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The chief executive officer (CEO) of a health care facility that employed about 700 people scheduled a weekly meeting with his 7 direct-reporting managers. These managers were expected to reserve the hours from 10:00 AM until noon for this meeting, and they were further expected to have specific agenda items ready for discussion.


The manager who mandates a meeting of direct-reporting employees effectively controls the scheduled amount of time for those subordinates. The subordinate managers can understandably be expected to arrange their day around the weekly meeting. Apparently not especially mindful of the value of his subordinate's time, this particular CEO approached his own staff meeting as follows:


* As often as 50% of the time, he canceled the meeting. However, notice of cancelation rarely occurred earlier than 15 minutes before meeting time and often failed to occur until the participants were already assembled.


* On days when the meeting convened, the CEO was usually 5 to 15 minutes late. Most of his late arrivals were for reasons well within his ability to control.


* On arriving, the CEO would often remember a call he "just had to make" and would do so while the 7 managers sat and waited. The CEO often took incoming calls during the meeting.


* It usually required up to 5 minutes for the CEO to find his agenda among the many materials he carried, and at least once every third or fourth meeting he had to call his secretary to bring his agenda and notes to the conference room.


* In what was meant to be an "around the table" presentation of items, the CEO always placed himself first. Given his tendency toward rambling digressions, he usually consumed as much as three-quarters of the meeting time with his own items. The 7 managers were invariably forced to compress their reports and skip some items altogether.


* Up to 20% of the time, the CEO cut the meeting short to rush off to something else. Often when this occurred, his agenda items were the only items that made it onto the table.


* Overall, the CEO's behavior reduced a 2-hour meeting of 8 managers-himself and 7 others-to an average actual meeting time of barely three-quarters of an hour and much of that of questionable value.



In Up the Organization (Alfred A. Knopf, Inc, 1970), author Robert Townsend included a brief quiz titled "Rate Your Boss as a Leader." In one point, he suggests that a tough, effective leader "won't let top management or important outsiders waste his time. Is more jealous of his people's time than he is of his own."


Beware the manager whose behavior implies that the subordinate's time is the manager's to waste. The CEO of the foregoing example undoubtedly believed himself to be a tough, fast-moving, effective manager, when in the eyes of his subordinate managers he was a self-centered and disorganized individual who wasted the time of those around him, thus reducing everyone's effectiveness. In making it possible for employees to do their jobs as they should, the truly effective leader must be the servant of the employees, not their master.


It pays to remember that regardless of organizational level one of the manager's primary responsibilities is to facilitate the subordinates' work performance and to make it possible for the people who do the work to do so as efficiently and effectively as possible.


This issue of The Health Care Manager (Issue 38:2, April-June 2019) includes the following articles for the reader's consideration:


* "Management Approach for Population Health Outcomes and Economic Improvement: Appointing Health Services Early Careerists to Rural Communities for Leadership Development" addresses a potential future path for students completing a health services administration curriculum training program and beginning their careers in underserved areas to positively impact rural communities.


* "Rethinking the Obvious: Time for New Ideas on Medical Malpractice Tort Reform" reports on a study undertaken to determine how successful traditional medical malpractice reforms have been at controlling medical costs, decreasing defensive medicine practices, lowering malpractice premiums, and reducing the frequency of medical malpractice litigation.


* "Choice of a Short-term Prediction Model for Patient Discharge Before Noon" addresses a study that presents a model for forecasting patient discharge performance applying the Box-Jenkins methodology using weekly historic data for the purpose of finding an appropriate ARIMA (autoregressive integrated moving average) model for forecasting rates of patients out by noon to facilitate the hospital administrators' decision-making process.


* "The Role of Patient-Centered Medical Home Recognition in Addressing Public Health Priorities" addresses a review of evidence gathered from academic and professional literature on how achieving accreditation as a patient-centered medical home advances the American Public Health Association's public health priorities.


* "An Analysis of Key Challenges Encountered by Various Stakeholders in the Evolving Private Hospital Ecosystem in India" addresses a current survey conducted with the aim of evaluating work-related challenges faced by individual hospital stakeholders and gauging potential engagement opportunities with industry to improve the quality health care services delivered.


* Case in Health Care Management: "To Manage the Manager" asks the reader to consider ways of addressing the problems presented by a single manager whose unsatisfactory behavior is causing problems for 2 peer managers who feel forced to take on some of what the subject manager fails to do.


* "Shared Vision in Nursing: An Evolutionary Concept Analysis Revealing Dualities Within the Profession" reports on a study undertaken to provide a concept analysis of shared vision from an evolutionary nursing perspective within health care organizations, recognizing nurses are central and active in visioning while patients and families are passive recipients.


* "The Factors Affecting Hospital Employees' Turnover Intentions: A Case Study of Iran" reports on an applied, cross-sectional, and descriptive-analytic study conducted on the administrative and financial employees working in teaching hospitals to establish a means of assessing the turnover intentions of staff.


* "To Rate or Not to Rate? Autonomic Response and Psychological Wellbeing of Employees During Performance Review" reports on an investigation of leadership undertaken by assessing psychophysiological responses during performance review and their effects on employees' well-being.


* "The Opioid Epidemic in West Virginia" reports on research undertaken to examine and analyze the causes of the opioid epidemic and subsequent responses to it in the state of West Virginia, concluding that the reasons for the epidemic incidence in West Virginia include a combination of sociocultural factors, a depressed economy, lack of education, and a high rate of prescribing and dispensing of prescription opioids.