American Association for Physician Leadership

Problem Solving

Do You Hide Behind Your Management Style?

Timothy W. Boden, CMPE

August 8, 2017


Abstract:

How would you describe your (or your practice manager’s) leadership style? Some people gravitate toward a “directive” style and prefer simply to tell everyone what to do and how to do it. Others approach the job with a “collaborative” style, taking on more of an advisory role. Whichever approach you prefer, your effectiveness depends on more than your style. The real issue is whether or not you lead the practice proactively. This article presents four habits of effective practice managers. These principles highlight every leader’s critical role in managing expectations. Every disappointment on the job—or in life, for that matter—comes from unmet expectations.




How would you describe your (or your practice manager’s) leadership style? Each person’s management style reflects a combination of his or her personality, experience, and training. Some people gravitate toward a “directive” style and prefer simply to tell everyone what to do and how to do it. Others approach the job with a “collaborative” style, taking on more of an advisory role. Defining “leadership” as influencing other people, directors exercise their influence by giving orders and instructions. Collaborators influence others by focusing on consensus-building and teamwork. The collaborator says, “Let’s do this,” whereas the director says, “Do it.” Both approaches can work well, but an organization’s culture will likely respond to one way better than the other.

Reactive or Proactive?

Whichever approach you prefer, your effectiveness depends on more than your style. The real issue is whether or not you lead the practice proactively. Bill Tiffan, a management consultant, describes four fundamental principles involved in managing people proactively instead of employing the all-too-common reactive approach.(1) The proactive manager doesn’t wait for problems to manifest and spin out of control. He or she serves as a catalyst for the employees in their efforts to deliver excellent performance in their jobs. Proactive managers anticipate problems and take preemptive action. They demonstrate a sense of urgency—they are characterized by action. By contrast, reactive managers seem to be playing “catch up” most of the time. If questioned about their management methods or supervisory styles, you might hear them saying, “I don’t like to micromanage my people. They’re adults—they ought to be able to do their jobs without me looking over their shoulders.” These managers typically pride themselves on having an open-door policy and say that staff members know “they can count on me—I’m always available to help them.”

A Measure of Independence

There is nothing wrong with hiring good people, training them well, and trusting them with enough autonomy to do their jobs. In fact, it can sound attractive to a business interviewing a candidate for the office manager’s job. Oppressive, tight oversight can quash creativity and initiative and can prevent staffers from giving their best performances. Micromanagement will often hinder excellence. But the disclaimer “I’m not a micromanager” may only mask an unproductive management approach that characterizes people who lack the confidence they need to lead others effectively. This supervisory hesitance may stem from inexperience or a feeling that the people who answer to them know more about their jobs than these managers do. More often than not, these managers have a general aversion to confrontation—perhaps in most relationships.

If your personality makes you uncomfortable with confrontation, that does not mean you are unqualified to manage.

Even if yours is a nonconfrontational style, however, you can still make it work for you. Hesitating at uncomfortable and challenging situations turns into organizational dysfunction when it prevents a leader from speaking up at critical times. It can prevent clear communication—without correction, subpar employees will likely cruise along under the impression that their performance is “good enough.” Nonconfrontive managers who recognize the boundaries of their personal comfort zones must sometimes force themselves to be more direct when the situation calls for it. But if they learn—and exercise—the principles of proactive management, they can still influence staff members without undergoing a personality makeover. They can use a collaborative style and still apply Tiffan’s four principles.

Four Habits of Effective Practice Managers

Tiffan clarifies that his four fundamental behaviors do not cover everything an effective manager must do. But these principles form a foundation on which the other skills and activities rest:

  • Setting clear expectations: To set clear expectations, the leader provides clear, written job descriptions. He or she uses thorough orientation and training to make sure the employee understands and can do everything in the description. Then, providing benchmarks and goals, the manager lets the employee understand what “success” will look like.

  • Monitoring and measuring performance: Setting goals without a sense of accountability renders the goals meaningless. The proactive manager studies the data and compares the employee’s performance to the stated goals.

  • Supporting performance: An organization with proactive management provides its employees with all the necessary tools and resources they need to excel at their jobs. Resources include technology and equipment, ongoing training, opportunities to network with other experts, and the like. Talking about performance helps employees understand it as one of your organization’s core values.

  • Acknowledging performance: Whether it’s an observation and compliment from time to time or a formal recognition and rewards system, the regular messages that say, “Thanks for a job well done” provide incentive for excellence. At the same time, if there are no consequences for failure, the compliments can start to sound hollow.

These principles highlight every leader’s critical role in managing expectations. Every disappointment on the job—or in life, for that matter—comes from unmet expectations. Without clear goals and proper directions, the most conscientious employee might work very hard to accomplish the wrong things. Practice managers who spend all their time sequestered in their offices cannot keep an eye on operations. They cannot provide the guidance and little course corrections needed for employees who occasionally stray from the plan. They cannot see the subtle clues that help them anticipate problems before they escalate to full-blown disasters. They cannot speak with confidence when delivering performance evaluations. They cannot be proactive. If your personality makes you uncomfortable with confrontation, that does not mean you are unqualified to manage. Proactive management does not require you to deny who you are and turn into a confrontational taskmaster!

But you must be able to handle looking an employee straight in the eye and stating clearly, “This is what we need and expect from you,” and sometimes, “You are not meeting our expectations.”

Proactive Managers in the Real World

We recently participated in a project that provided the opportunity to talk to physicians and administrators who run some of the most successful medical practices in the United States. These practices were identified by the Medical Group Management Association in its annual practice survey processes. About 500 organizations’ survey responses revealed them as top performers in four categories: (1) profitability and cost control; (2) productivity; capacity and staffing; (3) accounts receivable; and (4) patient satisfaction. Their success did not depend on size—top performers represented two- or three-doctor offices as well as large health systems with hundreds of physicians. Almost every medical specialty appeared in the list, too. As we reviewed dozens of success stories, each practice leader attributed his or her achievement to a unique combination of factors—none of them were truly identical. One common thread ran through all the stories, however. Based on Tiffan’s description, these leaders showed typical characteristics of proactive management. Each told stories about time-consuming “management by walking around,” strong relationships with the people they supervise, clearly communicated performance goals, and developing a culture of accountability and excellence. And that’s one of the often overlooked secrets of the best-run practices.

Reference

  1. Tiffan B. The art of team leadership. Am J Health Syst Pharm. 2014;71:799-801.

Timothy W. Boden, CMPE

Freelance Journalist

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