Home Organizational Psychology Leadership Physician as Leader II: From Theory to Practice Regarding Blended Leadership Styles

Physician as Leader II: From Theory to Practice Regarding Blended Leadership Styles

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How do we move to sustained collaboration? It begins with acknowledgement and appreciation for all three of the primary styles of leadership and interpersonal preferences associated with these styles. We need Ruby Red, to ensure that we don’t get stuck in analysis paralysis (Golden Yellow) or become too dreamy (Azure Blue). We need Azure Blue so that we might be clear about the direction in which we are headed. We don’t want to leap out of the foxhole without knowing the cause for which we are willing to give our life (or at least devote our time and energy) (Ruby Red).

Furthermore, we need to know what kind of information we are collecting and for what purpose—valid information is of no use if it is not goal-specific. The Thoughtful Golden Yellow is also important and must be engaged (even if those with this orientation are reticent to get engaged in these collective endeavors). Without Golden Yellow, a group can be charging out of the foxhole without adequate ammunition (Ruby Red) or can remain in the foxhole or never get to the foxhole while espousing a dream of peace that is unrealistic and unattainable (Azure Blue).

A clear articulation of the contributions to be made by each perspective, as well as recognition of the other two-color blends (to which we turn shortly) help to make the Integration possible. An even more important set of three strategies are required. They come from the writing of Watson and Johnson (1972) regarding the important role played by reform in structures, processes and attitudes when bringing about improvement in the functioning of a human system.

Structure

The foundation for effective team operations resides in the design of this team as it is situated in the system where it will operate.  McKenna and Pugno (2006 pp. 106-107) turn once again wisdom offered by Dr Jessee:

“. . . we must beware of the frequent challenges faced by teams. Namely, lack of accountability for performance, using the team for all issues rather than being selective, placing too high a value on individual autonomy, stereotyping team leaders or members, or simply going through the motions with ‘pseudo teams.”

I wish to expand on these insights offered by Dr. Jessee regarding the environment in which an effective team operates in a health care setting. Specifically, I attend to the four spans within organizations that Robert Simons (2005) suggests play an important role in determining the effectiveness of teams. These four spans are: (1) control, (2) accountability, (3) responsibility and (4) support.  Each of these spans can be narrowed or widened. Each span relates in a somewhat different manner to one of the three fundamental styles of leadership.

Two of the spans measure the supply of resources the organization provides to project teams. The span of control relates to the level of direct control a team has over people, assets, and information. The span of support is its “softer” counterpart, reflecting the supply of resources in the form of help from people in the organization.

The other two spans—the span of accountability (hard) and the span of influence (soft)—determine the team’s demand for organizational resources. The level of a project team’s accountability, as defined by the organization, directly affects the level of pressure on team members to make trade-offs; that pressure in turn drives the team’s need for organizational resources. The team’s level of influence, as determined by the structure of the team and the broader system in which the team is embedded, also reflects the extent to which team members need resources. We typically have substantial control (internal locus of control) with regard to two of the four elements (Control and Influence) but have very little direct control (external locus of control) with regard to the other two elements (Accountability and Support).

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