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Managers

Talking about leaders is the easy partlets turn ourattention to the manager. Managers are constantly told todeal with opposing ideas.

An excellent article, The Five Minds of a Manager4

by Jonathan Gosling and Henry Mintzberg, describeswhat it takes to be a great manager. The authors explainthat managers live in a world of paradox and cognitive

dissonance. Managers are told to be global and local, col-laborate and compete, change perpetually but maintainorder, make the numbers and nurture people. Managershave to work in this world of contradictions.

These McGill University professors organize thesemanagement paradoxes around five tasks, each with itsown mindset. Everything that every effective managerdoes is sandwiched between action on the ground andreflection in the abstract. As these authors note, Actionwithout reflection is thoughtless. Reflection without actionis passive. Those same statements could hold true forclinical practice.

MindsetsHere are summaries of these five manager mindsets,

according to Gosling and Mintzberg:

1. Managing selfthe reflective mindset

Reflective managers have a healthy respect for thehistory of their organizationsnot only the grand historyof the big deals and disasters, but also the everyday his-tory of the little actions that make organizations work.

Efficiency is doing the right thing, effectiveness is doing things

right. Peter Drucker

For at least the past decade, there has been apreponderance of articles discussing leadership and all itsattributes, and a dearth of articles on traditional manage-ment and the role of the manager.

This may be a manifestation of our societys attrac-tion to stars and hero worship, and the lack of interest inthe less-than-thrilling role of managing the show.

A recent article on leadership by Philippe Kahn1

discusses his view on leadership requiring a clear vision.According to Kahn, leaders turn that vision into successby building winning teams, by not ignoring problems thatwont go away, by focusing relentlessly on innovationand by taking risks.

David Spitzer writes in the same journal about TheEnergizing Leader,2who is capable of producing energyin an organization by creating contacts that will foster themaximum release of focused energy. He believes thatgreat leaders listen to their employees and insist onemployees telling the truth.

Leaders seem to instill a sense of significance in theworkforce by giving employees the power of their visionand values. Spitzer also believes that leaders need toinstill a sense of ownership in employees, allowing themto keep score of how the company is doing and bybuilding confidence and recognizing good work.

A third author, Mark Shaeffert, writes in his articleWhats Leadership3 that great leaders have vision,honesty, passion, authenticity, great communication skills,and competencies.

He believes that true leaders seek leadership becausethey want to make a positive difference in the lives ofothers. Bearing the burdens of leadership is worth itboth for the impact you have on the lives of others andfor the meaning it gives your own life.

Management vs. LeadershipBy Phillip M. Kibort, MD, MBA

What makes a good manager? A review of recent

literature finds its the person who deftly works

behind the scenes, juggling many tasks and living inthe world full of contradictions.

Literature Review

IN THIS ARTICLE

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THE PHYSICIAN EXECUTIVE NOVEMBERDECEMBER 2004 33

They must be able to understandthe past to use the present to get toa better future.

2. Managing the organizationthe analytical mindset

The authors believe this mindsetis like being in a tennis match with acrowd around you. You must appre-ciate the score and the crowd, butalways keeping your eye on the ball.It is important to know how to ana-lyze situations not with simple solu-tions, but with the ability to evaluatediligently and thoroughly.

3. Managing contexttheworldly mindset

Great managers need to beable to think outside the box, tolook at the world around them, tothink globallynot just how thebusiness has always been done.

4. Managing relationshipsthe

collaborative mindset

This is where managementdoes not involve managing peopleso much as managing the relation-ships among people in teams andprojects, as well as across divisionsand alliances. Managers need to getbeyond empowerment, accordingto the authors. Empowermentimplies that people who know thework best somehow receive theblessing of their managers to do it.Great managers move employeesinto commitment, away from thecurrently popular heroic style ofmanaging and toward a more engag-ing style. Engaging managers listen

more than they talk. They get out oftheir offices to see and feel, ratherthan remain in them to sit and fig-ure. And they do less controlling,allowing other people to be ingreater control of their own work. If,I deem, so that you do,is the implicit motto of the heroicmanager, then the engaging manag-

Managers are told to be global and local, collaborate and compete, change

perpetually but maintain order, make the numbers and nurture people.Managers have to work in this world of contradictions.

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34 NOVEMBERDECEMBER 2004 THE PHYSICIAN EXECUTIVE

ers motto is, We dream, so that wedo. To be in a collaborative mind-set means to be inside and involved.

5. Managing changethe actionmindset.

Imagine your organization is achariot pulled by wild horses. Thesehorses represent the emotions, aspi-rations, and motives of all the peo-ple in the organization. A managersjob here is to develop a sensitiveawareness of the terrain. We tend tobelieve that everything is changingaround us. But these authorsemphasize that not everything isalways changing; in fact manythings stay the same. Its importantto realize that change has no mean-ing without continuity. (There is aname for everything changing allthe time: anarchy!) Accordingly, thetrick in the action mindset is tomobilize energy around thosethings that need changing, whilebeing careful to maintain the rest.Action and reflection tend to blendin a natural flow.

In light of all these mindsets,managers need to have certain

other basic rules. An excellent bookon leading and managing yourorganization is Its Your Ship, byCaptain D. Michael Abrashoff. 5 Heconverts management techniquesfrom the best ship in the Navy.

This captain took one of theworst-performing ships in the Navyand made it into the best throughthe use of some basic rules:

Lead by example

Listen aggressively

Communicate purpose andmeaning

Create a climate of trust

Look for results, not salutes

Take calculated risks

Go beyond standard procedure

Build up your people

Generate unity and improve yourpeoples quality of life

Further techniques in manage-

ment can be learned from an articleentitled How to Lead NowGetting Extraordinary PerformanceWhen You Cant Pay For It by JohnA. Byrne.6 This article is about lead-ers and managers who get extraordi-nary performance out of people.

Byrne writes about builders inorganizationsthose who instillself-esteem in workers and buildunflagging support through remark-ably tough assignments. Greatmanagers understand that most

employees feel alienated from com-panies that spend years trimmingtheir health benefits and laying offtheir friends. Employees today areno longer loyal to organizations asmuch as they are loyal to people.Great managers need to know this.

Byrne has five fundamentalthemes for an effective toolkit forpride-building in organizations:

1. Always have your compass seton pride, not money.

2. It is more important for people

to be proud of what they doevery day than it is for them tobe proud of reaching a majorgoal.

3. Localize as much as possible.Dont wait for your organizationor its leaders to instill pride.

4. Make your messages simple anddirect. Dont confuse people withcomplexities.

5. Personalize the workplace. Getinvolved with your people. Dont

violate human resource rules butgetting involved with youremployees is the single best wayto build an emotional bond withthem. Know things that areimportant to them.

Great managers also need torealize that there are changes in themakeup of the workforce itself.

Baby boomers are giving way togenerations X, Y, and the new mil-lennium employees. The purpose ofbusiness is not simply to make a

profit, according to Charles Handy.7

As David Packard, co-founder ofHewlett Packard, once said, Agroup of people get together andexist as an institution that we call acompany so they are able to accom-plish collectively what they couldnot accomplish separately. Theymake a contribution to society.

Great managers know thatreorganizing structurally will nolonger answer whats difficult intheir organizations. Jeffrey A. Oxman

and Brian D. Smith, in their articleLimits of Structural Change,8 reviewwhy so many companies fall into thetrap of believing that simply movingthemselves into new organizationalcharts will have impact.

These authors believe that thewidespread malady of structuritis(the propensity to issue a new orga-nizational chart as the first solutionto any business problem) mustchange. In fact they believe thathierarchy currently plays a signifi-cantly smaller role than the nutsand bolts of how work gets done.

People learn how to workaround organizational structures.They believe that the rigid anatomyof structures is being trumped by thephysiology of organizations. Youngeremployees tend to ignore hierarchyin favor of operating within theirown informal networks (as opposedto within structures).

So, while our society isenamored by leaders (heroes) andvisionaries whom we need to tell us

about doing the right thing, we alsomust cherish the manager whohelps us do things right.

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References

1. Kahn P. The Leadership Journey,Leader to Leader, Vol. 29, Sept. 2003.

2. Spitzer D. The Energizing Leader,Leader to Leader, Vol. 29, Sept. 2003.

3. Shaeffert M. Whats Leadership TwinCity Business, Aug. 2003.

4. Gosling J. and Mintzberg H. Five Mindsof a Manager Harvard Business Review,Nov. 2003.

5. Abrashoff M. Its Your Ship, New York:Warner Books, 2002.

6. Byrne J. How to Lead NowGettingExtraordinary Performance When YouCant Pay For It, Fast Company, Aug.2003.

7. Fisher L. The Creative Mind, Strategy

and Business, Fall 2003.

8. Oxman J. and Smith B. Limits ofStructural Change, MIT SloanManagement Review, Fall 2003.

Phillip M. Kibort, MD,

MBA is vice president of

medical affairs and chief

medical officer at Childrens Hospitals

and Clinics in St. Paul, Minn. He can

be reached by phone at 651-220-6165

or by e-mail phil.kibort@childrenshc.

org. Kibort also thanks AudreyAnderson for editing this article and

Teri Leonard for her transcription.

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