#accountability

Physician Development Case Study: Academic Medicine

By:Joy Goldman RN, MS, PCC:  CEO SixSEED Partners, BSN, ACC

Background:

SixSEED Partners (SSP) participated in a coaching engagement with an Academic Medical Center physician leader.  Halfway into the engagement, we agreed to complete a 360-degree feedback process in support of the client’s ongoing systemic leadership and development.  The leader wanted to improve her leadership and also be able to cascade the learning to her physician partners.  The Leadership Circle 360 Profile (LCP) was administered to help hone in on priority development efforts.

Strategy:

The client’s role interfaced with faculty, residents, fellows, and administrators so the respondent group was very diverse.  The client’s results demonstrated high creative leadership (3-4 dimensions rated 80% or above yet there was a perceptual gap between self-ratings and that of others.(for detail on the tool, see The Leadership Circle Website).  Of note was the client’s self-rating in the 89 percentile for Passive, and respondents’ ratings of 81 percentile for Distance (reactive dimensions).  The client also had rated themselves in the 7% for courageous authenticity while her respondents rated her in the 53%.  What was clear was that the client was holding back and not bringing their full self and talents to the organization and the energy spent on protecting and playing it safe was draining.

The Solution:

As we explored internal and external dynamics, we found support in the theoretical frameworks of the Empowerment Dynamic, and Polarity Thinking which correlate perfectly with the LCP framework of reactive and creative modes of energy management.  Through coaching and much reflection, the client was able to see how his direct reports were placing him in a rescuer (hero) role and were presenting themselves as victims to system leaders, mainly hospital Presidents who were perceived as villains (see graphic).  This dynamic was evident through numerous cultural stories in the organization—not only did this dynamic occur within his organization:  it was prevalent throughout the system, with a displacement of accountability to “higher-ups,” which was also convenient when something didn’t work.  Blame was a well-known song sung throughout the system.

Impact:  

From the client’s perspective, he was able to see that he was re-enacting that dynamic with his boss and part of his development was to be conscious of the roles he was playing and putting on others.  He started individual meetings with his direct reports and shared the distinctions between victim and creator, encouraging them to take ownership and identify actions they can take to influence what they wanted to create in the system.

The client was also challenged to lead a system-level leadership development effort where both/and thinking (polarity thinking) would be introduced and measured for the prevalent tensions of Centralization and Decentralization (system service lines AND local hospital entities) and Individual AND Team accountabilities.  In this way, he would broaden the leadership capacity of system leaders which would minimize the victim/persecutor conversations and support mutual accountability throughout the system.

Are victim/ persecutor conversations rampant in your organization?  Are you fatigued in having to spend time on these draining discussions that result in stagnation and energy drain?  We feel your pain!  Contact us to learn how you can lead sustainable, empowering change in your system!