J. Bryan Bennett, MBA, CPA, LSSGB
Executive Director, Healthcare Center of Excellence, LLC, Chicago, IL
We are facing a leadership crisis which impacts all aspects of our lives. It affects us in healthcare, government, business, education and in the church. Lack of leadership is shown when a person in a leadership position puts their own needs or personal agenda ahead of those they are charged to lead. Just because someone is in a leadership position does not make them a leader. You can be in a leadership position (supervisor, manager, director, executive, etc.) and not have any leadership abilities. This is called positional leadership and occurs when someone has some position of authority but is not practicing any form of leadership. These people are not usually very effective at what they do and only accomplish what they do because of their authority. They were probably promoted to their position because they did their job well at a lower level, but little evaluation was given to their potential for leadership. The better word to describe them is manager, not leader. We have all known people who fall into this category and, unfortunately, many of us may have worked for them.
We define leadership as: “A process by which an individual or organization directs and inspires a team or organization to reach a goal or follow a vision in a particular environment.”
Further examination of this definition reveals:
- A process: leadership is not a skill. It is a process that must be worked at daily for a person to become a better leader.
- Individual or organization: there are many individuals who are leaders, but an organization can also be a leader. For instance, Apple has been a leader in several technology areas for years, as well as Amazon in online retailing. Their competitors follow them, copy them and try to pass them in the marketplace.
- Directs and inspires: there are leaders who are good at directing people but not very inspirational, as well as leaders who are very inspirational but couldn’t properly direct a team to cross the street with a green light. A favorite analogy is that of a baseball centerfielder running into the wall to make the catch for his team. He realizes that he might hurt himself (and many have), but he believes that helping his team win the game is more important than his personal safety. A leader must inspire people to willingly want to “go to the wall” for the team because they may have to someday. Good leadership will help them feel good about making that choice.
- Team or organization: these are the followers in the equation. The team is the immediate staff or project team and the organization is the entire company.
- Reach a goal or follow a vision: the leader must have a specific goal for the team to achieve whether it be a sales or income goal, technology implementation or cultural change. Whatever it is, in addition to being specific, it should be measurable and have a defined time period.
- Environment: this represents the area that is largely out of the leader’s control. It could be the industry, government regulations or other changes impacting the organization.
As previously mentioned, true leadership is a process that must be practiced every day to be effective. It’s like a maintenance drug for high blood pressure that must be taken daily or potentially suffer dire consequences. It’s like that athlete, amateur or professional, who continually works hard to improve their already exceptional abilities in order to become better and more competitive. It is the same way any other professional works to become better, including:
- musicians and singers
This process leads to what is called professional leadership, which is an individualized, continuously-improving leadership development process based on innate qualities, personality and abilities that is practiced every day incorporating regular reflection and coaching.
The Great Leadership Debate
The great debate about leadership is whether leaders are born or made. The correct answer is yes. Some people have certain innate qualities that give them a high potential for leadership (born). They can still become better leaders through additional training. On the other hand, others without all of the innate qualities can become better leaders through training (made). Keep in mind that not everyone will be a good leader; which is logical because society couldn’t exist if everyone was a leader.
Based on research, interviews and self-reflection, the innate leadership qualities are identified as:
- humility: putting the needs of others ahead of their own
- empathy: knowing how to get things done through people
- vision: the ability to see things others don’t see or before others see them
- risk-taking: comfort with being out front and charting new territory
Humility is the recognition of one’s own importance or standing. It is the self-awareness that you are no better than the person next to you or across from you. Sometimes known as modesty, humble people make everyone feel special. Humility is the quality that is most natural. It can be learned to a certain degree, but authentic humility is hard to duplicate.
Leaders exhibit humility by making themselves available to the people they work with. Their time is valuable, but it is not so valuable that they can’t take the time to listen or discuss something that is important with others. It is very easy for people to identify leaders with authentic humility. They are the ones who return phone calls, respond to e-mails and engage with others not as a leader-to-subordinate, but as a person-to-person.
Dr. Toby Cosgrove, CEO and President at Cleveland Clinic, is a firm believer in the need for humility in healthcare leaders. He considers humility, “the ultimate wisdom.” Leaders don’t know it all and should be aware of their own limitations. It “is not the absence of self-worth, but the validation of self-worth.”
Empathy is the ability to mentally identify with the feelings, thoughts or attitudes of others. It is not the same as sympathy which implies feeling sorry for someone. It involves knowing people and knowing about the people you work with, especially your direct reports. On a business level, this includes understanding their motivations, career goals, education, etc. On a personal level, it includes knowing their entertainment interests, marital status, children’s ages, etc. This information can be used to help establish a sincere relationship with the person which makes that go to the wall moment easier to accept.
Empathy is not just for direct reports but should also be included with relationships with indirect reports and peers. Some executives like to “walk the floors” and listen to people to get to know them especially when they start a new position. This quality can be learned somewhat especially by adding notes to a contacts file, but that only provides a “robotic” approach to empathy. Sincere empathy comes from the heart and is easily distinguishable from insincerity.
Leaders exhibit empathy by getting to know and understand the people they work with. They have to generally like people and like working with people to be the most effective. It is also a considered one of the requirements for effective leadership by Dr. Cosgrove.
Vision is being able to see things others don’t see or before others can see it. People with vision can sometimes see the endgame before it even begins. The challenge for such visionaries is getting others to see the vision to gain their buy-in. This process can be very frustrating for people with this natural quality because the people they work with, especially in healthcare, are so used to doing things a certain way and can be reluctant to make any changes. This is a quality that can be learned to a degree using decision making processes and tools, but those with natural vision can reach the same or better direction more efficiently with a better understanding of the most important variable—the human factor.
Leaders with vision can effectively chart the course for where they need to go and communicate that vision in a manner that everyone can understand. This is where the direction and inspiration comes in. Good leaders chart the course by providing direction. Great leaders make their followers feel good about where they are going.
Risk-Taking is built in to becoming a leader. By accepting the position, the leader has fundamentally accepted a certain amount of risk. The leader needs to be prepared to accept the good as well the bad outcomes that may occur. There are several types of risks the leader must be prepared for including: reputation risk, career risk, interpersonal risk and financial risk. Being at the front of the team or organization opens the leader to the arrows potentially pointed at their back. If the leader can’t accept criticism or negative feedback, maybe they should consider another position.
Leaders who take risk aren’t just taking risks for risk’s sake. The risk is calculated and weighed against the potential for success or failure. They have to be ready to try new things when necessary and adapt their leadership style to the situation. Calculating risk is a skill that can be learned, but the nature of leadership requires the leader to accept a certain level of risk with the position.
The next questions most people want to ask is how many traits do they need to have and how much of each trait has to be innate versus learned. At this time, there is no mathematical formula to unequivocally answer these questions, but, just like leadership, you sometimes just have to have a feel for it.
Based on interviews, observations and research, the best leaders are the ones that possess, and are good at all four traits. Some possess three traits while others only two. Even though they may not be gifted with all four traits, they may have other compensatory abilities that make up for what they are missing.
Although the best leaders have most of these traits innately, there is a room for some learning, but it in most cases, it has to be less than 40 percent. (See Figure 1). A person can learn some of the qualities, but there is only so far they can go with humility or empathy that is not authentic.
Why Most Leadership Training Fails
There is a plethora of leadership development programs being offered. Most are designed to keep the participants coming back again and again. Ironically, when leadership is taught at the university graduate school level, it is completely different. It is taught as a process that is personalized to the individual with appropriate feedback and mentoring. Consequently, the primary reasons most leadership training fails are because:
- Training is skills-based versus process-based. Possessing the skills without the process only addresses a portion of what is needed to become a better leader. It’s like the chef and the ordinary cook setting out to make the same dish. They may both have the same ingredients, but the dish created by the chef will usually be much better because they know the process intimately from extensive practice in making the dish.
- They use a one size fits all instead of an individualized approach. Not everyone has the skills taught in the classes or can be good at them once they’ve learned them.
- There is no follow up or feedback loop to see if what was learned was properly implemented. This approach is contrary to that used in most academic programs and is supported by the Kolb Experiential Learning Cycle. Kolb views learning as a multi-stage integrated process with each stage supportive of and feeding into the next. Effective learning only occurs when a learner is able to execute all four stages of the model. (See Figure 2).
Professional Leadership is an individualized approach that is designed to be learned once and adaptable to almost any situation the leader or potential leader may encounter. This concept is further discussed in my book, Prescribing Leadership in Healthcare. For more information visit The Healthcare Center of Excellence at www.healthcarecoe.org.
J. Bryan Bennett is the founder and Executive Director of the Healthcare Center of Excellence (HCOE). He is the primary researcher and blogger for HCOE and blogs for the HIMSS Future Care website on the subjects of big data, healthcare technology transformation and leadership.
He is a highly requested international speaker on the subjects of healthcare transformation, healthcare analytics, leadership and customer management. As a healthcare technology and advanced analytics consult, he has helped healthcare organizations meet the Meaningful Use Stage 1 requirements as an Allscripts certified partner. In addition, he is a course developer and adjunct professor for Northwestern University, West Virginia University and Judson University where he develops and teaches domestic and international courses in analytics, leadership and marketing. His presentations are engaging and witty as he challenges his audiences to think in different ways to reach better solutions.
He is the author of the book Competing on Healthcare Analytics and has written the “Data Stewardship” chapter for the book ADAPTIVE Health Management Information Management. Gartner, Inc. has recognized his work and his academic study was published in Capco’s Journal of Financial Transformation.