Leadership
models illuminate areas for personal growth and development using various
lenses to focus on different blind-spots.
My personal journey in leadership has progressed with fits and starts,
finally gaining momentum as I moved into residency as I developed a personal
vision of how I could and would lead.
I’ve discovered new skills, styles and situations to be a more
thoughtful and deliberative leader. Through
anecdotes from residency, I will share my current progress. Firstly, I will show my Situational Leadership in the clinic. Secondly, I will show how my Leadership style has keenly sharpened
under fire in a national organization. Finally, I will discuss how Authentic Leadership has affected me.
Tackling New Leadership Situations in a
Family Medicine Clinic and Residency
Our clinic has
small teams for coordinating care with patient outreach. We have weekly
meetings to review our tasks like calling patients to come in for routine appointments,
developing cancer screening scripts/protocols and other routine tasks. As
an intern, I discovered that leading a medical team on rounds in the wards does
not work the same way as a multidisciplinary setting with a secretary, medical
assistant and nurse. For example, when I
started working with “Jay,” a front-desk staff member, I needed to titrate my
leadership downward to suit his level of development. Following Hersey and Blanchard’s (1969) Situational Leadership II (SLII) model
of supportive and directive behaviors, I started with a hands-off approach. (Appendix 1)
Initially I used supportive “participating” behavior: High-relational,
low-task behavior. I gave “Jay” control
of day-to-day decisions while I was available to facilitate problem
solving. I sent messages along with some
tips on how to manage the work through the day.
However, the work was not completed at the end of the week, so I switched
to a coaching “selling” style: high-relational and high-task behavior. I
asked another front desk secretary to sit down and coach his outreach to give him
tips on how to complete the tasks in a timely fashion.
After a month went by, I sat down and used a directive “telling” style:
low-relational, high-task behavior. I gave
him direct tasks and directly supervised him carefully. Only under this level of scrutiny did I discover
that his inbox was cluttered with multiple versions of my messages I kept
sending to him that he was afraid to touch or act upon them without direct
approval.
My initial
problem was not matching “Jay” with his appropriate development level. Directive and supportive behavior needs to
match with the development level of the follower on a competence/commitment
continuum. I had initially assumed that “Jay”
was a D3 employee with moderate/high competence, when in fact he was a D1-2
employee with low competence. However, he
does not have the associated "high commitment" level. In order to work with him effectively, I need
to help motivate him.
When I
recognized the utility of the SLII model , I investigated Hersey and Natemeyer’s Power Perception Profile (1979) to assess
what my preferences were for a utilization of various power bases and identify
which type of maturity or development level best suited my preferences. There is a spectrum of power bases necessary
to influence people's behavior at specific levels of maturity: from
coercive-connection to reward-legitimate to referent-information and finally,
expert. (Appendix 2) My highest scoring preferences were in the
highest level domains of Expert and Information. According to Hersey and Natemeyer, this
correlates with a high maturity follower and I work best with M3-M4
followers. “Jay” is an M1 follower so a
better method of approaching his situation would be to form strong connections
with influential/important people in the front desk and provide small
observable rewards for those who do well.
A criticism I have with this model is that it implies that low maturity
followers respond best to “sticks rather than carrots” and it encourages a
coercive power base over a reward power base in some situations. While this may hold true in some fields like
the military, I do not think that harsh discipline has positive effects in the
healthcare field except to drive people away and hurt relationships. Finding this leadership model lacking in some
respects, I sought out other ways I could work better with a team.
Developing a New Leadership Style in the Committee of Interns and Residents
In
residency, I signed up as a union representative and quickly rose through the
ranks from regional delegate to hospital chapter president to state executive
board member for the national organization. During my fellowship, I have
worked as an elected resident board member on the Committee of Interns and
Residents (CIR), a U.S. national union organization for resident-physicians. Connecting with other future leaders, having
discussions about our collective residency mission/vision/values and developing
national programming around these issues has been exciting and stimulating for
me. However, it took me two years to
become the authentic leader we needed.
Initially I
had a laissez-faire leadership style with a hands-off attitude. During our monthly phone calls, I would mute myself
and tune out while doing other work. I
was disengaged in the tasks and had only superficial relations with the other
board members and senior CIR staff. I
was inexperienced and untrained in leadership. I did not engage in an ongoing dialogue
between the resident delegates. I showed
poor governance; I neglected to help develop policies for success and I did not
monitor for policy compliance/adherence. I engaged in what Blake and Mouton would term “Impoverished
Management (1,1)” with “little
contact with followers and could be described as indifferent, noncommittal,
resigned, and apathetic.” (Blake
and Mouton 1985, Appendix 3)
However, at
the end of my first year, we had an internal leadership crisis – the staff
executive director was up for a 5-year term contract renewal and we found out
that about half of the senior staff was dissatisfied with his management. There were an unprecedented number of union
negotiations ongoing in addition to new chapters being recruited while record
amounts of chapter losses also took place.
As a result CIR suffered low staff morale, divisive internal conflicts,
and a high attrition of key staff members through both resignations and
firings. I found myself face-to-face
with the sinking realization that I was a poor leader in a situation where
strong governance in a period of stress and change was critical. A series of
emergency meetings by the board was called.
A key quote made by the ex-president has stuck with me.
“We have been absentee landlords,
holding the power and influence but letting our local staffers run the
organization.”
In the past
year, I changed from an “Impoverished
(1,1)” toward a “Teamwork (9,9)” leadership style with high concern for
results and people. (Blake and Mouton
1985, Appendix 3) In order to do so, I
considered the personal frames of Expert and Informational power, my areas of
strength. I applied these personal frames toward
knowledge development and relationship-building to better engage in concerns on
results and people. I became an expert
on the subject of leadership through the Dundee course and used this competence
to solidify a strong corporate mission, vision, values statement and five year
strategic plan. Energizing fellow
resident board members, I developed strong relationships despite a growing
division between two sides of the board and we were able to agree on core parts
of a leadership development plan for our executive director.
Here is a key passage from an email exchange
during the discussion process that illuminates how I drew connections between
steps of our strategic plan development, using George’s Authentic Leadership principles of “True North” (2007) and
Collins’ and Porris’ “Big Hairy
Audacious Goals” (1996)
"A compass, I learned
when I was surveying, it'll... it'll point you True North from where you're
standing, but it's got no advice about the swamps and deserts and chasms that
you'll encounter along the way. If in pursuit of your destination, you plunge
ahead, heedless of obstacles, and achieve nothing more than to sink in a
swamp... What's the use of knowing True North?" – Abraham Lincoln
Imagine that CIR is taking
a physical journey towards a destination.
We are the leaders of this group through the wilderness of
residency. We are the ones with vision
and direction. We are providing
guidance.
Where do we want to go in
the next 3-5 years?
We can walk towards a hospital and rally a group of dissatisfied
residents, we can walk to a town hall and support legislation, we can go to a
conference or class room and learn about something we aren't getting in our
residency, etc. … Some paths may lead us
down dead-ends or take us on a long, expensive tangent. Others may be shortcuts that attract new
members or engage our current members to participate more in the journey.
Why are we walking down
some paths and not others?
I feel that this is because deep down; we know what we want at
the end of residency. We know why we
went into medicine. And we are looking
for ways to help our patients, to help our fellow residents and to pave the
path and make it safer and higher-quality.
These are the core values.
We are aiming towards the “Big,
Hairy and Audacious" True North.
Each step should take us a little closer. Each activity we have should reflect a value …
that provides the driving motivation to keep us walking.
(abridged email, full exchange in attached
leadership portfolio)
As George’s
interviews with great leaders showed, Authentic
Leadership is about something more than traits alone: “[the] team was startled to see that you do not have to be born with
specific characteristics or traits of a leader.
Leadership emerges from your life story.”(George 2007) This reflective exercise shows a few examples
from my life story in residency and fellowship.
The
components of Authentic Leadership model are self-awareness, internalized moral
perspective “true north,” balanced processing and relational transparency. (Appendix 4)
Reflecting on this model raised my awareness that developing Authentic
Leadership meant two things for me.
1) My relationship with “Jay” has struggled due to my “false front” and
lack of transparency with my feelings. I
have been passive-aggressive in my leader-member interactions and I will strive
to be more open without coming across as abrasive or aggressive.
2) Initially in CIR, I contributed to a culture of disengagement. In a period of critical change, I recognized
how I was complicit and at fault. I
helped shift the CIR executive board from a management organizing/staffing
discussions toward a leadership paradigm with vision-boarding and
coalition-building.
Moving
forward in future leadership positions, I will be open and aware of my own
personal failings. I will center myself
around my internal moral compass. I will
become even-keeled and measured in my emotions, thoughts, and actions. I will develop deeper bonds with my team to
find out what drives us all so we can pump each other up when we are down. I will be an Authentic Leader.
Appendix 1:
Situational Leadership
Appendix 2:
Power Perception Profile
1. Coercive power is derived from having the
capacity to penalize or punish others. (French and Raven 1962)
2. Connection power is based on connections with
influential or important people… in which compliance occurs because they try to
gain favor or avoid disfavor of the powerful connection. (Hersey, Blanchard and Natemeyer 1979)
3. Reward power is derived from having the
capacity to provide rewards to others. (French and Raven 1962)
4. Legitimate power is associated with having
status or formal job authority. (French and Raven 1962)
5. Referent power is based on followers’
identification and liking for the leader. (French and Raven 1962)
6. Information power is based on the ability of
an agent of influence to bring about change through the resource of
information. (Raven and Kruglanski 1975).
7. Expert power is based on followers’
perceptions of the leader’s competence. (French and Raven 1962)
Appendix 3: Leadership Style Grid
Appendix 4: Authentic Leadership
Bibliography
Blake, R.
R., & Mouton, J. S. (1985) The
managerial grid III. Houston, TX: Gulf Publishing Company.
Collins, J.
and Porras, J. (1996) Building Your Company’s Vision. Harvard Business Review.
George, B.
(2007) Discovering Your Authentic Leadership.
Harvard Business Review. Reprint
R0702H.
Hersey, P.
and Natemeyer, W.E. (1979) Power
Perception Profile -- Perception of Self. Center for Leadership Studies.
University Associates, Inc.
Hersey, P.,
Blanchard, K. and Natemeyer, W.E. (1979)
Situational Leadership, Perception, and the Impact of Power. Group
Organization Management. 4(4) p418-428
McCaffery,
P. (2010) The Higher Education Manager's
Handbook. Second Ed. New York: Routledge.
Raven, B.
& Kruglanski, W. (1975) Conflict and power. In P. G. Swingle
(Ed.), The structure of conflict. New York: Academic Press
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