. You also have to act as a role model, not only in theory but also in practice. Coworkers will do as you do and not just follow your words. In this respect, I took part in regular clinical work, even though it was not that much, it mattered. Furthermore, it is important to create a positive atmosphere and always emphasize the value of everyone’s efforts in order to reach common goals. I also believe that it is important to listen to coworker’s ideas and give them the chance to grow in their roles. It is of the utmost importance to communicate the context and conditions which all coworkers just relate to. And of course relating to a healthcare management who understand and trusts how the clinic is run.

Fewer and fewer physicians choose a career a chief. What are your thoughts about this?

This is something that has varied over the years. In periods, the ability to lead has been given so much more importance than the medical profession itself. At other times, it has been considered important that the head of a clinic is both a medical doctor and a good leader. I do believe that doctors have something extra to contribute in leadership positions.

When everything was going so well professionally as chief, why did you suddenly stop?

It was due to a series of different happenings. The award as “leader of the future” led to much recognition and with it, higher expectations, probably mainly from myself. In one way, this led to increased stress. Of course, it is nice to feel appreciation. However, I think that this led to me not going through with some of the changes in the organization that I had planned to do, such as introducing levels of leadership under myself. In the end, I had 35 chiefs who directly reported to me, and this was in an organization with 750 employees. As a result, I was actively involved in too many processes, which with time had obvious consequences.

I found it quite difficult with an increasing scrutiny from the media and other involved parties as I sometimes had to stand up for things I really did not support. And it didn’t matter how I expressed myself, there were always some persons who felt that I had not argued or defended them enough. That I did not take a clear stand on any particular issue. However, from my perspective, I could often see that all involved parties were right in their own way and had done things as they should. It was important to me to communicate the facts in a balanced way, when the situation or issue at hand was a complex one. This was indeed quite difficult, and was often challenging to involve people in a constructive and fruitful dialogue.

In 2014, Tobias Nordin, then 42-years old and chief of a large psychiatric clinic, received an award from the Queen and was named the “Healthcare leader of the future”. Image by Izabelle Nordfjell.
In 2014, Tobias Nordin, then 42-years old and chief of a large psychiatric clinic, received an award from the Queen and was named the “Healthcare leader of the future”. Image by Izabelle Nordfjell.

Other reasons were that, despite leading the whole clinic, I felt increasingly like a small cog in a large wheel. The public system is often slow, making the entire process from idea to action a sometimes long and tiresome one. All too often it was not possible to carry out the ideas and changes that my colleagues and I found important for the further development of the clinic. For example, I wanted to increase the extent of out-patient services in order to reduce the need for in-patient care but this process took too long to implement. Also, I wanted more freedom to hire people I believed would bring value to the clinic even if the cost to the clinic would increase. This and many other plans did not come to fruition. I must however add that despite these obstacles we actually achieved in making major differences and were supported by the bigger organizational apparatus for this.

However, one day I realized that all was not well.

You suffered from stress. In what way?

Suddenly, I felt something was not right. I was involved in too much. My sleep was impaired and started making mistakes, such as not finding things, showing up late to meetings and forgetting important matters. I even experienced somatic symptoms. For a long time, I asked myself if this was temporary and if there was anything I could do to remedy this. Maybe things would have worked out, but after 12 years as chief I felt that it was the right time to hand over the reins to someone else.

After so many years as a chief, how does one plan a future career?

After deciding to quit, I wanted to optimize the conditions for my successor to take over. I did not wish the clinic to suffer in this process, we had accomplished so much that it was important to keep the good work going.

I undoubtedly wanted to work as a clinician again. Actually, I had never had the chance to work full time as a doctor, since I became chief so early on in my career. However, continuing in the public system was not an alternative for me. As so often the fate played an important role. I was contacted by a company offering me work in Denmark. I thought, why not? You can only guess how nervous I was before taking on the new position in a different country. But this passed soon – and everyone was so welcoming. The time that followed was very exciting and brought me lots of joy. I learnt so many new things. Working abroad is indeed very rewarding. Working in Denmark is in many ways like working in Sweden, but many things are also different, not only the language.

At the out-patient clinic there are many colleagues with an academic background and there is a constant and creative scientific discourse. The hierarchy is more obvious than in Sweden and the chiefs do communicate in a more direct way that they do in Sweden which would probably never work in Sweden. However, I think that this structure brings the clinical work into focus and enhances cooperation between colleagues in a way that I find very liberating.

What advice would you give to a younger colleague who is considering a career in a chief’s position?

Think and plan before you embark on a chief’s career. Are the conditions right and do you have the right people around you? It is also wise to have an experienced mentor to guide you.

It is so important to be yourself, and not to “play the role” of chief. I believe that insecurity in this role may sometimes express itself in undesirable behaviors, such as being too authoritative. Dare to admit your shortcomings and always maintain a dialogue. And do remember that you can always leave the position if you are not happy with it.

Finally, what is it like not having the same level of influence you once had as chief?

At present, I feel no desire to lead again. I am most happy to work full time as a doctor. It is also nice and inspiring to see others lead, experiencing how they do it and evolve over time. Being a former chief myself, I have always told my superiors that I now am happy being just a coworker. I am however always ready to share my experiences of leadership if and when asked. This has then happened on several occasions, and I believe that they been fruitful and constructive conversations. □


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