American Association for Physician Leadership

Operations and Policy

Duck, Duck, Leader: How We Pick, Promote, and Should Prepare Our Leaders

Monica Wofford, CSP

December 8, 2019


Abstract:

In a hospital, small ambulatory surgery center, or mid-sized practice, do we not tap unwitting management candidates, run off to do our own tasks and action items, and watch the newly picked people walk around in circles while we expect them to eventually get how leadership works? Think about it. Perhaps your organization does better in one area than another, but when was the last time you really sat down with a promotable candidate and talked candidly about the realities of the open position? As an administrator who would need three people to do the job you pull off, when did you meet with the last newly promoted leader and walk the person through the needs, dangers, and expectations of the promotion? How long did you give the person to get it before you threw your hands in the air as if asking to be picked, so that you could just do what he or she wasn’t doing? These are all variations of playing a figurative game of duck, duck, leader, and if you’re playing it, it’s no wonder your leaders aren’t performing, and you’re frustrated. But who’s got the time to do anything different? You do, if we fix the fundamental problems.




Likeability

Far too often we hire candidates because they seem likeable. There’s a click. It’s an easy gravitation toward friendship. Maybe this existing team member really is your favorite. If any of these are the case, then hiring him or her to be your next leader makes perfect sense—until you realize that friend and leader are two entirely different positions. A coworker you can depend on and with whom you can share secrets is distinctly separate from a person with superb management potential. You may find both in one person, but to assume both are present based on a degree of “clickage” is dangerous. We’ve all done it. We’ve all hired the person who was the most like us in an interview. We’ve all hired the person or strongly considered hiring someone with whom we had the most in common or who lived in the town where we also went to college. They might make great friends, but hiring based on likability alone may not be the way to find good leaders. It’s a common problem and puts hiring managers in a position to defend their hiring decision—one they are often as ill equipped to backup as the decision they would have made to tap that person on the head if all candidates were in a circle.

Do more than determine whether you like the candidate.

Picking leaders is part art and much more effective when it also is part science. In other words, cease picking leaders because they made eye contact when you were walking around the duck, duck, leader circle. Do more than determine whether you like the candidate. Even if you simply determine if others on the team you lead like the person, you’ve made progress. Conduct a panel interview with front-line team members on the panel posing questions. Make a list of pros and cons on how this person would work well with the others in your practice. This is likely not your first-time interview situation. You probably even have a stringent hiring process in place to prevent this from happening, but think back for a moment. Remember that last conference you went to—it was full of new people to meet, but they did not seem nearly as appealing as the friends you sat with the entire three days and at every session. Meeting new people, much like likability, is largely subject to behaviors that fall into the category of human nature; but then again, so is leadership.

Role Clarity

People who are willing to take on a leadership position like to know what they are going to be doing. Provide them with job descriptions and tell them what you remember of the position when you did it, but then go three-, four-, or five-layers deeper. Tell those you have earmarked for future leadership what could happen in the worst-case scenario, much like you would advise a patient. In every position, there are inherent risks and pitfalls and, yes, possibly wonderful opportunities, but all we tend to talk about is the glamour. In healthcare, if all you told your patients were the positive chances of what could happen before, during, and after surgery, you’d have more lawsuits than you knew what to do with, and yet we wonder why leaders are so disgruntled when we didn’t tell them key aspects of the position.

What is the good, bad, and the ugly of the role for which you are picking an ideal leadership candidate?

Assumptions are dangerous. If they’ve never been a leader before, they have no way of knowing what could happen. If they’ve never been promoted among their peers before, they may not know what hours they’ll put in and how being an exempt employee really works. If they’re under the age of 30, they may assume this position is merely a stepping stone, and their next promotion is a rite of passage. Be specific. What is the good, bad, and the ugly of the role for which you are picking an ideal leadership candidate? Prepare them for what is likely to happen if you are promoting them from among their peers. Prepare them for what the union may say to or about them. Prepare them for the first time an employee calls the compliance or ethics line to complain about his or her manager and how much, whether the claim is real or complete fiction, that hurts and burns. Your goal is not to scare the person or to never fill the position, but, instead, to prepare this future leader adequately by letting the person know exactly what he or she is walking into. Provide role clarity. Otherwise, you will find the new leader running around in circles chasing issues, drained of energy from being frustrated by the unexpected. Some things it is hard to prepare a new leader to face, but let those elements be fewer than the real and significant truth that the transition from front line to leadership changes, well . . . everything. It’s a lot like the point of view that changes when you’re sitting on the floor and someone else is tapping the heads of those around you. Then you get tapped and are now looking down at the heads of everyone in a circle.

Role Parity

When we were kids playing this game in which children ran around chasing each other, smacking another on the head and running, most of the time no one got injured. As adults, who gets picked, how fast they take off running, how we are perceived when we can or can’t catch up, and how we react if we don’t ever get picked, all lead to a variety of labels and reactions in the workplace. Promotions are a significant trigger. If you promote a team member due to his or her stellar performance, thorough understanding of the position, and clear preparation to ascend into leadership, the person’s relationship with his or her peers will be forever altered. Many manage to handle it, but in many other offices it breeds resentment. It could even breed sabotage or just snarky comments, and while we believe it’s obvious that front-line and leader roles are different, perceptions, not reality, are what matters. If “Why did she get the role and not me?” is a question that has not been answered, an answer will be formulated and shared with others, creating gossip. If “How do you expect me to report to her?” goes unanswered or unaddressed, the front-line tech or nurse or front desk receptionist will endeavor to show you all the reasons creating this reporting relationship was a bad decision. Each of these becomes a drama mountain that could have been addressed with a moment of awkward but candid molehill-sized conversation. You’ve found the right person, clarified exactly what he or she will be doing, and prepared your candidate for a few inevitabilities; but leave out clarification of the lack of role parity, and you make dealing with difficult people the new leader’s first priority.

Being a leader and being a worker are different. Team members treat you differently. Patients treat you differently. Who’s the first person you ask for when you’re ticked off about the service at your favorite place of business? The lovely front-line team member with 30 years of experience and much more knowledge than the leader, or the just-out-of-college, brand-new, started-here-three-weeks-ago manager? The roles are different, and while the front line sees management as glamorous and promotion as a type of praise, those who’ve been there, done that know it is at times much different. Experience is a much clearer lens to look through, but that doesn’t mean you don’t explain the similarities and differences of the promotion and situation to those who don’t yet need or wear those glasses.

Foundation Quality

From the timing of the promotion to the transition that must happen, a new leader’s foundation has an impact on that leader’s future and that of the team members he or she has the privilege of leading. The way in which you set them up for success determines their level of influence. The groundwork you lay and the expectations you think, but don’t say, all make a difference. Thus, if your goal is to bring on board a new administrator, and you know you work with a number of doctors who are what most would call difficult, then ensure you don’t just pick someone you would enjoy working with. Pick a new leader who will stand his or her ground, put up with some initial testing, and win over those excessively assertive or challenging individuals, or at least be able to continue working without letting them wreck him or her in the process. If your goal is to employ a new nurse manager, consider the power of credibility, familiarity, and the right mix of personality with the existing nurses and team members. If you’re considering promoting an internal candidate, clarify what the person’s role will be versus what it is, and support this new leader through the transition. Stand with them when they lose all of their friends because they are now one of “them” in management. Give them extra support, and talk directly to the team members who will now report to them. Make sure they understand the new lay of the land in this office going forward.

Regulations in your state would not let you build a medical facility with a flimsy or shoddy or poorly mixed foundation. Although regulations on promotions are more about pay and human resource violations, no one will fine you or shut you down if you don’t set up a future leader for success. Few will get fired for setting one up for failure, but if you want less stress, less drama, and less frustration to deal with, you’ll spend the time to lay a proper foundation for the person you’ve promoted, even if it appeared to be done in a manner as random as picking someone straight out of a circle.

Leadership is not a game and should not happen through what appears to be random selection or because no one else feels like running.

All promotions sound great until someone proves it to be a problem—much like all children’s games are fun until someone gets injured. The problem occurs when we act like we’re playing a children’s game when conducting something as adult-like as a promotion. Leadership is not a game and should not happen through what appears to be random selection or because no one else feels like running. Leadership is a privilege and a responsibility. It is an ever-changing role with stress as well as good days; celebrations as well as days when one imagines firing everybody. The more you can clarify the role, pick your candidates wisely, prepare them for their promotion, and help them transition from the peers they work with daily, laying a strong foundation from which they can successfully springboard into the future, the more you will be remembered for your powerful impact on their future leadership. The alternative is to continue walking around in circles looking for your ideal candidate, picking someone only when you’re too tired to keep doing both their job and the one to which you got promoted.

Monica Wofford, CSP

Leadership advisor who speaks and coaches professionally; CEO, Contagious Companies, Inc.; and author of Contagious Leadership: 15th Anniversary Edition (PresentersPublishing, 2018) and Make Difficult People Disappear (Wiley, 2012). PO Box 683316, Orlando, FL 32868; phone: 866-382-0121; e-mail: monica@contagiouscompanies.com; website: www.ContagiousCompanies.com .

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