Five Key Leader Behaviors that Keep Your Best Staff on Your Team

Every person in a medical practice, including the physician-owner, medical director, office manager, lab technicians—everyone—has some thought of quitting their work. The thoughts may be pervasive or momentary, and action may be imminent or a “me—never.” In social science literature, this range is called voluntary turnover intention (VTI). Each person in the medical practice has a level of VTI that varies over time and is measurable. More importantly, good practice leaders can keep the level low through certain specific and learnable relation-oriented behaviors. Leaders who want to keep their best people should exhibit these behaviors often and authentically.

An example of not-so-good leadership helps to put this in context. Morgan is the office manager of a thriving five-partner practice. Alex is the main scheduler and is a hard worker, dedicated to keeping the schedule filled, adding to the practice’s profits through efficient balancing of the schedule. Morgan believes Alex is happy at work, never complaining, always on time, well... except lately. Alex quit today, giving notice to a surprised Morgan that another practice offered Alex a position. Why was Morgan surprised? How did this dysfunctional outcome come to be? The bottom line is that Morgan was not aware of Alex’s level of VTI, which rose to the high end of the scale, resulting in the intention to voluntarily quit becoming the action of quitting.

Five Star Leadership® research suggests that if Morgan had implemented five leader behaviors a while back, this problem could have been avoided, if it was avoidable. These five behaviors are inclusion, respect, reward, improvement, and modeling. Academics have other names for these behaviors,(1) but Five Star Leadership® researchers find these names to be more descriptive than those from academia.

These behaviors accomplish much more than lowering employee VTI, thereby reducing turnover. The behaviors affect a wider range of desirable outcomes, including higher productivity, greater participation by employees in extra-role tasks, job satisfaction, organizational commitment, and a feeling of being treated fairly.

How do these behaviors accomplish so much? They affect a variable called leader–member exchange (LMX) quality. Think of LMX as the health of the relationship between a leader and a follower. In the example just offered, the LMX relationship between Morgan and Alex likely was of low quality, given Alex’s surprise departure. LMX is a one-on-one relationship. If Morgan has four other direct reports, then she has four more LMX relationships, totaling five distinct LMX relationships for her to keep in mind. LMX is important because positive outcomes (e.g., low turnover, high productivity, low alcohol- and drug-related problems) are associated strongly with high-quality LMX. Conversely, low-quality LMX is strongly related to negative outcomes (e.g., turnover, disruptive employee actions, work mistakes, absenteeism). If practice leaders want more positive outcomes and fewer negative outcomes, they should act to strengthen the LMX relationships they have with subordinates. The five behaviors, when implemented correctly, consistently, and authentically, increase LMX quality. Correctly means understanding what the behavior is, how to use it, and how to apply it individually with each worker they lead. Consistently means making these behaviors a part of the day-to-day way of leading. Authentically means believing that the set of behaviors is a positive way to work with employees to help accomplish organizational goals. An understanding of the parts and how they relate to each other brings awareness of the importance of these five leadership behaviors.

Inclusion

Simply put, inclusion means ensuring the leader and team member have open discussions about decisions affecting the work required. These discussions cover task goals, processes, resources, obstacles, and other factors, with the team member having ample opportunity to give input. The decisions are the leader’s, but they begin with a one-on-one effort to agree on how the task is to be done. Although this sounds cumbersome, these discussions usually are quick and easy, and they must occur. Failure to use inclusion in leadership results in lower LMX quality, leading to lowered positive outcome. These discussions are one-on-one, even if the task is a team task, to allow each employee a chance to participate in a way that builds the one-on-one relationship. This is especially important if private issues are involved (e.g., “I can’t do that this weekend because my mom is having trouble and I need to go home”); or the team member is more introverted than other team members (“I don’t express myself in the group because someone always comes right back with a comment and that intimidates me”); or if there is a strong need for a comprehensive or serious discussion about the task (“I know this isn’t how you have always done this, but change is necessary to get better results.”)

People want to feel included, and the more they know about their work, the more committed they are to the practice.

Inclusion is more than one-on-one task-oriented discussion. For example, the LMX relationship is improved by discussions of organizational goals and results, which lead to members feeling more committed to the practice. Any discussion that involves “the reasons why” is good for team members who do care about their work, their fellow workers, and their leader. People want to feel included, and the more they know about their work, the more committed they are to the practice. This type of inclusion is good in both one-on-one and group discussions, replacing lectures, pronouncements, or impersonal e-mail notices. Invite feedback. Agree to take some issues offline and into one-on-one sitdowns, as needed, to ensure good communication. If Morgan, the office manager, had spent time on the inclusion behavior with Alex, perhaps the reasons why Alex quit could have been addressed early to keep her VTI from reaching such a high level that it led to her finding another job. Inclusion behavior allows many issues to surface that are not related directly to the task or the practice. Personal issues arise and can be discussed if there is trust, and high-quality LMX relationships are high-trust relationships.

Respect

A frank discussion between Alex and Morgan would have required the leader behavior of respect. Respect shown by a leader means that the leader is relating to his or her team member as an important person who has feelings and a life beyond work, and is someone they consider valuable to the practice. Acting respectfully increases LMX quality, leading to better outcomes.

Group discussions may not produce the same respect that can be shown one-on-one.

In the example we are using, assume Alex quit because of a very personal issue. This issue may or may not have had direct bearing on the job, but if Morgan doesn’t know what the issue is, there can be no discussion about what can be done about it. First, Alex must feel comfortable and believe Morgan will show her respect. A brand-new employee may not feel enough comfort to trust Morgan with such a discussion, but over time employees learn who they can trust and who gives them respect, so they do share about personal issues. Respect isn’t always about private issues. During an inclusive discussion about tasks, Morgan should treat Alex’s opinions with respect. Note that group discussions may not produce the same respect that can be shown one-on-one, especially if strong opinions hold sway. This is another reason to ensure that one-on-one inclusion is the rule.

Reward

Rewarding behavior is a state of mind as much as it is a capitalist system of motivation. In leadership literature, transformational rewards appeal to the higher self in a team member, whereas transactional rewards supply the quid pro quo of payment for work done. Both types of rewards (and some rewards are both, to some degree), correctly implemented, increase the quality of LMX between the leader and team member. A leader should develop the view that rewards can be used to acknowledge progress toward or attainment of a positive outcome. Because the goal of leadership is to get the employee to do the things that the leader needs done, it makes sense for this rewarding behavior to be individualized. Even in a team environment, it is each individual’s contribution to the team results that matters. Motivating individuals is a one-on-one effort where individualized reward behavior can make a difference.

At first, a leader may say to him- or herself that rewards can’t be customized—that there are too many formal constraints or competing interests. That will be true—at times, to a large extent, but at other times perhaps less so. Certainly, the reward of “Hey, great job!” especially in a team meeting, is available and generally valued. Extra time off may be a greater reward than more money. Having the practice pay for a seminar that improves their work but that they couldn’t afford can be a great reward for both the employees and, coincidentally, for the practice. The key ingredient is spending enough inclusive time to respect the team member’s opinion about what rewards he or she would value. Why provide a gift card to a store the employee never goes to, or offer use of a partner’s condo at Vail if the employee doesn’t really like the outdoors, doesn’t have anyone to go with, or can’t afford the airfare? Just ask! Perhaps Alex quit because of how bonuses were structured, or how vacation days were earned. Customization to the greatest extent possible is the important concept to keep in mind regarding rewarding behavior. This reward state of mind can require some out-of-the-box thinking. In fact, leaders may have to work with their own boss to get the rewards in place that work for the team. If the LMX relationship at that level is of high quality, it will make those discussions easier.

Improvement

Improvement behavior considers what the team members individually value in developing their skills, their personal strengths, and other areas. Inclusive behavior is basic to this. Leaders may need to coach team members as to what is possible and how it can be done. Alex may have had a desire to learn management skills to move up in the practice, but Morgan probably would not have known that without an “improvement discussion.” Perhaps the new employer has a “management track” mentality for Alex to take advantage of. Improvement as a leader behavior is a great opportunity to show that the leader cares for each individual employee and wants what the individual wants, not just what the practice needs. Improvement can be tied to rewards as well. This feeling that the leader respects their goals and cares about those goals individually improves the LMX relationship quality, which leads to positive outcomes for the practice and the leader.

Dysfunction can arise when a leader decides that developing a team member is not in the best interest of the leader. For example, Alex might want to earn an MBA, but Morgan could think getting that degree is Alex’s ticket out. That may be true—but helping the member achieve that goal will keep a valuable employee around longer, and, secondly, a good leader should simply want to help. He or she should want to be a leader, not only a manager.

Modeling

Modeling behavior works in two ways. First, a leader models the characteristics he or she would like to see team members emulate. Second, a leader also models the best ways to get tasks done. Sometimes this behavior is called “showing the way” or “leading by example.” The goal of modeling is to improve each team member’s performance proactively by ensuring a good example is set and best practices shared. This shows that the leader cares about the team member by modeling behavior and finding ways to accomplish the goals. If leaders want their team members to act in certain ways (e.g., be courteous or kind), dress a general way (e.g., business casual, suits), be respectful (e.g., on time for meetings, getting expenses done before the deadline), then the leader needs to act, dress, and show respect accordingly. The “Do as I say and not as I do” way of leading is destructive, according to both common sense and scientific studies of dysfunctional leadership.

Summary

Employee engagement using these five leader behaviors can lower employees’ desire to leave the practice. This outcome, as well as the many other positive aspects of the high-quality LMX relationship, is why leaders need to pay attention constantly to these five relation-oriented behaviors. To achieve desired outcomes, leaders must decide they want to adopt the behaviors, find ways to do so, and track that they are, in fact, behaving as planned. The results will speak for themselves. The pinball machine that is the workplace needs all the leadership it can get, and leaders can learn these great skills, implement them strategically, and reap the rewards.

Reference

1. Yukl G. Leadership in Organizations. 8th ed. Boston: Pearson; 2013:221-246.