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We invariably agree when we hear it said that a manager is someone who gets things accomplished through other people. However, many times a manager may be called upon to perform something that is essentially nonmanagerial simply because he or she possesses certain technical or professional expertise. For some managers, such demands occur often enough to make one wonder whether the seemingly regular performance of work somehow makes them less of a manager.


For many first-line and middle managers, the regular necessity to do a fair amount of nonmanagerial work sometimes calls up doubts and uncertainties about the true role of a manager. Does falling back on the performance of one's technical or professional specialty make one less of a manager? The answer depends on the circumstances surrounding each instance that causes the thought of those questions to arise.


The answer may be yes, doing so makes one less of a manager if:


* One or more employees in the group possess the proper skills and have time to do the work, but the manager fails to delegate. If delegation is possible but is avoided for the usual reasons-the manager believes there is insufficient time to train someone or feels it would be easier to simply do it alone and move on to the next problem-then the manager is not behaving as a true manager.


* Performance of the specific task interferes with the manager's active management performance; in other words, managerial tasks do not get done because the manager is doing nonmanagerial work. Or


* The manager takes "called upon to perform" in the literal sense, not appreciating that an assignment from higher management does not mean do it yourself as much as it means see that it gets done. The tendency to take on all such requests as personal assignments indicates that the manager is most likely thinking and responding more as a rank-and-file employee than as a manager.



Assuming a reasonable awareness of appropriate management practices, the answer will be no, the manager who takes on a specific nonmanagerial task is not any less of a manager as long as:


* The manager is performing the task because there is not another person available who can do it at present and because other considerations such as timeliness and quality are legitimate concerns.


* The task in question is a one-time task, and teaching someone to do it would clearly take longer than simply doing it. Under these circumstances, delegation is not the answer.


* In performing the task and solving a particular problem, the manager can at the same time be teaching by example and can also be taking advantage of the occasional performance of technical work to enhance his or her credibility with the employees.


* Performance of the task represents part of a working manager's fair share of the work of the department. At all but the highest organizational levels, and especially at the first-line manager's level, the manager should know the technical aspects of the department's work. Doing some of this work when the occasion demands should serve to reinforce one of the most important characteristics of leadership-the leader works with-and not over-the employees.


* The manager has the time, outside the demands of important managerial duties, and is doing so because technical task performance frequently provides the welcome relief of variation. In addition, such technical task performance helps the manager remain current in the field. Most managers will readily concede that professional and technical skills can be weakened or even become lost over time if they are not used.



In most instances-again, at all organizational levels except the highest-the manager is both a manager and a hands-on worker. As a worker, the manager is usually a technical specialist or a professional in a specific field. It is necessary for most managers to divide their time and effort between 2 entirely different areas of endeavor, the performance of management work and the performance of technical-task work. Certainly the average first-line manager-and that manager's boss as well-must often be a worker as well as a manager.


In most instances, the answer to the original question will be no, the performance of a specific nonmanagerial task will not make the manager any less of a manager. However, the manager must be performing that particular task for the right reasons. Because the manager exists to make it as easy as possible for the employees to accomplish the work of the department, this purpose is often best served when the manager functions as an active, producing part of the work group.


As one may regularly utilize technical task performance to help stay current with technology and technique, so also may one help to maintain an edge by staying abreast of the literature of health care management.


Toward that end, the following articles are offered for reader consideration in this issue of The Health Care Manager (26:4, October-December 2007):


* "The Facility Audit and Review Method: Evaluating Institutional Ethics in Health Care Organizations" introduces an effective method for conducting an ethical assessment of an organization, in effect an ethics audit to be applied within a health care facility to ensure that its health care delivery is being fulfilled.


* "Epidemic Simulation for Syndromic Surveillance" reports on a project undertaken to develop a simulation-based test bed for a syndromic surveillance system that will extract data from syndrome reports from emergency rooms and elsewhere to produce early alerts of the onset of epidemics.


* The Case in Health Care Management, "The Mail Room Challenge," asks the reader to adopt the viewpoint of a recently hired manager and consider how to go about addressing the need for significant change with an apparently strongly resistant long-term employee.


* "Measuring Functional Service Quality Using SERVQUAL in a High-Dependence Health Service Relationship" addresses the use of a specific instrument for assessing service quality in the long-term care setting, suggesting that many medical professionals have fallen out of touch with patient issues and concerns.


* "Changing Workforce Demographics Necessitates Succession Planning in Health Care" provides managers with a framework for improving the systematic preparation of the next generation of managers through analysis and conscientious application of the succession planning process.


* "Evaluating the Relative Clinical Efficiency of Family Medicine Satellite Clinics" reports on a study undertaken to evaluate the impact of decentralization in family medicine clinic services by comparing the service utilization in satellite clinics with utilization patterns at a hub clinic.


* "Privacy Policy Analysis for Health Information Networks and Regional Health Information Organizations" examines the privacy issues raised largely by the Health Insurance Portability and Accountability Act of 1996 and recommends a means of resolving the privacy concerns of both providers and patients.


* "Is CEO Turnover Good for the Hospital?" reports on a study undertaken to examine the general characteristics of chief executive officers and their hospitals and draw some conclusions concerning the perceived impact of chief executive officer turnover on various organizational activities.


* "Health Care Disparities as a Health Care Quality Management Challenge" addresses distributive justice relative to health care disparities and explores the ethical issues involved in determining to which persons or groups in need that necessarily limited health care resources are allocated.


* "Patients Meet Technology: The Newest in Patient-Centered Care Initiatives" addresses the changing patient-provider relationship and the forces behind this change, identifies new care technologies and their likely effects on consumers, and suggests the possible future impact of patient-centered technology initiatives on the health care industry.


* "Exchanging Honest Employment References: Tiptoeing Between Defamation and Negligent Hiring" explores the fears and misgivings behind many organizations' reluctance to supply reference information and suggests how to engage in exchanging honest and useful reference information with minimal legal risk.


* Book Review: 222 Secrets of Hiring, Managing, and Retaining Great Employees in Healthcare Practices.