by Margaret (Maggi) Cary

As we move into patient-centered care and a collaborative approach to practicing medicine, I’ve been researching the latest on effective teams. Creating a high-performing team is an acquired skill, and a skill we don’t learn in medicine school.

Harvard professor J Richard Hackman has observed hundreds of teams and then analyzed the data to find out what makes the most difference. He’s identified five factors, and the more of them a team has, the higher the team performs. The key role of the leader is to create the five conditions for the team. Dr. Hackman has studied many leadership styles and believes it doesn’t matter what style you use to get the five elements in place, just that you do it.

1. It has to be a real team, rather than in name only, with a team task that requires joint collaboration, clear boundaries of who is on the team and who isn’t, defined authority so team members know what they can and can’t do, and stability of team members.

2. The team members need a clear goal that is challenging, clear and consequential. How they achieve the goal is up to them.

3. Members need to view their goal as meaningful, feel responsible for their work and get feedback on their results.

4. The team needs a supportive environment that includes rewards team members care about, information to perform that is available at the right time and format, and training and tech assistance to insure members have the necessary skills for the job.

5. The team needs expert teamwork coaching. If the other conditions are lacking, coaching has little impact on performance. If the other conditions are in place, poor leadership has minimal negative impact on performance.

Have you put the five conditions in place for your team? Can you step back and let your team members get the job done?

Margaret Cary, MD, MBA, MPH
Maggi is a family doctor and leadership coach who engages her audiences in highly interactive presentations. Maggi is a doctor’s doctor with a physician’s mind and a friend’s heart. As an executive coach, she blends a scientist’s thinking with empathy. She is a constant learner and serial focuser with a lifelong passion for sharing what she’s learned. She is an inspirational motivator, occasional humorist, and excellent listener and storyteller. She translates the latest research in leadership development into her coaching process and into entertaining and highly interactive presentations. She is an author, trainer, facilitator, and teacher (Georgetown University School of Medicine). Her authenticity and ability to communicate and connect emotionally with her audience through storytelling—combined with just enough humor—result in rave reviews and standing ovations. She embodies a warm, sincere approach in sharing lessons learned as she guides you in creating your own Leadership Expedition. Email Dr. Cary at to learn more.


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