When confronted with a difficult or contentious relationship, the Ruby Red leader will indeed punch. They will push against and often confront the other person in order to “cut through the crap” (McKenna and Pugno, 2006, p. 178):
“Professionally, family physicians were just starting to make senior colonel and general officer level where they could influence important medical issues. As I was more involved in the politics of the departments of the hospital, my chief reminded me that family doctors would rise to positions of authority and responsibility if for no other reason that hospital departments are like dysfunctional family members and who better than a family doctor to cut through the crap and get things done. That concept–cut through the crap and get things done –has served me well. [John R. Bucholtz, DO, Family Physician, U.S. Army]”
I suspect that Dr. Bucholtz is not alone in pushing hard against the dysfunction to be found in mid-21st Century medicine. While this Dominant Ruby Red strategy may serve Dr. Bucholtz well, it can also be engaged inappropriately in the midst of the complex, dynamic systems operating in contemporary medical institutions (Fish and Bergquist, 2022; Fish and Bergquist, 2024).
Some of the inappropriate uses of the Dominant Ruby Red are based on a set of assumptions identified on the DISC website (DISC, 2024).
“I’m the manager—people need to adapt to me.
Praise should be used very sparingly.
I don’t need to be tactful if I’m being honest.
I can’t show weakness or vulnerability.
People are getting paid—they don’t need morale building.
I’m the best suited to make most decisions.
It’s fine to use a little intimidation to get things done.
People who need emotional support are expecting coddling.
I should be the one in control.
If we get results, that’s what matters.
Everyone should be as driven as I am.
I’m the manager—it’s OK if I lose my temper.
I can’t slow down.
D-style managers tend to be direct, firm, and strong-willed”
As I have just noted, Dominant leaders in the DISC profile find it hard to slow down—and it is in the act of putting on the cognitive breaks and engaging in some slow thinking (Kahneman, 2011) and reflective practice (Schön, 1983) that much of the dysfunction can be most effectively addressed. This is also a time for the Dominant Ruby Red physician leader to take a deep breath as they find themselves continually challenged by the emergence of a powerful managed care perspective and as their powerful alliance (over the past century) with third party payers has often collapsed (Bergquist, Guest and Rooney, 2004). This is a time for strategizing and collaboration rather than riding into town (medical community) as the tough, shoot-first “hombre.”
