Leadership

Richard Gunderman Indiana University

Leadership: The Plan for Today

Three 45-minute sessions:

1.

Targets for leadership

MISSION VISION GOALS

1.

Competencies for leadership

MOTIVATION Communication Delegation

1.

Ethics for leadership

Big picture FLOURISHING Patients good

Targets for Leadership

Why

do we need a target?

Alices Adventures in Wonderland Storm-struck transatlantic jet airliner Aristotles archer

Targets for Leadership

What

are the benefits of knowing where you are going?

Targets for Leadership

Benefits

of knowing where you are going

Develops identity Fosters change where change is needed Fosters communication Fosters cohesion Improves financial performance

Targets for Leadership

Who

needs a target?

Targets for Leadership

Who

needs a target?

Society Profession Hospital Department Team Self

Targets for Leadership

What

targets does an organization need?

Targets for Leadership

Levels

of Targets

Mission Vision Goals

What

does each of these mean? What are they for your organization?

Targets for Leadership

Mission
Why would the world be worse off if we didnt

exist?
What

can you say about an organization with no mission?

Targets for Leadership

Mission-less

organization

No reason for being No idea what it contributes No sense of where we are trying to accomplish

Mission

must be

Clear Widely known

Targets for Leadership

Vision
What do we want to look like in three to five

years?
Why

is vision critical? If our mission is to build a new hospital, what is our vision?

Targets for Leadership

Vision

adds:

How our purposes will be achieved Creates sense of forward motion

If

our mission is to build a new hospital, the vision is:

The architectural plans Based on the functions of the hospital

Targets for Leadership

Goals
What specific things must we do to achieve our

vision?
How

should goals be formulated? Are goals written in stone?

Targets for Leadership

Goals
Top 10 lists Periodically revised as circumstances change

Targets for Leadership

Does

your department have one mission or several? Do you have one mission or several? What are they?

Targets for Leadership

Missions

of academic radiology depts.

Patient care Research Teaching

What

is our vision for achieving these? What goals should we be pursuing right now?

Targets for Leadership

What is your mission?
Get rich and famous Care for the sick

What is your vision?

Community radiologist Tenured faculty member

What are your goals?

Know everything Never make a mistake

Targets for Leadership

How

would developing targets help in dayto-day work?

Balancing multiple missions Establishing a vision for yourself as a physician Developing achievable goals for this week

Case

# 1:

Case #1
Fellow residents complain that they are not

receiving a high-quality education in this program. Many faculty members treat them as hired help. They ask you to speak with the chair and program director, who respond that the department is shortstaffed, and cannot commit any more faculty effort to teaching at this time. How do you respond?

Competencies for Leadership

What

sorts of things do effective leaders excel at?

Competencies for Leadership

MOTIVATION Communication Delegation What

motivates the people you work with?

Competencies for Leadership

Motivators:

Money Status Power ?

Why

is it important to understand what motivates people?

Competencies for Leadership

Reasons to understand motivation
Recruitment Retention Performance Esprit de corps Mission

What is the relationship between how you view

people and your approach to motivation?

Competencies for Leadership

Theories

of motivation

McGregors Theory X and Theory Y McClellands Learned Needs Theory

Competencies for Leadership

McGregors

theory of motivation

Two fundamentally different views of human

nature spawn two fundamentally different leadership approaches:

Theory X Theory Y

Are you a theory X person or a theory Y person?

Competencies for Leadership

McGregors

theory of motivation

Theory X The average person dislikes work and does as little as possible People only work if prodded by control, coercion, or punishment. Otherwise, they care little for organizations objectives People have no ambition and want as little responsibility as possible

Competencies for Leadership

McGregors

theory of motivation

Theory X How does a theory X organization regard its workers? How does a theory X organization handle recruitment and retention?

Competencies for Leadership

McGregors

theory of motivation

Theory X No interest in enhancing satisfaction or loyalty workers have none Workers regarded as tools For R and R, leaders must
Dangle very large carrots Brandish very large sticks

Competencies for Leadership

McGregors

theory of motivation

Theory Y Work is as natural as play, and workers can find it satisfying for its own sake When workers are committed, they exercise selfdirection and self-control Workers can be committed to organizational objectives, when intertwined with their own selfactualization

Competencies for Leadership

McGregors

theory of motivation

Theory Y People actively seek out responsibility, unless they have been taught otherwise Imagination and creativity are widely, not narrowly distributed in organization In many organizations, intellectual abilities of average worker are only partly engaged

Competencies for Leadership

McGregors

theory of motivation

Theory Y How does a theory Y organization regard its workers? How does a theory Y organization handle recruitment and retention?

Competencies for Leadership

McGregors

theory of motivation

Theory Y Match needs and aspirations of workers with those of organization Look for ways workers can make important contributions Involve workers in how work is targeted, organized, and evaluated

Competencies for Leadership

Theory

X or theory Y

What kind of organization do you want to be

part of? What kind of leader do you want to be? What kind to team do you have?

Competencies for Leadership

McClellands

theory of motivation

People have three fundamentally different sets of

needs The balance between these needs is not inborn, but learned Which sets of needs predominates exerts great influence on how people see their work
What

are these three sets of needs?

Competencies for Leadership

McClellands

theory of motivation

Need for achievement Need for power Need for affiliation

What

is the need for achievement?

Competencies for Leadership

McClellands

theory of motivation

Need for Achievement Where this need predominates, people

Prefer situations where they can take personal responsibility for solving problems Set moderately high goals for themselves Need and want feedback on their performance

What happens when these are lacking?

Competencies for Leadership

McClellands

theory of motivation

Need for Achievement If workers think success and failure arise from chance, they will lose interest If workers are not challenged, they will lose interest If workers get no feedback, they will lose interest

What

is the need for power?

Competencies for Leadership

McClellands

theory of motivation

Need for Power Not the same as desire to be in charge Not exploiting organization for selfish gain People who want to help organization reach its goals Want to have positive impact What if these are lacking?

Competencies for Leadership

McClellands theory of motivation
Need for Power

If need for power not attended to. . . If no control over organizations destiny. . .

People will look elsewhere for opportunities to play a

more important role

What is the need for affiliation?

Competencies for Leadership

McClellands

theory of motivation

Need for Affiliation Where this need predominates, people

Want to be identified with the group Want to be well liked by its members Place a higher premium on relationships than their own accomplishments

Are

such people good leaders?

Competencies for Leadership

McClellands

theory of motivation

Need for Affiliation Frequently poor leaders

Want to be on good terms with everybody Fear offending people Not good at discipline, rule enforcement, and termination Leadership makes them do things they dont like

Competencies for Leadership

McClellands

theory of motivation

Are high achievers good leaders? Do these people make good leaders?
Best clinicians Best researchers Best teachers

Competencies for Leadership

McClellands

theory of motivation

High achievers frequently poor leaders Success of organization hinges

Not on responsibility and control at individual level But rather on responsibility and control at group level

High achievers may find wide diffusion of responsibility and control hard to cope with

Case

#2:

Case #2
Your large radiology group needs to elect a new

president. The two candidates are:

Candidate A

Pursues leadership roles Recently earned MBA degree Known to be somewhat abrasive Has enemies Most popular Go to person for news about group and its members Little interest in finances Prefers to avoid confrontation

Candidate B

You know that if the election were held this week,

candidate B would win. What do you do?

Ethics for Leadership

Big

picture FLOURISHING Patients good

Ethics for Leadership

Why

do we need ethics? What ethical perspectives characterize

Good leaders? Poor leaders?

Ethics for Leadership

What

ethics gives us

Our mode of operation How targets are formulated How individuals are rewarded How disagreements are handled

What

ideals do your leaders embody? What ideals do you want to embody?

Ethics for Leadership

What makes people feel good about the work they do? Will people who feel better about their work do a better job? How leaders help people get more out of their work?

Ethics for Leadership

Frederick

Herzberg

Two questions Think of a time when you felt especially good about your job. Why did you feel that way? Think of a time when you felt especially bad about your job. Why did you feel that way?

Ethics for Leadership

Flourishing

at work

What are the two factors that promote it?

Ethics for Leadership

What

makes people flourish?

Two factors Extrinsic

Conditions under which you expect me to work

Intrinsic
Content of the job itself What do you ask me to do at work?

Ethics for Leadership

Why

is distinction important?

Extrinsic factors Improvements only

Prevent dissatisfaction Reduce dissatisfaction Cannot significantly improve performance

Intrinsic factors Improvements may

Enhance the work people do

Ethics for Leadership

Extrinsic

factors

Administrative policies Unfair policies Unarticulated or unclear policies How to produce dissatisfaction
Deal with people in a critical, condescending way Act not as their advocate but their prosecutor

Ethics for Leadership

Extrinsic

factors

Supervision Dont appoint yes men

Leader becomes more isolated, ill-informed

Dont assume best employees will be best supervisors

Must confront people, delegate tasks, motivate

How to produce dissatisfaction

Appoint supervisors employees dont respect

Ethics for Leadership

Extrinsic

factors

Salary People who perceive that they are underpaid will be dissatisfied But you cannot motivate people by paying them more Motivating through pay only distracts people from the job they are supposed to be doing

Ethics for Leadership

Extrinsic

factors

Interpersonal relations Needs for affiliation, socialization Member of team, camaraderie How to produce dissatisfaction
In order to increase productivity, decrease amount of time employees have for socialization

Ethics for Leadership

Extrinsic

factors

Workplace conditions Warm and friendly environment Equipment up to date and well maintained Personal space Academic practice tends to pay less attention
Lounges, parking spaces

How to produce dissatisfaction

Allow workplace to cease to be a place people are proud of

Ethics for Leadership

Intrinsic

factors

What are the key intrinsic factors in flourishing

at work? How important are intrinsic factors in explaining dissatisfaction?

Ethics for Leadership

Intrinsic factors
Work itself

People need to see their work as

Important Meaningful

People who regard their work as a paycheck will not perform at their best Help people see how work they do enriches lives of others How to produce dissatisfaction
Implement a performance-based compensation system

Ethics for Leadership

Intrinsic

factors

Achievement People really want to do their jobs well People need to see improvement in their performance How to produce dissatisfaction
Focus on productivity to the neglect of quality

Ethics for Leadership

Intrinsic

factors

Recognition We define and appraise what we do in part through the eyes of others Praise can be worth far more than dollars Look for opportunities to acknowledge a job well done How to produce dissatisfaction
Create an employee of the month program

Ethics for Leadership

Intrinsic

factors

Responsibility Give people ownership of their work Reduce control while retaining accountability How to produce dissatisfaction
Add accountability while taking away authority

Ethics for Leadership

Intrinsic

factors

Growth People need to feel challenged by what they do Keep knowledge and abilities from becoming static Invest in education of employees How to produce dissatisfaction
Routinize work to point there is nothing new

Ethics for Leadership

Attention

to extrinsic factors can reduce dissatisfaction Attention to intrinsic factors can improve quality of work Dont look for ways to prod or entice workers Look for ways to enrich work itself

Where Are You Focused As a Leader?

Extrinsic factors
Administrative policies Supervision Salary Interpersonal relations Workplace conditions

Intrinsic factors
Work itself Achievement Recognition Responsibility Growth

Herzberg
If you want people to do good work, give them good work to do Case #3:

Case #3
Some

members of your group complain that they are unfairly underpaid. They generate twice the RVUs of another section. They want more money, or threaten to leave. How do you react to this challenge?

Leadership Review

What did we talk about today?

1.

Targets for leadership

MISSION VISION GOALS

1.

Competencies for leadership

MOTIVATION Communication Delegation

1.

Ethics for leadership

Big picture FLOURISHING Patients good

Other Resources
Gunderman RB.

Images of the Imager: The Essential Role of Ethics in the Future of Radiology. Acad Radiol. 1999 Mar; 6(3): 148155. Gunderman RB and Willing SJ. Motivation in Radiology: Implications for Leadership. Radiology. 2002 Oct; 225: 1-5. Gunderman RB. Take Me to Your (Future) Leader. Acad Radiol. 2001 Aug; 6: 762-767. Gunderman. Strategic Imagination. AJR. 2000 Oct; 175: 973-976 .