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LOOKING AT THE GAP BETWEEN THEORY AND PRACTICE

A successful, longtime manager recently described having a number of key decisions openly challenged by an employee who claimed superior knowledge. The employee, who had no management experience, based these challenges on having "taken a course in management."

 

The expression "easier said than done" might come to mind when trying to decide how to respond to an employee who "has all the answers" based on minimal exposure to management theory as contained in textbooks and presented in the classroom. The employee has yet to appreciate that formal education is but a part of the education of a manager.

 

Formal education in management paves the way for and eventually supplements knowledge and expertise gained through experience; it cannot implant the essential benefits of on-the-job experience. What is called for "by the book" and what is encountered in reality can differ significantly according to the individual situation. This is especially true when it comes to handling people problems, frequently the greatest area of concern for the working manager. It is true that there are generic, common-sense approaches that should be exercised in many problem situations involving employees, but people are different from each other and what works with 1 person under a given set of circumstances may not work at all with another under similar circumstances.

 

The difference between what is absorbed in the classroom and what is encountered on the job is the fundamental difference between theory and practice. There will forever remain a gap between what is learned and what is done. Regardless of the steps taken to minimize the gap between theory and practice, what one learns from book or in a classroom will always lack 1 critical element that is often the determinant of the solution to a given problem. This key element is the manager's personal, emotional involvement in a real problem.

 

When a problem is considered in the form of a case study-a recounting, for example, of a real situation faced by an active manager-it lacks the personal involvement of the management student and is thus no more than an exercise in theory. When a problem is encountered on the job, however, the manager finds that he or she is part of the problem and is indeed personally involved. Even in the best of programs, the management student forever remains an outside observer; in a real problem, however, the manager is an inside participant.

 

The know-it-all employee's attitude may seem annoying, but it is far from unusual. It is often the reaction of the individual who has not yet worked as a manager but elects to pursue some management education. The employee mentioned in the opening paragraph will eventually have to alter the know-it-all attitude, but this person may be able to get off to a better start in management than some working managers who have had no formal orientation at all. The manager who is forced into learning everything on-the-job must work on instinct and survive in a sink-or-swim situation; a person who has had some formal education may at least be pointed in a more productive direction and thus be in a position to minimize the hazards of proceeding by trial and error.

 

Often the know-it-all employee has not yet come to appreciate that there are no formal approaches to the solution of everyday management problems. Certainly, a person can learn some problem-solving fundamentals in the academic setting, but the most valuable part of the individual's education will not occur until he or she has actually experienced contact with a variety of real management problems.

 

Because the employee whose behavior inspired these paragraphs is not a member of management, it is likely that he or she lacks a genuine management perspective regarding the department and its problems. Residing in the lower levels of the organization, the employee necessarily has a limited view of many situations that arise. From the lower levels, it is usually possible to see many of the negative aspects of a situation, but without a management perspective and the attendant knowledge of other circumstances having a bearing on the problem, the employee sees not a real problem but simply a "management problem" that seems generic in nature and appears to call for a textbook solution. In short, the employee may be attempting to approach management as all science without recognizing that it is much an art as a science.

 

This issue of The Health Care Manager (30:4, October-December 2011) offers the following articles for the reader's consideration.

 

* "Decision Making for Health Care Managers and Supervisors: Theory into Practice" addresses common decision-making theories and relates these to actual decision making, providing specific examples and suggesting how personal decision-making skills can be improved.

 

* "Serving Distinct Populations: Preventative Care in Medicaid HMOs and Commercial HMOs" reports on a study undertaken to examine preventable emergency admissions by Medicare HMO beneficiaries and analyzes the effects of HMO market conditions relative to such admissions.

 

* "The Improving Efficiency Frontier if Inpatient Rehabilitation Hospitals" reports on a study using a linear programming technique called Data Envelopment Analysis to identify changes in the efficiency frontier of inpatient rehabilitation hospitals after implementation of prospective payment.

 

* Case in Health Care Management: "The Second Chance" asks the reader to consider how a manager might approach a problematic example of delegation in which the employee to whom a task has been assigned keeps coming back with questions.

 

* "Compassion Fatigue and Burnout: What Managers Should Know" addresses the negative syndrome of compassion fatigue that some caregivers experience when dealing with the traumatic experiences of patients and suggests a number of interventions for coping with this emotional hazard.

 

* "An Empirical Investigation of the Differences Between Male and Female Medical School Physicians" reports on research undertaken to investigate sex-related differences among medical school faculty in a number of areas including information technology, medical malpractice, compensation, and patient care.

 

* "Electronic Falls Surveillance System (FSS) Model" introduces a preliminary falls risk assessment and prevention model using standardized clinical and operational performance indicators linked through the Web to patients' electronic health records to produce an electronic falls surveillance system.

 

* "A Conceptual Framework for Achieving Balance Between Innovation and Resilience in Optimizing Emergency Department Operations" presents a comprehensive review of theories and practices pertaining to emergency department operations, service innovations, and risk management, focusing on value creation and operational resilience.

 

* "The Manager and Equipment Decisions: The Capital Budget" examines the role of the individual department manager in preparing for the department's desired capital budget requests and describes the manager's involvement in assembling the total organization's capital budget.