Home Organizational Psychology Leadership Physician as Leader I: From Theory to Practice Regarding Fundamental Leadership Styles

Physician as Leader I: From Theory to Practice Regarding Fundamental Leadership Styles

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For the D leader, cautious deliberations are frustrating and demoralizing: “Let’s get on with it!” Being driven toward results, the Dominant leader tends to define the world in terms of risk-taking: “Nothing ventured, nothing gained.” He or she often suspects that the real problem of those who urge more deliberation is an unwillingness to take risks. Action must be taken even though not all the information is in and even though the proposed solution is not perfect: “Something is better than nothing.” One of the physicians that McKenna and Pugno (2006, p. 6) quoted offered a poignant statement about this Dominant Ruby Red push toward action:

“All leaders realize they must accomplish difficult tasks. . . .  Great leaders understand that “timing is everything.” Successful leaders do not run from making decisions, but rather they know that making a bad decision (and taking responsibility for it) is often better than making no decis10n at all. So leaders learn to deal with problems “now.” [Kevin Scott Ferentz, MD. Family Physician, Residency Director and Associate Professor, University of Maryland School of Medicine]”

In their interactions with other people, the Ruby Red leader tends to be assertive and quite clear about what they would like to see in (and want from) their relationships. They tend to build their relationship around shared engagement and their relationships are often most pleasing for them when they accomplish something important (and perhaps even unanticipated). On the other hand, these leaders tend to be poor listeners and are not very artful diplomats.

The best working environment for someone with a Ruby Red orientation is one in which there exists strong formal accountability and deference (McKenna and Pugno, 2006, p. 83):

“Right or wrong–people defer to you.  Good leaders recognize that phenomenon . . . .[W]hen medical groups organize themselves, nine times out of 10 the leader is a doctor. [Monte L. Anderson, MD, Gastroenterologist and Hepatologist, Mayo Clinic Scottsdale]”

As noted, the nuances of skillful interpersonal engagements and artful diplomacy are not to be found among most Dominant Red leaders. They operate best in an environment where there are concise and often quantifiable goals and in which costs and benefits can be enumerated (return on investment). “I want to know when I have scored a point and don’t want the goal posts to be moving!”

Karen Horney is a noted and often controversial psychoanalysts. She suggested that each of us, under conditions of anxiety (especially if it is related to our relationship with other people), is inclined to take one of three actions in relating to other people. We can move toward other people, away from other people or against other people. Her description of the preference to move against other people fits with our description of the Dominant Ruby Red leader. They like to “punch”—especially when faced with opposition or a repressive hierarchy (McKenna and Pugno, 2006, p. 85):

“I punched through the glass ceiling by being immersed in situations that required leadership. I’m watched every day in my current role as interim CEO of this medical center. The responsibility involves a steep learning curve, but I’m doing the job, knocking down big issues, building a track record of accomplishments. [Randall Oates, MD Family Physician Founder and President, Docs, Inc.]”

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