Make forward progress: master lateral management.

Good news. The number of effective physician executives and physician senior managers is rapidly growing in health care organizations throughout the country. And that's great.

Even more heartening is that, there's an observable improvement in quality. In my professional opinion, these physician executives clearly are becoming better at managing.

To a high degree, physician executives have learned to "manage up" (maintaining excellent communication with the CEO and/or the board) as well as to "manage down" (enhancing medical management and relationship while developing new skills for general organizational management).

"Managing laterally" is the new challenge facing them in the complex matrix that is today's health care delivery system. Perhaps it will be even tougher to master than previous management directions, as it involves factors--and people--rarely under the physician executive's direct control.

There are more nuances in lateral management. Lateral management and teamwork do overlap but are not entirely the same, although they are often substituted in casual discussions. But teamwork--which includes collaboration, cooperation, communication and participation-still doesn't encompass the key aspect of managing individual, undefined relationships that is implied in lateral management.

Essentially, these relationships are with colleagues with a wide range of personalities and various strength levels, knowledge bases and ambitions. It's a tall order for the physician executive to be skilled in managing specific, separate relationships with colleagues while also managing the group relationship. Although difficult, it's vital for future success.

This really is new stuff, which may be best demonstrated by a recent search of the Internet for "lateral management." The search yielded little in the way of references except some obscure mentions of smoke inhalation, academic requirement revisions from New Zealand, filing and software situations, ankle instability and some material on sports marketing.

In light of the pervasive use of 360-degree evaluations, you'd expect there would be more on the topic, but the literature hasn't caught up yet.

Success in lateral management is important for a number of reasons:

* Your personal success in your current job is clearly interconnected with that of your colleagues and peers.

* Your career reputation relies upon the good opinion of others who assess your work ethic, professionalism and results. The people closest to you should favorably endorse your decisions and your style as well as your effectiveness. That reputation precedes you.

* Because they will be asked to provide peer referrals for potential candidacies, your colleagues are actually "gatekeepers" for your professional advancement.

Specifics of lateral management

Here are a few specific principles and examples to further illuminate this unique new career development challenge:

Make your colleagues look good

This is a corollary to "make the boss look good," with much the same outcome. Speak well of colleagues whenever possible. Minimize their limitations. I recall an instance where a blundering new physician executive was rescued by kind words in his defense. The more experienced colleague who spoke well of him just felt it was the right thing to do, even though she knew none of the details. Once the new executive learned how he'd been protected from his own mistakes, he would've walked through fire for the senior colleague. And he learned a positive lesson as well.

Earn loyalty and trust

Communication and trust are cornerstones of success for health care management teams these days. When colleagues know they can count on you, that you're loyal and committed to helping them look good, the entire team will be profoundly strengthened.

Assume others will support you

There are three kinds of people:

1. Those who assume others are trustworthy until proven otherwise

2. Those who wait for others to demonstrate trustworthiness 

3. Those who assume others are not trustworthy

Fortunately, the latter is a small minority. Be openhearted and assume that others have integrity and honesty. Occasionally, you'll be burned, but generally people live up to expectations.

Trade knowledge

As Rod Hochman of Sentara Health noted in a recent column in The Physician Executive, the strongest executive management teams are those with excellent give and take. Sharing information and ideas is an extremely effective strategy that enhances results for everyone. Taking the lead in trading knowledge is also a great way to demonstrate your commitment to team success. It's likely you'll become a mentor.

Remember the Golden Rule

This is so basic it can be overlooked. Treat others as you would like to be treated and use this as a yardstick to measure the effect of your actions on those around you.

When in doubt, be generous

People usually mean well. Everyone who works has many opportunities each week to see the positive and negative sides of colleagues. Nobody's perfect. It's important to remember that all of us are "works in progress" who can benefit from mentoring or other positive development. It's a fascinating paradox that I've seen too often not to trust--the more credit you give others, the more that comes back to you.

Acknowledge others' ambitions

This may be the most challenging aspect of lateral relationship management because colleagues are often also competitors for a position on the organization's next level. ultimately, only one individual can be promoted and it's important to recognize this fact as part of your own career situation. Honestly evaluate your capabilities and prospects, along with those of your colleagues, and proceed accordingly.

Applying these notions to your lateral relationships will make a major contribution both to your professional growth and satisfaction. Immediately, your time at work will become more pleasant.

In addition, you will begin to generate the positive reputation that accurately represents your capabilities and style--his is what will make you recognized as a high-caliber candidate for greater responsibilities. This is the kind of reputation that precedes leading executives in every industry, but especially in the tightly interlocked world of health care management.

The achievement of your own professional ambitions can depend on how well you learn the lessons of lateral management.

Reference

(1) Lyons, MF. "Physician Executive Offers Advice from the Front Lines." The Physician Executive, Vol. 29(3), May/June 2003.

Mary Frances Lyons, MD, is a senior consultant at Witt/Kieffer in St. Louis. She can be reached by phone at 314 862-1370, or by e-mail at [e-mail].