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THE MANAGER'S GREATEST SOURCE OF POWER

If you are the typical department manager, you are probably accustomed to having your employees respond positively to most of the direction you provide. From time to time, you may be called upon for some clarification or expansion of what you expect of them, but by and large they perform as you direct.

 

Have you ever wondered why your employees respond to you the way they do when you provide them with direction? Have you considered whether they are consistently fulfilling your wishes because you are the manager? In other words, do your employees react to your leadership as an individual, or are they simply responding to the authority of your position?

 

It would behoove anyone in a position organizationally superior to others to avoid confusing positional power, that is, the legitimate power that comes from the subordinates' recognition of the right of command, with referent power, which arises from one's inherent ability to inspire a following toward the achievement of common goals. However, some managers have fallen into the trap of assuming that all employee compliance represents deference to them personally. In other words, it is often not the individual manager commanding obedience but rather the authority of the manager's position.

 

A great many employees-no doubt an overwhelming majority-expect to comply with positional authority and do what is expected of them. Surely we have all been conditioned by our lifelong understanding of superior-subordinate relationships to expect to do what the boss tells us to do. Even though we do as we are told, however, we are not always doing so primarily out of respect for or agreement with the person who provides the direction.

 

As we are accustomed to the boss possessing the legitimate power of the position, so too are we aware that the boss usually possesses reward power and coercive power. Reward power-exactly what its name indicates-and coercive power (the right to punish) both accompany the legitimate power of the position. Therefore, a great many employees simply do as they are told both because they expect to do so and because they know they can be rewarded for doing right or punished for doing wrong. Yet some employees can regularly defer to these 3 common kinds of positional power while their behavior makes it plain that something is missing.

 

The missing ingredient is usually respect for the manager as an individual equal to respect for the manager's position. This respect must be earned by the manager; it is not conferred by anyone but the employees. It should be an objective of every new manager and indeed a continuing goal of every experienced manager, to earn and keep the respect of the work group. Never settle for the group's simple acceptance of the authority of your position.

 

The respect of the work group does not come through formal education or management training. It is not granted by organizational superiors. It does not accrue overnight. It arises from honest effort applied to interpersonal relations with employees, from regular visibility and availability, from consistent treatment of employees, from respect for individuals, and from caring about people as individuals as well as producers.

 

The most successful managers possess the most potent form of power available in organizational life: the willing acceptance of their leadership.

 

This issue of The Health Care Manager (34:3, July-September 2015) offers the following articles for the reader's consideration.

 

"Workforce and Leader Development: Learning From the Baldrige Winners in Health Care" suggests that as change appears to be the only constant in today's health care organizations, to compete successfully in health care and to position an organization for high performance amid continuous change, it is important for managers to have knowledge of the best learning and development practices of high-performing organizations in their industry.

 

"Health Care Finance Executive Personalities Revisited: A 10-Year Follow-up Study" suggests that today's dynamic health care industry calls upon health care leaders to possess multiple competencies, reporting on a study undertaken to determine personality-type differences between practicing health care finance professionals in 2014 as compared with a previous 2003 study.

 

"Implementation of Measures to Improve SCIP Perioperative [beta]-Blocker Compliance: Quality and Financial Implications" addressed the need to create low-cost, standardized processes on an institutional level to improve compliance with continuation of preoperative [beta]-blockers, demonstrating that a single hospital was able to significantly improve SCIP compliance and emphasis on patient safety within a year of intervention implementation.

 

"Interventions of an Academic Medical Center to Improve Likelihood to Recommend" advances the premise that improved patient satisfaction is correlated with improved adherence and health outcomes for patients and financial performance for health care organizations; thus, increasingly efforts are being made to measure and optimize patient satisfaction by both providers and insurers.

 

"Tweeting and Treating: How Hospitals Use Twitter to Improve Care" reports on a study undertaken to explore the benefits that Twitter utilization has had in improving quality of care, access to care, patient satisfaction, and community footprint while assessing the barriers to its implementation.

 

The Case in Health Care Management, "Sylvia's Choice," asks the reader to consider how a manager might address the apparently demotivating effects on the performance of a valued employee who saw the promotion she desired go to another employee.

 

"A Single-Center Multidisciplinary Initiative to Reduce Catheter-Associated Urinary Tract Infection Rates: Quality and Financial Implications" reports on a revenue analysis with a standard sensitivity analysis to assess the impact of a low-cost catheter-associated urinary tract infection reduction program on direct costs to specific hospital over a period of 4 years.

 

"Social Media in Health Care: How Close Is Too Close?" explores the utilization of social media in the health care field, specifically how the treatment of a physician's Facebook friends would differ from that of a patient the physician did not know prior to treatment and how the incorporation of social media into health care presents both advantages and risks.

 

"Exploring Social Quality and Community Health Outcomes: An Ecological Model" reports on a study of the interrelationships among institutional capacity, citizen capacity, and their associations with community-level health indicators such as mortality and suicide among 230 local governments in South Korea, concluding that fundamental social welfare benefits need to be guaranteed while improving social quality capacities in order to improve the health status of localities.

 

"Professional Quality of Life of VA Staff and Providers in a Patient-Centered Care Environment" suggests that changes to the work environment prompted by the movement toward patient-centered care have the potential to reduce occupational stress among health care workers by improving team-based work activities, collaboration, and employee-driven quality improvement.

 

"Participation of Rural Health Care Providers in Accountable Care Organizations: Early Indications" examines the characteristics of southeastern rural health care providers and the counties they serve and reveals how those characteristics compare with other regions across the country and suggests what role the differences might play in an organization's decision to participate in an accountable care organization.

 

"The Effects of Supervisors' Support and Mediating Factors on the Nurses' Job Performance Using Structural Equation Modeling: A Case Study" reports on a study intended to determine the effects of supervisory support and other mediating factors on the job performance of 400 nurses working in a number of teaching hospitals, using structural equation modeling.