John D. Kelly IV, MD, is a professor of orthopedic surgery at the University of Pennsylvania. He focuses his blog on helping surgeons reduce stress while achieving balance in their practices and families.

BLOG: Own your life

In their masterful treatise, “Extreme Ownership: How U.S. Navy Seals Lead and Win,” former Navy Seal Officers Jocko Willink and Leif Babin artfully convey key leadership principles learned during SEAL training and months of battle experience in war-torn Ar Ramadi, Iraq. The authors delineate several battle-tested principles of leadership ranging from minimizing ego to respecting chain of command. However, the singular most important leadership trait illustrated in their handbook is the practice of extreme ownership. That is, exemplary combat leaders own the outcome of every aspect of their mission. They assume responsibility and do not look to others for success. If failure manifests, true leaders take the heat and do not blame subordinates – they are responsible for all the dimensions and consequences of a mission. The authors are emphatic in the importance of leadership. They flatly state: “There are no bad teams, only bad leaders.”

Extreme ownership, the authors write, is the singular most important characteristic of any high- performance winning team. When subordinates do not perform, extreme ownership leaders look themselves in the mirror and recognize they failed in explaining the mission, developing the tactics to succeed or securing the training and resources necessary for proper mission execution. Real leaders train and mentor underperformers, including simplifying the mission and communicating effectively so everyone believes in the purpose of the directive.

Taking ownership for failure requires exceptional humility and character. However, humbling oneself and owning failure is the only path to growth. When we look failure in the face, we take inventory of what went wrong and endeavor to improve. Mission debriefings, held after mission execution, are an excellent exercise in continual improvement as leaders convey what aspects of the mission went well and what actions fell short of excellence.

When extreme leaders take the heat for their subordinates in the midst of failure, trust and loyalty are increased and junior members of the team are more likely to respond in kind when confronted with their own defeats. Dysfunctional leaders play the “blame game” and hold everyone else accountable for failure. Subordinates are thus more likely to follow suit and sow the seeds of a blame culture as opposed to one based on constructive feedback. Growth is stunted and criticism flourishes.

Orthopedic surgeons can readily apply extreme ownership to several aspects of their lives:

1)     If your OR culture is not positive or efficient, own it. Convey the importance of the mission (patient care) to all team members and train your associates accordingly. When everyone believes in your vision, teamwork and productivity will meteorically rise.

2)     Office hours may seem like drudgery. Own it. Convey to your staff your need to see the types of orthopedic patients that feed your bliss. If you love shoulders, ask to see more. When room turnover seems to be dragging, assume responsibility that you did not ensure your staff was adequately trained. If the front desk is not cordial, you have failed in educating them in the importance of kindness.

3)     If your marriage is languishing, own it. Assume responsibility for what you are bringing (or not bringing) and endeavor to grow. When you own your relationship, you will begin to see the ways in which are not holding your end of the bargain.

4)     Exercise a mission “debriefing” after every surgery, even if it requires only a few moments. Be vigilant as to why certain aspects of surgery may not have gone as planned and discuss with your team how to improve for similar cases.

Willink and Babin concede that some subordinates were refractory to correction. The mission took primacy over disgruntled soldiers, and certain warriors were relinquished of their responsibilities. Thankfully, this was a rare occurrence.

When we practice extreme ownership in every aspect of our lives, we are practicing proactivity in its highest order. We assume responsibility for our lives and do not abdicate our fates to others. 

The quest for excellence in all realms of life starts with us; we are the masters of our fate. When we own it, we can change it.



Willink J and Babin L. Extreme Ownership: How U.S. Navy SEALs Lead and Win. St. Martin’s Press; 2017.