Leadership is in crisis and the command and control model is bankrupt. In healthcare, we will need a cadre of physicians to lead us to the promised land. However, doctors don’t seem interested and are pre-occupied mostly with keeping their heads above water or putting them in the sand.
Coping, let alone thriving , in this turbulent sick care environment will require an attitude change. Consider:
1. Doctors need to evolve from technicians to managers to leaders to entrepreneurs to leaderpreneurs to thrive. Some call it practicing at the top of your license. In addition, filling the C-suite with more physician managers just makes it harder to innovate and adds further clutter to the organization.
3. The large majority of “leaders” are managers with no leadership skills and are examples of the Peter Principle. At best, most are managing process, safety and quality improvement, not significant and meaningful sick care innovation.
4. Leadership is about communicating vision, direction and inspiration. It is not managing. Entrepreneurship is the pursuit of opportunity with uncontrolled resources with the goal of creating user defined value through the deployment of innovation. Innovation has both a qualitative and quantitative component and is measured by user defined multiples of both.
5. Most leaders fail because they have poor communications skills. They have poor communication skills because they don’t know how to listen, engage and motivate followers.
6. Listening fails for many reasons, not the least of which is not ignoring your internal conversation and changing the lenses through which you see and hear people.
7. Who is “the leader” is not something determined by the org chart. Get rid of it and take advantage of the leadership potential of those without the titles on their office door. Navy Seals do. Israeli army officers do. You can too and it won’t be nearly as dangerous but it usually involves having as much courage.
8. Require every manager to go to leadership boot camp before they can assume any leadership position. Assign them a mentor and get them coaching.
9. Value is the coin of the realm. Leaderpreneurs have to evolve and adopt an entrepreneurial mindset. In the new world of robotic infested work, everyone has to be an entrepreneur or run the risk of losing their jobs. Just ask Watson.
10. Hire, develop, promote and reward for innovation.
Leaderpreneurship development isn’t creating leaderpreneurs whether it be those who deliver are or those who manage and lead it.
Leadership development expert, Alan Patterson, describes the four stages of leadership at it applies to technical experts like physicians:
Stage 1: Expertise derived from technical competence
Stage 2: Credibility derived from people skills
Stage 3: Execution, alignment and engagement, derived from teaching, coaching and inspiring other people , focusing on the now
Stage 4: A strategic mindset focusing on the next (making existing products and services better) and the new (making existing products and services obsolete)
One key difference between management and leadership is that the former is about you and the latter is about coaching and teaching the people you lead.
Leadership styles depend on the situation. Here are the six leadership styles Daniel Goleman uncovered among the managers he studied, as well as a brief analysis of the effects of each style on the corporate climate:
The pacesetting leader expects and models excellence and self-direction. If this style were summed up in one phrase, it would be “Do as I do, now.” The pacesetting style works best when the team is already motivated and skilled, and the leader needs quick results. Used extensively, however, this style can overwhelm team members and squelch innovation.
- The authoritative leader mobilizes the team toward a common vision and focuses on end goals, leaving the means up to each individual. If this style were summed up in one phrase, it would be “Come with me.” The authoritative style works best when the team needs a new vision because circumstances have changed, or when explicit guidance is not required. Authoritative leaders inspire an entrepreneurial spirit and vibrant enthusiasm for the mission. It is not the best fit when the leader is working with a team of experts who know more than him or her.
- The affiliative leader works to create emotional bonds that bring a feeling of bonding and belonging to the organization. If this style were summed up in one phrase, it would be “People come first.” The affiliative style works best in times of stress, when teammates need to heal from a trauma, or when the team needs to rebuild trust. This style should not be used exclusively, because a sole reliance on praise and nurturing can foster mediocre performance and a lack of direction.
- The coaching leader develops people for the future. If this style were summed up in one phrase, it would be “Try this.” The coaching style works best when the leader wants to help teammates build lasting personal strengths that make them more successful overall. It is least effective when teammates are defiant and unwilling to change or learn, or if the leader lacks proficiency.
The coercive leader demands immediate compliance. If this style were summed up in one phrase, it would be “Do what I tell you.” The coercive style is most effective in times of crisis, such as in a company turnaround or a takeover attempt, or during an actual emergency like a tornado or a fire. This style can also help control a problem teammate when everything else has failed. However, it should be avoided in almost every other case because it can alienate people and stifle flexibility and inventiveness.
The democratic leader builds consensus through participation. If this style were summed up in one phrase, it would be “What do you think?” The democratic style is most effective when the leader needs the team to buy into or have ownership of a decision, plan, or goal, or if he or she is uncertain and needs fresh ideas from qualified teammates. It is not the best choice in an emergency situation, when time is of the essence for another reason or when teammates are not informed enough to offer sufficient guidance to the leader.
There is a growing acceptance of the practice of formally developing physician leaders to help navigate the increasingly turbulent health care landscape. Research points to the important role that clinical leadershipcan play in improving the performance of health care organizations. Growth in compensation for physician executives, particularly those with postgraduate management degrees, signals higher demand and appreciation of their value.
While satisfaction scores might be high, unfortunately, only about 10% of leadership development programs are successful. They fail for 3 basic reasons:
“The first is a gap in motivations. Organizations invest in executive development for their own long-term good, but individuals participate in order to enhance their skills and advance their careers, and they don’t necessarily remain with the employers who’ve paid for their training. The second is the gap between the skills that executive development programs build and those that firms require—particularly the interpersonal skills essential to thriving in today’s flat, networked, increasingly collaborative organizations. Traditional providers bring deep expertise in teaching cognitive skills and measuring their development, but they are far less experienced in teaching people how to communicate and work with one another effectively. The third reason is the skills transfer gap. Simply put, few executives seem to take what they learn in the classroom and apply it to their jobs—and the farther removed the locus of learning is from the locus of application, the larger this gap becomes. To develop essential leadership and managerial talent, organizations must bridge these three gaps.”
Politicians,whether in your company or in the upcoming elections, promise change. Leaders make it happen. They lead innovators, they don’t manage innovation. There just seems to be fewer and fewer of them wearing white coats and physician leadership and MBA programs are not working.
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