American Association for Physician Leadership

Quality and Risk

Strategic Management Practices of Medical Technology Deans: Tackling Organizational Challenges Through Sun Tzu’s Art of War

Maria Luisa R. Olano, RMT, PhD | Maria Minerva P. Calimag, MD, PhD | Ma. Frieda Z. Hapan, RMT, PhD

August 8, 2020


Abstract:

The 12 deans interviewed were playing the lead role in determining which strategy is the most appropriate one to tackle the challenges involved in keeping the academic program running. Using Creswell’s inductive logic of research in a qualitative study and repertory grid technique in gathering information, the researchers found out that the deans of the Schools of Medical Technology in the Philippines applied the principles of strategic management practices reflected in Sun Tzu’s Art of War.




The complexities currently facing higher education call for the use of a variety of managerial or leadership strategies in handling college program operations. The Filipino Medical Technology deans playing the lead role had to determine which were most appropriate for tackling the challenges arising from managing the said program. For instance, solving and resolving people-related problems in the internal organization are different from doing the same with external stakeholders; the dean has complete control over resolving the former issues but no control at all on problems in the latter group. Moreover, workload-related challenges such as setting deadlines, class scheduling, and extra workload are tackled differently. Finding resources for the department poses yet another problem. Requests for new facilities or upgrades of existing facilities often cannot be granted due to scarcity of funds.1 Most of all, compliance with changing state policy implementation, such as adherence to the standards and policies set by the state for the medical technology program, requires the deans to form a strategy to persuade top management to follow the standards and implement the policies. These are just some among the many challenges faced by the academic deans, but all could be faced and defeated by following Sun Tzu’s Art of War.

For Sun Tzu, the best policy in war is to keep the state intact.(2) In accordance with this goal, the deans in the college and/or university, such as those from the college of medical technology, must strive to keep the organization running despite the difficulties they are facing. Existing beyond survival is the ultimate goal of war, hence; the deans’ strategies in achieving this end are explored and analyzed in terms of principles laid in Sun Tzu’s Art of War.

Methodology

Creswell’s inductive logic of research in a qualitative study(3) was employed in determining the best strategic management practices of SMT deans. Information was gathered from them using the repertory grid technique.(4)

Results and Discussion

If you know the enemy and know yourself, your victory will not stand in doubt.

— Sun Tzu(5)

In the Philippines, the deans, being in the middle management of administrative hierarchy, act both as administrative and academic manager. There is no clear dividing line, however, between dean as a leader and dean as a manager. As dean, he should be able to play both roles—lead the human resources of the organization and manage its financial and physical resources to achieve the vision and carry out the mission. Thus, a dean should be able to blend the two to maintain equilibrium and, like all other deans, serve as the operations and academic manager of the program. As operations manager, they take the responsibility of delivering quality service to their students, the students’ parents, and all other stakeholders and work to recruit the most qualified faculty and procure necessary laboratory equipment to produce quality graduates. As academic managers, they do the supervisory tasks—ensuring that the program is implemented above and beyond the standards and policies set for the program by the Philippine Commission on Higher Education. Four categories of challenges are inevitable:

  • People-related;

  • Physical resources;

  • Workload-related; and

  • Personal-related.

Each category corresponds to the enemy in Sun Tzu’s Art of War.

Resolving People-Related Challenges

The category people-related challenges pertains to the problems deans may encounter in handling people in medical technology program implementation. Challenges often cited include resistance, conflict, and the rise of informal leaders.

The 12 deans interviewed, coming from Luzon, Visayas, and Mindanao, disclosed that in planning and implementing program-related activities, they often encountered resistance from the people around them—a typical reaction of the disgruntled few and even the intellectual ones whose ideas and plan of actions contradict those of the deans. One dean reacted to this situation by saying: “We cannot advance if there is resistance, although at times it helps us think and rethink our plans before implementing it. It means that resistance sometimes provided us feedbacks that would guide us in redesigning our plans. It’s a matter of how we respond to it that makes resistance beneficial and/or detrimental to our program implementation” (respondent D3).

Insightful and well-intended debate, criticism, or disagreement do not necessarily equate to negative resistance, but, rather, may be meant to provide better understanding, as well as additional opportunities and solutions.(6) Deans can overcome employee resistance by conducting broad-based meetings where goals and tactics are openly discussed and introduce processes that leave little room for individual discretion. Sun Tzu reminded the generals “to avoid fight as possible and should know when to fight and when not to fight.” He said further that, “Supreme excellence consists of breaking the enemy’s resistance without fighting.”

At times, conflict arises and may eventually give rise to informal leaders. This possible situation makes the organizational atmosphere unhealthy. To Sun Tzu, the word “conflict” defines all the circumstances under which two competitors will continue to act in order to prevent the other from winning. Because the goal is to prevent the adversary from winning, the strategy often aims to damage the competitor enough to prevent them from continuing.(7) Some may view conflict as a negative condition that ought to be averted at any cost. Others may see it as a problem that needs to be managed. Still others see conflict as an exciting opportunity for personal growth.(8)

Conflict cannot be avoided. It is necessary, therefore, for the deans to be able to identify the source of the conflict and to view its constructive and destructive potential. They must learn how to manage conflict and to implement conflict resolution technique in a practical way.(9) De Church et al.(10) pointed out that active conflict management helps people to talk openly about problems and conflicts, to exchange information, and to resolve conflict together. In addition, Tjosvold et al.(11) argue that openness makes it possible to refute statements when necessary. Research has shown that there are great opportunities for open conversation and argument confrontation.

The goal is to create an environment in which it is safe for informal leaders to ask questions, take risks, and challenge by providing different perspectives.

If conflict is not resolved, an informal leader may arise. In the workplace, informal leaders emerge because certain aspects of leadership and management are lacking. When team members do not trust the formal leader to listen to their concerns and suggestions, an informal leader surfaces and assumes that role.(12)

The goal is to create an environment in which it is safe for informal leaders to ask questions, take risks, and challenge by providing different perspectives. If you don’t agree, explain the rationale for your position and ask for suggestions. Give informal leaders frequent feedback, being careful not to shut down communication.(12)

The deans saw communication as a very important tool in dealing with other people in the organization. As Sun Tzu’s words imply, fighting or engaging in conflict can be avoided when the issues can be resolved by sincere words. Subtle words can neutralize conflicting parties. Moreover, failure of communication can be attributed to the manager. As Sun Tzu further observed, “If words or command are not clear and distinct, if orders are not thoroughly understood, the general is to blame.”

The deans perceived motivation to be important as well. They won their subordinates’ support by treating them well. As Sun Tzu said, “When one treats people with benevolence, justice, and righteousness and reposes confidence in them, the army will be united in mind and all will be happy to serve their leader.”

Mutual trust and respect provide a setting that leads individuals in the organization to work collectively for a common goal.

Effective academic managers have to use appropriate communication in dealing with people to align with them. Deans not only observe direct interactive communication, but also provide an effective communication network inside and outside the universities. Mutual trust and respect provide a setting that leads individuals in the organization to work collectively for a common goal. Deans should be collaborative, knows how to delegate, encourage participation, and develop teamwork.(13)

Facing Resources-Related Challenges

One significant problem with operational strategy is the lack of available resources for program implementation. The deans are tasked with managing their departments and providing quality education to students, despite constraints on resources. They are responsible for procuring laboratory equipment and apparatuses, for budget development, for management, for reviewing the budget, and perhaps even for fundraising for extracurricular activities. With limited budget allocation, decisions should rest on the necessity of the resources required. The priorities then should be laid down in the plan. Sun Tzu taught managers what to do when resources are low. He said, “Focus more on exploiting your competitor’s weakness rather than throwing more cash/resources at the problem.”

A number of deans resort to amalgamation to solve problems related to physical resources. Using their affiliation with the Philippine Association of Schools of Medical Technology, they are able to borrow—and even acquire through donation—laboratory equipment and library facilities from the big universities offering medical technology program.

Furthermore, the academic deans are found to be creative and innovative when it comes to utilization of resources. In the absence of laboratory facilities, for instance, they have guided faculty to come up with improvised or alternative laboratory apparatuses while waiting for funds to be approved to purchase the equipment that is needed.

Innovation is not limited to the acquisition of resources. It also can be observed in strategy. For instance, to improve performance in the board examination, the deans have come up with new and different ways of preparing for that examination. If old review strategies did not work well, they try hiring external experts. In the words of Sun Tzu, “Make your way by unexpected routes, and attack the enemy where he has taken no precautions.” The most significant point for the purpose of creative execution is the idea of making your way by “unexpected routes.”

Like war, therefore, it is necessary to search continuously for new and innovative ways of meeting the challenges. As Sun Tzu further stressed, “Do not repeat the tactics that won you a victory, but vary them according to the circumstances.”

Meeting Workload-Related Challenges

Faculty typically had difficulty budgeting their time to come up with desirable outcomes and goals. The workload of the faculty is very complex. They do module preparation, lecturing, supervising clinical laboratory activities, advising them in conducting research, and in doing community extension services. With these multiple tasks assigned to them, their efficiency and effectiveness are affected.(14) The dean then has to consider scheduling in class structuring.

Time allocated in performing each task should be balanced with the other task so that the faculty would be able to perform their work assignment accordingly. As Mundt(14) stated, a balanced work mission provides institutional support for the main strategic functions of a higher education institution: instruction, research, and extension service. The real time spent on those areas of the job will vary by the faculty member’s rank and job expectations, but the institution will agree on a standard investment in each of the functions. In the college of medical technology, for instance, the schedules of faculty and staff schedule should be divided equally to enable them to carry out all of their tasks successfully, in instruction, research, and community service.

Individuals have a limited amount of time and energy to work, including people in the academic setting. Deans should understand that human energy is definitely finite. Hence; they should not overload their faculty and staff with responsibilities that are impossible to finish on time. As Sun Tzu said, “Pay attention to nourishing the troops and do not tire them unnecessarily.”(15)

Dealing with Personal-Related Challenges

Academic managers are subject to various pressures. They are faced with inadequate time for decision- making, coupled with the requirements to be responsive to different individuals, all of whom have a claim on their attention. Often, they lack time for reflection and contemplation because they are occupied with the detailed processes and practices that constitute their day-to-day activities in performing their functions.(16)

The deans may find their position overwhelming and may overlook the issues to be settled and communicated. They may be tempted to fire those they perceived as “against” them.(17) It is easy, therefore, to understand why academic managers tend to separate, shun, and disengage themselves from others, which eventually would make them lonely.(18) Often, the social separation maintained by the deans serves as a major contribution to their loneliness they experience. Wright(18) stated that social isolation is a professional hazard in high positions. The deanship role within organizations often does not promote work environments where friendship and social interaction are possible, and, therefore, loneliness may well develop.

Academic managers are at risk of loneliness and isolation because of their position, but there are various ways to cope with it. They must be willing to listen to and respect their colleagues and subordinates, which would contribute to real mutual understanding between the leader and his or her employees.(17) Various mutually beneficial strategies could be applied, such as reaching out to others by coaching, showing support, and acting as a confidant. Other approaches can be generated by the deans themselves, such as journal writing, self-development, self-understanding, and introspection.

Moreover, deans can be stressed by the different roles they play in the organization. Stressors for academic leaders spring from the resources they handle in their department and even from within themselves as in work–personal conflict,(19) which can lead to burnout. If they fail to resolve this, the performance of the college of medical technology would be affected.

Sun Tzu reminded the general when to fight and when to quit, as well as when to inspire and when to drive. As he said, “He who knows when he can fight and when he cannot, will be victorious.”

To perform effectively, deans from time to time should engage in self-reflection; otherwise they may become an enemy to themselves. An honest dialogue with oneself and an acceptance of one’s strengths and weaknesses would lead them to understand themselves. It would also give them the decision-making power of whether to quit or not to quit the activity that is causing stress. As Sun Tzu further advised, “If you know the enemy and know yourself, you need not fear the result of a hundred battles. If you know yourself but not the enemy, for every victory gained you will also suffer a defeat. If you know neither the enemy nor yourself, you will succumb in every battle.”(5)

Conclusion

The medical technology deans resolved the challenges they faced according to their nature, as is advised in Sun Tzu’s Art of War. They applied strategies to bring the human and operational elements together— the former to work in harmony as one, utilizing the latter, so that the organization will exist beyond survival—that is, toward excellence.

Now the general who wins a battle makes many calculations in his temple ere the battle is fought. The general who loses a battle makes but few calculations beforehand. Thus do many calculations lead to victory, and few calculations to defeat: how much more no calculation at all! It is by attention to this point that I can foresee who is likely to win or lose.

— Sun Tzu

References

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  2. Baum N. Sun Tzu and the Art of War: implications for the healthcare professional. J Med Pract Manage. 2015;30:422-424.

  3. Creswell JW, Creswell JD. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. 5th ed. Thousand Oaks, CA: SAGE Publications; 2018:63-64.

  4. Curtis A, Wells TM, Lowry PB, Higbee T. An Overview and Tutorial of the Repertory Grid Technique in Information Systems Research. ResearchGate. www.researchgate.net/publication/228296401_An_Overview_and_Tutorial_of_the_Repertory_Grid_Technique_in_Information_Systems_Research .

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  17. Kets de Vries MFR. Leaders who self-destruct: the causes and cures. Organizational Dynamics. 1989;17:5-17.

  18. Wright S. Is it lonely at the top? An empirical study of leaders’ and nonleaders’ loneliness in organizations. J Psychol. 2012;146(1-2):47-60.

  19. Hsieh YJ, Pearson TE, Kline SF. The moderating effects of job and personal life involvement on the relationship between work–personal life conflict and intention to quit, Journal of Human Resources in Hospitality & Tourism. 2008;8:1-14, DOI: 10.1080/15332840802274387.

Maria Luisa R. Olano, RMT, PhD

Faculty of Pharmacy, The Graduate School, University of Santo Tomas, Manila, Philippines; e-mail: marialuisaolano@gmail.com.


Maria Minerva P. Calimag, MD, PhD

Faculty of Medicine and Surgery, Research Center for Social Science and Education, The Graduate School, University of Santo Tomas, Manila, Philippines.


Ma. Frieda Z. Hapan, RMT, PhD

Faculty of Pharmacy, The Graduate School, University of Santo Tomas, Manila, Philippines.

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