In Reply:

Abstract

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.