We just went through our Joint Commission site survey and I have a few thoughts after doing this as a medical director. The Joint Commission for the Accreditation of Healthcare...
In 1995, New York Times columnist Daniel Goleman authored Emotional Intelligence, a book that popularized the idea that people who are able to recognize their own and other people’s emotions and then use that information to optimally manage relationships are more effective leaders. Goleman also examined leadership behaviors of executives and classified them into 6 leadership styles using different elements of emotional intelligence. Four of these styles are generally positive and two are generally negative. When you are working with physicians, no one leadership style works best in every situation.
This is a top-down, bullying style where the leader demands immediate compliance with his or her directives and can be summed up by the phrase “Do what I tell you”. Subordinates are dissuaded from expressing their own ideas and there is a sense of lack of flexibility in the organization. This is not a style of leadership for the long-run of an organization but can be effective in the short-run when there is a crisis in the institution or when there is a group of problem employees. After the crisis is resolved, however, the coercive leader has a negative impact on the organization by undermining motivation and rewards.
Authoritative leaders are visionary and motivate subordinates to want to follow them. Their style can be summed up by the phrase “Come with me”. These leaders tend to not direct people in the specifics of how to do their job but rather on what the ultimate goal of the organization is, thus allowing people to devise their own means to that goal. This is one of the most effective leadership styles for most organizations, particularly when the organization has lost sight of its long-term mission. However, in hospitals, where the physicians are the subordinates, an authoritative hospital leader can sometimes come across as overbearing or out-of-touch, particularly when those physicians are more skilled or experienced than the leader.
These leaders create harmony and create emotional bonds by utilizing empathy and building relationships. It can be summed up by the phrase “People come first”. Communication skills are the greatest tool of these leaders. They use frequent positive feedback to motivate and build a sense of belonging. Although generally a positive leadership style, by exclusively relying on positive feedback, poor performance may go uncorrected. Furthermore, exclusive use of this leadership style can result in people losing sight of the ultimate mission of the organization.
These leaders strive to create consensus and their style can be summed up by the phrase “What do you think?” They seek input by their employees and use their actions to maintain high morale. By doing this, employees are better able to be realistic about what can and cannot be accomplished in the organization. However, in a committee, this leadership style can result in endless meetings where everyone is speaking their mind and nothing gets accomplished. This style works best when the leader needs ideas and guidance from employees and works best when the leader can subtly use it to make subordinates come to a desired conclusion on their own to make them feel empowered. It does not work in times of crisis or when the employees are not knowledgeable or competent in the issue at hand.
These leaders set an example of high performance standards by being a high performer. They are often the hardest workers and set expectations for everyone else to work just as hard. This style can be summed up by the phrase “Do as I do, now”. The problem with this style is that most of the other employees can’t keep up with the highest performer and over time, these leaders can be exhausting. It can be used effectively in brief and selective situations in order to motivate highly skilled employees, for example, to meet an upcoming, important deadline.
This style of leadership is best for developing people for the future by improving their performance or developing their individual strengths. These leaders are great listeners and use their communication skills to foster employees career growth. This style can be summed up by the phase “Try this”. These leaders will accept short-term failures if those failures result in better long-term performance. However, this is a very time intensive leadership style that requires the leader to do a lot of one-on-one personal mentoring and it can be hard to incorporate into a 60 or 70 hour work week. Furthermore, some employees are not able or willing to change their behaviors and in this situation, persisting with coaching can be frustrating and waste the leader’s time.
So, what is the best leadership style? Ideally, all 6, when used in the right situations. No one style is best all of the time. This is especially true when you are leading physicians. Ideally, a hospital leader needs to primarily use authoritative, afflictive, democratic, and coaching styles most of the time. But, there can be occasions when coercive and pacesetting styles need to be used in moderation. The key is to try to match the style of leadership you employ to the specific situation. And the reality is that most of us cannot do all 6 styles but we do need to be able to recognize others who do have the leadership styles that we lack so that we can appoint them to leadership positions when that style would be the most effective one to use.
August 17, 2017