Abstract:
Over the past 30 years, I have worked in medical practices of all sizes and specialties, practice settings and organizational structures. I’ve seen dysfunctional practices full of miserable doctors and staff, and I’ve seen practices that perform so well, so smoothly that if I tried to describe them, you might find it hard to believe me! Top-performing practices—regardless of size and specialty—invariably had outstanding leadership. Lead physicians and administrators in these practices consistently demonstrated many, if not most, of the 10 qualities of servant leadership.
The man who gave me my first job in healthcare found great satisfaction in mentoring men and women in whom he saw potential. He bragged like a proud papa about his successful protégés. Under his tutelage, I eventually became one of three assistant administrators at the multispecialty practice that employed us.
His desire to develop leadership skills in his administrative staff led him to include a training segment in our weekly meetings. One of our most memorable study courses took us through the 12 chapters of Earl Nightingale’s Lead the Field audiobook (Nightingale-Conant Corporation, 1986). Each week, we listened to a chapter playing on the portable cassette player (it was the late 1980s) in the middle of our conference room table. Chapter 3, “A Worthy Destination,” included a quote that left a lasting impression on me:
“Now, whom do we serve? Each of us serves a portion of humanity. And humanity, to any given person, is the people with whom he comes in contact. It is family, friends, neighbors, coworkers, customers, prospects, employers—all those he has chosen to serve. Everyone—everyone with whom we have any kind of contact—is to us humanity. And our rewards will be determined by the extent to which we serve.”
Buzzwords come and go. The concept of servant-leadership gained popularity in the 1990s, and you could hardly attend a management conference without hearing how servanthood could provide the key to successful leadership. The concept, revitalized and applied to business management by Robert K. Greenleaf in his essay “The Servant as Leader” (Robert K. Greenleaf Center, 1970), traces its roots back to ancient times. The idea can be found in the teachings of China’s Lao-Tzu, India’s Chanakya, and (probably most familiar in our culture) Jesus: “The greatest among you will be your servant.”
Servant-leadership seems to have become somewhat passé among some of the high-powered executives and politicians that have risen to prominence in recent years. I, for one, don’t believe the concept was merely a passing fad. Neither would I categorize it as a management method or strategy. Rather, I am convinced that it goes much deeper—it’s a fundamental truth about human relationships.
Servant-leadership is a fundamental truth about human relationships.
Scholars who study management and leadership theory generally agree on several themes characteristic to the development of a servant-leader:(1)
Listening: An obvious emphasis on listening effectively to others;
Empathy: A demonstrated understanding of others’ feelings and perspectives;
Healing: A conscientious fostering of each person’s emotional and spiritual health and wholeness;
Self-awareness: An above-average understanding of his or her own values, feelings, strengths, and weaknesses;
Persuasion: An ability to persuade and influence others;
Conceptualization: A gift for integrating present realities and future possibilities;
Foresight: A well-developed sense of how the past, present, and future are connected;
Stewardship: A sense of stewardship that holds an organization’s resources in trust for the greater good;
Commitment to the growth of people: A burden of responsibility for serving the needs of others; and
Building community: An ability to create a sense of community among people.
In Best-Run Practices
Over the past 30 years, I have worked in medical practices of all sizes and specialties, practice settings and organizational structures. I’ve seen dysfunctional practices full of miserable doctors and staff, and I’ve seen practices that perform so well, so smoothly that if I tried to describe them, you might find it hard to believe me!
Top-performing practices—regardless of size and specialty—invariably had outstanding leadership. Lead physicians and administrators in these practices consistently demonstrated many, if not most, of the 10 qualities listed above. On the other hand, foundering practices often had leaders with opposing characteristics:
Self-importance: A clear attitude of aloofness or inapproachability that clearly said, “I’m better than you”;
Self-absorption: An apparent carelessness about others’ (especially subordinates’) concerns or problems;
Entitlement: An attitude that seems to say that everyone else owes them something;
Contempt: An apparent irritation, or even hostility, toward the “peons” surrounding them;
Fear/paranoia: A sense that disaster lurks around every corner or that others are trying to take advantage of them;
Divisive: A lack of interest or even ability in team-building; and
Ineffectual: A lack of influence and persuasive skills, causing them to resort to intimidation and fear to get things done.
Now how do these characteristics manifest in the medical practice setting? You can see evidence of servant-leadership (or the lack thereof) in the attitudes and behaviors of physicians and administrators, but you can’t see into their hearts.
Servant-leadership is a mindset, not a method.
Unlike your leadership approach or style, your heart isn’t quickly revealed or easily observed. Servant-leadership is not a strategy. It’s something deeper than that. The characteristics identified by all those scholars for the most part point to internal attitudes. Servant-leadership is a mindset, not a method. You will likely profit from introspection and self-assessment; however, it takes real honesty and insight. Most people are quite adept at lying to themselves.
To determine how much servanthood you have in your nature, honestly reflect on your first reaction to situations like these:
Walking through the practice’s parking lot, you notice a discarded diaper lying on the pavement between two cars. Do you pick it up, or do you direct someone else to take care of it?
Your front-desk personnel have patients three-deep at each workstation, every billing clerk has a phone to his or her ear, and every nurse is dealing one-on-one with a patient. Do you pick up a ringing phone, or do you let it go to voicemail?
One of your lab technicians has been making a lot of mistakes lately. Reports are haphazard and late. As you pass by the lab, you notice her sitting at the computer with tears in her eyes. Do you hurry on by, or do you step inside and ask her what’s troubling her?
You have a jam-packed schedule—every exam room is occupied. The patient you have just examined is clearly terrified and doesn’t understand his condition or your treatment plan. Do you take the extra time to explore his fears and find an effective way to enlighten him, or do you shove some patient education materials toward him and excuse yourself to try and stay on schedule?
We could come up with any number of scenarios to illustrate the point, but I think you get it: What is your initial impulse when faced with an opportunity to “go the second mile”? Your visceral response might range from resentment to eagerness—resenting that anyone would bother you with unreasonable expectations or eagerness to meet someone’s needs.
I’m not talking about vapid, neurotic people-pleasing! I’m talking about appreciating, valuing, and caring for others, even those who work for you and answer to your authority.
Servant-leaders aren’t weak, sniveling sycophants. They demonstrate a strength that comes from self-awareness and confidence in their abilities and positions. From that position, you can afford to be generous in your service.
And as the late, great Mr. Nightingale pointed out: “Our rewards will be determined by the extent to which we serve.”
Reference
Servant leadership. Wikipedia. http://en.wikipedia.org/wiki/Servant_leadership