Ten Deadly (Health Care) Leadership Sins

The monthly Harvard Business Review opens with Forethought – a section of short pieces that typically pack a lot of punch in a page or less each. I am always tempted to write about each of them but I’d have to blog daily to hit these in addition to everything else that’s potentially relevant to health care leaders from the business press. But if you pick up the HBR, do read the short stuff.

The shortest this month, and the most concentrated value per word for health care leaders is provided in Ten Fatal Flaws That Derail Leaders by Jack Zenger and Joseph Folkman. It’s a great list of “don’ts” that serves up way more impact than the few minutes of your reading time it takes.

Survey Results for Failed Leaders

The authors, both leadership development consultants, looked back at the results of several hundred 360-degree feedback instruments completed by Fortune 500 leaders who were dismissed from their positions in subsequent years. They compared these to a much larger database of feedback results on leaders who were deemed ineffective and identified the convergences. Essentially, they identified the feedback from co-workers, subordinates, and supervisors that predicts eventual leadership failure. Each failed leader received feedback in one or more of these areas:

  • Lack of energy end enthusiasm
  • Accept their own mediocre performance
  • Lack clear vision and direction
  • Have poor judgment
  • Don’t collaborate
  • Don’t walk the talk
  • Resist new ideas
  • Don’t learn from mistakes
  • Lack of interpersonal skills
  • Fail to develop others

Wherefore Health Care Leaders?

So these are sort of obvious, right? Well, according to the authors:

“These sound like obvious flaws that any leader would try to fix. But the ineffective leaders we studied were often unaware that they exhibited these behaviors. In fact, those who were rated most negatively rated themselves substantially more positively.”

In my consulting work I find 360-degree evaluations in use in many organizations 0- but rarely are they used for health care leaders. This is at their (your) own peril. So if you are thinking you’re a star in the eyes of your peers, maybe you should ask some of them how you rate in each of these areas. And maybe even consider instituting a 360-degree program in your shop.

Which Sins do Health Care Leaders Favor?

Since this article is short, it would be a sin of its own to make the commentary more than twice the length of the original. So here are some quick notes on the top sins I see most out there – and the order and places in which I tend to see them. But as I’m sure you know, we are immune to none of those identified by Zenger and Folkman:

  1. Fail to develop others: In medical training, we have historically gone with a “survival of the fittest” approach to talent development. And a “superman” approach to personal responsibility for achieving the impossible. Neither leverage through the development of others not intentional leadership training and mentoring come naturally.

While this is slowly changing on the clinical side, it appears to be alive and well on the senior leadership end at many institutions. At most organizations where I consult, in addition to frustration about how much leaders must manage in their (unleveraged) portfolios, lack of physician leadership pipeline is on the short list of worries. I am currently doing unrelated strategic leadership work simultaneously at an academic medical center, a risk-bearing IPA, a large community hospital, and a semi-rural health system – all of which are concerned about their lack of intentionality around physician leadership development.

The more forward healthcare institutions are launching leadership development and mentoring programs but there are few models and no data out there on the effectiveness of mentoring models for academic centers or community hospitals. It’s bad enough that the state of the art is underdeveloped – but for a leader to stand in the way of what can be done is a cardinal sin.

  1. Accept their own mediocre performance: This is tied to the additional sin of disbelieving any data or measurement system that could be applied to objectively characterize your effectiveness. I find these most common in provider delivery organizations in the context of productivity, quality, and utilization metrics. Physicians generally bristle at having patient care measured in part by productivity, or by what they see as imperfect measures of clinical quality. However, the best actually rise to the occasion and innovate efficiencies while participating in the development and proper measurement of meaningful metrics of quality. In my experience, the strata that expend effort on justifying their outlier status, or debating about measurement systems that most others accept, tend to be increasingly marginalized and poor leadership material going forward.
  2. Lack of clear vision and direction: There’s a popular video on YouTube these days that illustrates the hazards of highly efficient movement without attention to the goal. It’s hard to succeed in health care these days without being in constant intentional motion. But the failure to pause over strategic direction, to do effective long-range planning, and to consider nontraditional solutions is an affliction I see frequently in both provider and payor organizations.

I worry less about these leaders being dismissed than I do about their missing the boat or, worse, going down with the ship that, like the antelope in the video link above, is headed for disaster.

Watch it, and think about your organization (and your leadership style).