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Much is said about management style, the implications of certain styles of management, and the relative success of various styles in encouraging people to respond as management desires. However, it is one thing to talk about management style and quite another to make a conscious decision about the value of a particular style and to deliberately adopt that style in practice. As one middle manager commented,


I can't see how all this talk about style can be any more than just an academic exercise. How I manage is a reflection of my personality and who I am as an individual, and to change my style I would have to change me. But I do appreciate the need to sometimes deal with different employees in different ways, so: am I reflecting any particular style at all if I'm always altering my approach?


There is much of common concern to managers in the foregoing comment. To a certain extent, one's style is indeed a reflection of one's personality, but consider why this may be so. Most managers enter their positions with far less training in management than they received in their primary specialties; they are not fully prepared at all times to answer the question: "What do I do in this particular situation?" Because of this and because the largest part of the management task consists of dealing with people, the manager, especially when new, tends to deal with employees much as he or she would deal with most other people. In this respect, one's management style is indeed a reflection of the manager as a distinct personality.


The middle manager's comment was also correct in recognizing that changing one's own style can mean changing one's self, at least in some ways. We may argue long and loud about the possibility of changing the essential self in any substantive way without massive effort, but it is reasonably clear that altering one's management style requires changes in how one deals with people and often calls for changes in one's habits. And anyone who has striven to alter a deeply ingrained habit knows how tough this task can be.


It is also correct to concede to the necessity of sometimes dealing with different employees in different ways. This is, in fact, a recognized style-the situational style, in which one's approach in a particular situation is governed neither by personality nor by a fixed set of rules or reasons but by the dictates of the circumstances and the manager's knowledge of the people involved. Thus, it may be fully appropriate for the manager to give specific, detailed instructions to one employee and only general direction to another, or to request frequent feedback from one employee while letting another work independently. These people are different from each other, and the manager has come to know and appreciate these differences. Not all employees in the group need the same things to the same extent from the manager.


Where does one's management style actually come from? Certainly, some of it comes from the manager's personality; but some of it comes from deliberately learned techniques, from consciously acquired habits, and from the accumulated experience of dealing with people. And much of a manager's style, often the less appropriate parts of that style, comes from the manager's role models.


Of all positions existing above the levels of unskilled and semiskilled hourly workers, the title manager remains one of the few that can be acquired without specific, specialized education. A growing number of managers in healthcare organizations have had some formal education in management, but many are still of the "UP-from-the-ranks" school of preparation.


The new manager's most visible role models are managers who were in the hierarchy before the new manager arrived. Each day the new manager observes the established managers' conduct. This conduct becomes a strong influence on the new manager's approach to management. Unintentionally, elements of management style that should perhaps have been altered or discarded long ago are passed on by example. Along with the good-and there is much good to be learned from the examples of many practicing managers-comes the bad, which often cannot be immediately recognized as inappropriate.


Style is indeed partly in the person, but style is also in the organizational hierarchy, in the existing management structure, to be inherited by the new manager. Knowing this, however, makes it possible for the manager to develop his or her own style. Although there is much to be learned from higher management, there is as much or more to be learned from today's environment, today's unique problems, and today's employees who in many respects are markedly different from their counterparts of past years. To build a management style, the new manager should read, study, occasionally try something new or different, and learn from those who have already been there.


This issue of The Health Care Manager (26:1, January-March 2007) offers the following for reader consideration:


* "Examining the Effects of Professional and General Liability Exposures and Related Adjudication Costs on a Multi-Hospital System" presents the results of a study of the frequency, causes, location, and cost of liability exposures experienced by the members of a multihospital system and suggests that significant reforms in addressing professional liability should be considered.


* "The Challenge of Sustaining Healthcare in Oman" reports on the current health status indicators in Oman, addresses specific threats to that nation's healthcare system and describes international funding opportunities, and reports on efforts to maintain health outcomes in Oman.


* "Case in Health Care Management: A Good Employee, But[horizontal ellipsis]" asks the reader to address the problem presented by an employee who, after several years of dependability, has fallen into an unacceptable attendance pattern, with circumstances complicated by the manager's failure to address the problem in its earlier stages.


* "The Growing Importance of Dental Services in Rural America" suggests that the availability of dental services is inconsistent across the country and that dental resources could be better allocated to provide a consistent level of service across the entire population.


* "The Department Manager and Effective Human Resource Planning: An Overview" identifies the department manager's pivotal role in ensuring the success of human resource planning and describes human resource planning's importance to the organization and to individual managers.


* "Gender-Based Wage Differentials Among Registered Dietitians" reports on a study of the compensation of male and female registered dietitians for the purpose of determining whether there are apparent disparities in registered dietitian compensation that appear owing to gender, that is, to what may be described as wage discrimination.


* "The Mystery of Altruism and Transcultural Nursing" addresses the question of why individuals choose the professions they choose and whether altruistic reasons enter into career selection, and presents an assessment model that could shed additional light on the effects of altruism on transcultural nursing.


* "Snapshots of Health Care Managers: A Measure of Leadership" examines present-day challenges to healthcare management and identifies apparent best practices to apply in selecting and developing healthcare leaders, especially those engaged in first-line management.


* "Roles, Skills, and Competencies of Middle Managers in Occupational Therapy" addresses the most essential roles, skills, and competencies needed by middle managers in occupational therapy settings. Although specifically directed at occupational therapy managers, this article has strong implications for middle managers in all healthcare settings.


* "Analysis and Control of Employee Turnover" attempts to overcome the confusion wrought by inconsistent and conflicting definitions of staff turnover, suggesting how to define turnover, how to assess turnover's costs, and how to recognize and differentiate controllable turnover and uncontrollable turnover.