Strategies for Health Care Leaders in (Daily) Transition

The entire January 2018 issue of the Harvard Business Review is devoted to perspectives on leadership, cover to cover. So it’s hard to recommend one article over another. That being said, Picking the Right Transition Strategy is particularly relevant to health care leaders. In this article, Michael D. Watkins examines the critical importance of differentiating situations (rather than positions) as a success factor when moving into new job situations. Healthcare leaders, especially when they have responsibility over clinical areas, do this every day, within the same job!

One Style Doesn’t Fit All

Watkins wisely points out that leaders must behave differently based on the managerial situation they face. He inferentially separates these from the job title or position the leader holds. The framework he proposes distinguishes 5 types of organizational situations. The acronym STARS refers to common business scenarios: Start-up, Turnaround, Accelerated Growth, Realignment, and Sustaining Success. For each scenario, he details differing assumptions for the viability of pre-existing leadership, organizational recognition of the need for change and readiness for it, likely associated cultural challenges, and the pace of leadership action required. His point is that one size of leadership does not fit all. Simple, right? Well not really…

One Style Doesn’t Even Fit One Organization

As I commented in Too Much of a Good Thing Sinks Leaders in the February 18 post in this blog, physician leaders, in particular, don’t always find it easy to switch gears from the strengths that made them successful clinicians to those that make good leaders. So success in one scenario or organization may not carry over to the next. But to make matters much worse, a physician leader or health care executive leader in a complex organization may have responsibility over many departments (as a Dean, CMO, VP of Operations, or VPMA), divisions (in the case of a Chair), service lines (as a VP for Clinical Services), sites of service (as a Practice Director or VP of Ambulatory Services), etc.

In a subtlety missed in the HBR article, it is extremely unlikely that these business or clinical units will be synchronized in their location within the STARS framework. The Emergency Department in a hospital may require a turnaround due to failing operations at the same time Radiology may be experiencing accelerated growth due to new technologies and Cardiology may require realignment due to a major group pulling referrals and services out of the hospital. “realignment” and a third is in need of a “turnaround.” The first situation may require bold and immediate action – and perhaps major personnel changes; the second calls for managerial patience, foresight, and analytic planning; and the third depends upon the leader’s ability to generate creative solutions and to persuade participation by multiple self-interested parties in a compromise plan.

Beware Your Default Style

So successful healthcare leaders, in particular, must be extraordinarily flexible and malleable. They must understand the situation, culture, and psyche of the target unit and its members. And maintain (simultaneously) a toolkit of skills and styles to be differentially deployed – often in the same day. In order to appreciate this and to know which tool to use in which situation: “It’s critical for leaders to understand their reflexive responses to management challenges…” and to substitute situation analysis and strategic response when reflex doesn’t serve best. This sort of introspection and self-awareness is not always our strongest suit. But for successful leaders, it needs to be.