Management vs. leadership.

"Efficiency is doing the right thing, effectiveness is doing things
right."--Peter Drucker

For at least the past decade, there has been a preponderance of articles discussing leadership and all its attributes, and a dearth of articles on traditional management and the role of the manager.

This may be a manifestation of our society's attraction to stars and hero worship, and the lack of interest in the less-than-thrilling role of managing the show.

A recent article on leadership by Philippe Kahn (1) discusses his view on leadership requiring a clear vision. According to Kahn, leaders turn that vision into success by building winning teams, by not ignoring problems that won't go away, by focusing relentlessly on innovation and by taking risks.

David Spitzer writes in the same journal about "The Energizing Leader," (2) who is capable of producing energy in an organization by creating contacts that will foster the maximum release of focused energy. He believes that great leaders listen to their employees and insist on employees telling the truth.

Leaders seem to instill a sense of significance in the workforce by giving employees the power of their vision and values. Spitzer also believes that leaders need to instill a sense of ownership in employees, allowing them to "keep score" of how the company is doing and by building confidence and recognizing good work.

A third author, Mark Shaeffert, writes in his article "What's Leadership" (3) that "great leaders have vision, honesty, passion, authenticity, great communication skills, and competencies."

He believes that true leaders seek leadership because they want to make a positive difference in the lives of others. "Bearing the burdens of leadership is worth it both for the impact you have on the lives of others and for the meaning it gives your own life."

Managers

Talking about leaders is the easy part--let's turn our attention to the manager. Managers are constantly told to deal with opposing ideas.

An excellent article, "The Five Minds of a Manager" (4) by Jonathan Gosling and Henry Mintzberg, describes what it takes to be a great manager. The authors explain that managers live in a world of paradox and cognitive dissonance. Managers are told to be global and local, collaborate and compete, change perpetually but maintain order, make the numbers and nurture people. Managers have to work in this world of contradictions.

These McGill University professors organize these management paradoxes around five tasks, each with its own mindset. Everything that every effective manager does is sandwiched between "action on the ground" and "reflection in the abstract." As these authors note, "Action without reflection is thoughtless. Reflection without action is passive." Those same statements could hold true for clinical practice.

Mindsets

Here are summaries of these five manager mindsets, according to Gosling and Mintzberg:

1. Managing self--the reflective mindset

Reflective managers have a healthy respect for the history of their organizations--not only the grand history of the big deals and disasters, but also the everyday history of the little actions that make organizations work. They must be able to understand the past to use the present to get to a better future.

2. Managing the organization--the analytical mindset

The authors believe this mindset is like being in a tennis match with a crowd around you. You must appreciate the score and the crowd, but always keeping your eye on the ball. It is important to know how to analyze situations not with simple solutions, but with the ability to evaluate diligently and thoroughly.

3. Managing context--the worldly mindset

Great managers need to be able to think outside the box, to look at the world around them, to think globally--not just how the business has always been done.

4. Managing relationships--the collaborative mindset

This is where management does not involve managing people so much as managing the relationships among people in teams and projects, as well as across divisions and alliances. Managers need to get beyond empowerment, according to the authors. Empowerment implies that people who know the work best somehow receive the blessing of their managers to do it. Great managers move employees into commitment, away from the currently popular heroic style of managing and toward a more engaging style. Engaging managers listen more than they talk. They get out of their offices to see and feel, rather than remain in them to sit and figure. And they do less controlling, allowing other people to be in greater control of their own work. If, "I deem, so that you do," is the implicit motto of the heroic manager, then the engaging manager's motto is, "We dream, so that we do." To be in a collaborative mindset means to be inside and involved.

[ILLUSTRATION OMITTED]

5. Managing change--the action mindset.

Imagine your organization is a chariot pulled by wild horses. These horses represent the emotions, aspirations, and motives of all the people in the organization. A manager's job here is to develop a sensitive awareness of the terrain. We tend to believe that everything is changing around us. But these authors emphasize that not everything is always changing; in fact many things stay the same. It's important to realize that change has no meaning without continuity. (There is a name for everything changing all the time: anarchy!) Accordingly, the trick in the "action mindset" is to mobilize energy around those things that need changing, while being careful to maintain the rest. Action and reflection tend to blend in a natural flow.

In light of all these mindsets, managers need to have certain other basic rules. An excellent book on leading and managing your organization is It's Your Ship, by Captain D. Michael Abrashoff. (5) He converts management techniques from the best ship in the Navy.

This captain took one of the worst-performing ships in the Navy and made it into the best through the use of some basic rules:

* Lead by example

* Listen aggressively

* Communicate purpose and meaning

* Create a climate of trust

* Look for results, not salutes

* Take calculated risks

* Go beyond standard procedure

* Build up your people

* Generate unity and improve your people's quality of life

Further techniques in management can be learned from an article entitled "How to Lead Now--Getting Extraordinary Performance When You Can't Pay For It" by John A. Byrne. (6) This article is about leaders and managers who get extraordinary performance out of people.

Byrne writes about builders in organizations--those who instill self-esteem in workers and build unflagging support through remarkably tough assignments. Great managers understand that most employees feel alienated from companies that spend years trimming their health benefits and laying off their friends. Employees today are no longer loyal to organizations as much as they are loyal to people. Great managers need to know this.

Byrne has five fundamental themes for an effective toolkit for pride-building in organizations:

1. Always have your compass set on pride, not money.

2. It is more important for people to be proud of what they do every day than it is for them to be proud of reaching a major goal.

3. Localize as much as possible. Don't wait for your organization or its leaders to instill pride.

4. Make your messages simple and direct. Don't confuse people with complexities.

5. Personalize the workplace. Get involved with your people. Don't violate human resource rules but getting involved with your employees is the single best way to build an emotional bond with them. Know things that are important to them.

Great managers also need to realize that there are changes in the makeup of the workforce itself. Baby boomers are giving way to generations X, Y, and the new millennium employees. The purpose of business is not simply to make a profit, according to Charles Handy. (7)

As David Packard, co-founder of Hewlett Packard, once said, "A group of people get together and exist as an institution that we call a company so they are able to accomplish collectively what they could not accomplish separately. They make a contribution to society."

Great managers know that reorganizing structurally will no longer answer what's difficult in their organizations. Jeffrey A. Oxman and Brian D. Smith, in their article "Limits of Structural Change," (8) review why so many companies fall into the trap of believing that simply moving themselves into new organizational charts will have impact.

These authors believe that the widespread "malady of structuritis" (the propensity to issue a new organizational chart as the first solution to any business problem) must change. In fact they believe that hierarchy currently plays a significantly smaller role than the nuts and bolts

of how work gets done.

People learn how to work around organizational structures. They believe that the rigid anatomy of structures is being trumped by the physiology of organizations. Younger employees tend to ignore hierarchy in favor of operating within their own informal networks (as opposed to within structures).

So, while our society is enamored by leaders (heroes) and visionaries whom we need to tell us about doing the right thing, we also must cherish the manager who helps us do things right.

References

1. Kahn P. "The Leadership Journey." Leader to Leader, Vol. 29, Sept. 2003.

2. Spitzer D. "The Energizing Leader," Leader to Leader, Vol. 29, Sept. 2003.

3. Shaeffert M. "What's Leadership" Twin City Business, Aug. 2003.

4. Gosling J. and Mintzberg H. "Five Minds of a Manager" Harvard Business Review, Nov. 2003.

5. Abrashoff M. It's Your Ship, New York: Warner Books, 2002.

6. Byrne J. "How to Lead Now-Getting Extraordinary Performance When You Can't Pay For It." Fast Company, Aug. 2003.

7. Fisher L. "The Creative Mind," Strategy and Business, Fall 2003.

8. Oxman J. and Smith B. "Limits of Structural Change," MIT Sloan Management Review, Fall 2003.

By Phillip M. Kibort, MD, MBA

Phillip M. Kibort, MD, MBA is vice president of medical affairs and chief medical officer at Children's Hospitals and Clinics in St. Paul, Minn. He can be reached by phone at 651-220-6165 or by e-mail [e-mail]. Kihort also thanks Audrey Anderson for editing this article and Teri Leonard for her transcription.

[ILLUSTRATION OMITTED]