THE MANAGER'S BEHAVIOR: CONTRADICTIONS AND PERCEPTIONS
A new boss arrives from outside the organization. Whether coming in as chief executive officer, a division or department head, or in some lesser managerial capacity, as long as this person is an experienced present-day manager, you can count on this new boss to make 1 or more statements like some of the following:
* "I'm very much a participative manager; I know the employees have much to offer."
* "You'll see me around a lot, wandering the floors and units; I like to be where the action is."
* "I believe in decentralization. Decisions should be made at the level of the people who know the work best."
* "I believe in being available; my door is always open."
* "I'm very much a people-person."
We can probably agree that the foregoing statements represent a number of desirable aspects of modern management behavior. However, consider what occurs when:
* The months pass, but the "participative" manager never gets around to soliciting employee input or has involved only a select few employees.
* The manager who spoke of managing while "wandering around" is seen as consumed by external affairs and other concerns and, after 6 months on the job, has yet to visit a department.
* The manager who expressed a belief in decentralization has retained all true decision-making authority centrally.
* The stated open-door policy is contradicted by an attitude that says one is too busy for employees and a schedule that makes it difficult to even get an appointment.
* The one who claimed to be "very much a people-person" has clearly become consumed by processes and outputs.
Why do so many managers trap themselves by the obvious differences between what they say and what they do? They probably say the "good" things because they know they should; these reflect what we are supposed to believe about modern management. Most managers who make such noble statements probably believe they are saying the right things. Their intentions are commendable; however, if they really believe what they are saying, why then the contrary behavior? This most likely occurs for 2 principal reasons: Making the right moves takes more time than doing things the "old" way, and old habits formed by outmoded notions about management take over.
Thus, the well-meaning manager can become less so in the eyes of the employees because of behavior that contradicts the manager's statements. And it does not take a great deal of such contradiction to disappoint the employees who have heard-and can be counted on to clearly remember-a manager's early claims. To the perceiver, perception is reality, and the employees whose perceptions are affected by just a couple of such contradictions may become sorely disappointed with the manager.
What is the solution to the problem of contradictory statements and behavior? Do not say what kind of manager you are and how you practice management: Do not voice your management philosophy, do not simply tell people what you think they want to hear or what current theory might suggest you should be saying. Describing yourself as a manager is very nearly a guaranteed losing proposition; you will never be perceived as living up in every respect.
Your employees should have a particular expectation of you that you should have of your immediate superior. We can express this as follows: never tell them what you are or what you believe except in the broadest, most general terms. Rather, show them with actions that reveal what you are and what you believe. If your employees' primary perceptions of you are formed by your actions, you will never have to worry about creating the contradictions that can weaken you as a manager.
This issue of The Health Care Manager (33:2, April-June 2014) offers the following articles for the reader's consideration.
"Foundation of Evidence-Based Decision Making for Health Care Managers, Part 1: Systematic Review." This 2-part article addresses evidence-based decision making as an important benchmark of best practice, with part I concentrating on systematic reviews as a major source of evidence to support decision-making.
"Accountable Care Organizations: Financial Advantages of Larger Hospital Organizations" explores the relatively new concept of accountable care organizations and reports on a study undertaken to determine the organizational characteristics that would best support accountable care organization development.
"Measuring Efficiency Among US Federal Hospitals" reports on a study undertaken to evaluate the efficiency of federal hospitals, specifically hospitals administered by the US Department of Veterans Affairs and the US Department of Defense. The study used data envelopment analysis to evaluate a number of hospitals in both 2007 and 2011.
"Reduction of Intensive Care Unit Length of Stay: The Case of Early Mobilization" reports on a research study undertaken to analyze the effects of early mobilization for intensive care unit patients and determine whether it has an impact on length of stay, cost of care, and medical complications.
"Dress Codes and Appearance Policies: Challenges Under Federal Legislation, Part 3: Title VII, the Americans With Disabilities Act, and the National Labor Relations Act" concludes a 3-part examination of legal challenges to dress codes and appearance policies, this part focusing on regulations stemming from Title VII of the Civil Rights Act of 1964, the Americans With Disabilities Act, and the National Labor Relations Act.
"Implementation of the Physician Assistant in Dutch Health Care Organizations: Primary Motives and Outcomes" reports on a study undertaken to examine the apparent reasons for employing physician assistants, relatively new to Dutch health care, concluding that they are being employed primarily for improving continuity and quality of care and for other reasons including providing relief for specialists' workload.
Case in Health Care Management: "You're the Boss" asks the reader to consider a situation in which a manager must try to motivate an openly resistant and unwilling employee to apply his full capabilities to and important assignment. Note that the "Case" department leads off with a correction concerning case-response placement in Issues 32:3 and 33:1.
"Building an Ethical Organizational Culture" suggests that the success of a health care organization, as defined by high-quality, high-value care, positive patient outcomes, and financial solvency, is highly dependent on the culture within the organization and that the ability to achieve and sustain alignment of mission, values, and everyday practices defines a positive organizational culture.
"Fostering Acceptance of Computerized Physician Order Entry: Insights From an Implementation Study" acknowledges that some physicians have resisted computerized physician order entry and reports on a study undertaken to determine how this growing practice may be made more acceptable to more physicians.
"Impact of a Pedometer Program on Nurses Working in a Health-Promoting Hospital" reports on research undertaken to determine the impact of a pedometer-based activity program on a number of nurses in a university-affiliated, multisite health care center in Canada using preintervention and postintervention questionnaires for data collection.