Possibly the greatest challenge for clinicians transitioning into management is the shift in their relations with the people they work with. For many, they are moving out of the ‘ranks’ and it feels uncomfortably like they are leaving their ‘friends’ behind. They are often feel very conflicted – “Whose interests do I serve now?” The unit managers I have surveyed cite managing people as the most stressful aspect of their job. It is hard to tell people what to do, manage them when they don’t do it, deal with the conflicts and the emotions.
Why does it have to be this hard? In healthcare, the people that make up these clinical teams are highly qualified and skilled to perform their clinical roles relatively autonomously – they know what to do without their manager telling them. So why do they need to be managed at all? The skills needed to manage highly autonomous experts doing highly complex work, are very different to those needed to manage unskilled people doing less complex work.
The greatest mistake a healthcare manager makes is assuming their people won’t do their jobs unless they are ‘managed’. And yet there is so much evidence to the contrary. We know of hospitals and hospital units that keep delivering patient care despite the lack of leadership and effective management. There are other cases where the management actively, yet unconsciously undermines the capacity of clinicians to do their jobs well.
It raises the question – do we need managers at all?
There is a growing movement outside of healthcare from hierarchical organisations toward the open organisation where the ratio of managers to workforce is diminishing radically. This is occurring because:
- The environment in which organisations are operating is changing so rapidly that the traditional, bureaucratic approach to management undermines organisational agility.
- This environmental turmoil is being driven by the exponential increase in knowledge and the rise of the knowledge economy. Organisations are buying people’s knowledge – not necessarily their presence or their strong backs!
- People who perform complex work are motivated by autonomy. They need to have control over their work and how they do it. Being ‘managed’ actually demotivates and disengages these people.
Did I just make managing people sound even harder? Sorry – I meant to make it sound redundant. Ideally, your people will manage themselves if you do it right.
Managers in healthcare must add value not bureaucracy. Very little in traditional leadership and management development prepares our managers to manage in this new world. But here are 6 things for you to consider if you are making the transition from clinicians to manager:
- Dig deep – what difference do you want to make as a manager – what value do you add? Can you do that in this organisation?
- Articulate the purpose of your role so your team knows exactly what to expect. Ultimately, your role is to support your team to contribute to the organisational mission and vision. When there is a conflict of expectations, demands or interests, then that purpose needs to take precedence. Managers are so often unconsciously managing conflicts of interest, which is why the job is so uncomfortable at times. Clarifying the purpose of the manager role is one way of bringing potential conflicts of interest to light and helping others understand your position.
- Clarify your roles (and there will be many) and make sure these add value rather than unnecessary limitations and controls.
- Identify the roles your people will need to own to be ‘self-managing’.
- Articulate the outcomes that must be achieved, and let your team members decide how best to achieve these outcomes. Do not micro-manage experienced, skilled people!
- Put people in their strengths. Give them work that they have the skills and drive to do well.
The ultimate goal of managers is to multiply the capability of their team – not diminish it. If you really want to understand how to do this and develop the skills and tools to become a multiplier manager, then enroll in the “Clinician to Manager Acceleration Program”.