Managing the new technical employee.

If you haven't read the predictions, spread ad nauseam through the media, about all the health care jobs to be created in the next five years, you've either been in Bangladesh or in a coma. The accounts are true, but not an unalloyed blessing or sign of boom times in health care.

What you didn't read is that the bulk of new hires will not be in patient care; they will be recruited to manage and expand the technology explosion. As organizations flatten, and they are rapidly doing so, management jobs are decreasing. Effectively managing these new workers has or will become the true test of a manager's leadership skills.

Techno savants are challenging employees who must be led, not managed. They have different values, expectations, and needs. They work best when rewarded differently. To assume that a management style that works with caregivers will work with techies is the first step on the road to ineffectiveness.

I talked recently with a medical director whose department now includes a technology group. His body language said it all: anger and frustration mixed with incomprehension. He'd just been turned down flat by a thirtysomething biomedical statistician he'd offered a promotion. The employee was certainly capable of supervising the group. He chose not to do so. "I'd lose my edge," he said, "and it's my most marketable asset."

"What's wrong with him?" the medical director asked. "He's going to kill his career here if he doesn't get with the program." The employee, if pressed, might have pointed out that there were plenty of jobs for people with his skills. Killing his career was no high statistical probability.

A senior manager in an HMO can't understand why not one of his technical project managers will go on site for a six-month start-up at a remote location. "It's a great career move. Well pay all expenses, a handsome bonus, plus a leg up on the promotion list. Don't these people have ambitions?" Yes, but why leave town to realize them when there are three hospitals, two HMOs, and three medical information companies in a five-mile radius.

I've heard the same stories across the country. The common thread is that the more technically skilled the worker, the more cutting edge he or she is - regardless of age - the more independent. One vice president for medical affairs in a 500-bed hospital, assuming such independence was age-related, sought to hire forty- and fiftysomethings. "What ever happened to the so-called "50-50" rule," he asked. "If you're over 50 and earn more than $50,000, you're supposed to be expendable and a glut on the market. Its not true. I found out that only applies to the technologically challenged, many of whom are |career' managers. Everyone I talked to, regardless of age, was highly selective. I ended up trying to sell them on the job."

Whether it's technicians, computer gurus, statisticians, engineers, researchers, or newly minted hybrids, each knows his or her market value. Even the anemic economic recovery has caused the best and brightest to see all employers as temporary. Temping, locum tenens, and contingency work aren't dirty words to the technically gifted. Short-term projects may even be preferred, especially if one's spouse provides health insurance. Such assignments promise variety, change, and new and better information - all of which are highly desirable. That's a 180 degree difference from nontechnical people, who think being attached to an institution or company is heaven.

The techie's message to the employer is, "I'll be here as long as the job meets my needs - and not one day longer." Imagine responding to that with, "You have to play on the team if you want a future here." Talk about cross talk!

Many MDs and RNs are deeply offended by these attitudes. Their response has been to see discipline rather than adaptation as the best management technique. That's a prescription for failure. Among techies, attitudes toward organizations are mixed - at best. "I'd be surprised if any of my systems people had anything nice to say about the hospital, if they thought about it at all," a medical director said. "To a person, they are focused on their skills, their field. They act out the laser focus on their own jobs in a way physicians were accused of 10 years ago. My technical stars are highly mobile and dedicated to advancing their knowledge. As one described it, he is building his |arsenal.' Any would move in a second for a better deal." It's not just the stars. New baby programmers fresh from trade schools show the same detachment. "What's to connect with? What's this vision and mission stuff.?" they say, followed by requests for software upgrades or new hardware. If you try to manage techies as you'd manage other knowledge workers, you'll motivate nobody. How can you modify your management strategy to engage, capitalize on, and anchor the techies you need without alienating everyone else?

Individualize reward systems. Rethink your assumptions about what should or does motivate employees. Focus on results alone. Attitude is a techie blind spot. They don't get it and they don't care. Don't assume that one reward, money for example, has universal appeal. There will always be a core of "organization men," and women. The core group cuts across age, education, and skills. They care about traditional motivators. Most techies don't. Don't disregard this information because you know an extroverted, golf-mad, promotion-minded systems analyst. They exist. However, certain rewards consistently work better with some groups than others.

I was at a state CPA society expo recently, talking about changing worker attitudes. After the presentation, the chief financial officer of a regional medical center collared me. He said that my presentation had clarified one important point. He was never going to "throw cash at any of my systems people again." (I suspended my disbelief that a CPA ever threw cash at anyone.) He described three analysts who told him they'd buy back their time for cash, e.g., a salary cut. They didn't want more money; they wanted more time. Two computer gurus said the same thing.

Offer rewards that bond. Pay time charges (set a limit) on services such as America On-line, Prodigy, Internet, or other specialized systems. Offer a lend/lease plan to those who want to use notebook computers, other kinds of special equipment, or databases after hours. Nothing appeals to techies as much as more of the same.

Flexible hours work like glue. As one materials engineer pointed out, why did he need to be at the hospital before 10 a.m.? He didn't drink coffee and nobody did anything productive until then anyway. He always worked until 8 or 9 p.m. His boss wanted everyone propped up in an ergonomic chair by 9 - a bad move on the boss's part.

It's the same with employees who want to work from home one or two days a week. Ditto for those who'd like nothing but business casual dress. Except for employees who work with patients or must keep specific hours, a flexible schedule is worth more than a raise.

One caveat: Tachies, and everybody else, must be told specifically when they are trading advancement and money for flexibility. Most techies won't care, but nontechies who think the techies are being pampered may not understand the limits iconoclastic behavior and dress impose. (This is true of physicians, too.) Fairness dictates that who gets what be carefully explained, negotiated, and agreed to in detail. It prevents recriminations and whining.

Why should someone who's roaring down the information superhighway have to stop for lunch? Hot or cold meals delivered cubicle side are a coveted perk. Let employees order lunch the night before and have it delivered at a specific moment - at the employee's expense, of course. It's less costly and more desirable than bowling or softball teams. Anything that keeps techies productive, innovative, and focused matters. Think of yourself as an orchestra conductor. No maestro every treated all musicians the same.

Education means skills development. It's both the ultimate motivator and the ultimate reward. For the past five years, technical employees have treasured every skill-building opportunity, because it meant they were more mobile. Challenge, which is the handmaiden of education, is a major job anchor. When problems become routine or the "m" word - maintenance - is mentioned, worker satisfaction plummets. Cross train and rotate assignments. Don't stick any one worker with too much routine.

It's difficult for health care leaders to keep up with management fads and decide which to embrace. Physicians at the bedside reel at the amount of information they must absorb. It's equally difficult for techies, because the desire to create the next generation of software or incorporate the newest materials or procedures into the job and the desire to find a plateau and digest what's already there are rarely in balance. Consequently, techies report that achieving top results and getting professional satisfaction means pushing the envelope And dodging overload. Use books, seminars, consults, and individual access to technical gurus to enhance people's skills and commitment.

Yes, techies have among the most portable, expensive skills. If Jane leaves Healthco for Blessed Sufferer Hospital, she takes your investment in her training. You'll still benefit when she's replaced by someone your competitor trained equally well. You can't prevent cross-pollination, but you can benefit from the process.

Buffer your techies politically. Most employees hate office politics, but they'll struggle along. Great techies won't. They walk. Think of Bill Gates, the techie's favorite pin-up. For techies, politics is stupid, illogical, and a waste of good brain power. (Many clinicians say the same.) How many times have you said, "Just do it. I know it's playing politics, but it makes the administrators happy.' The role call has just sounded on the other side, as an outstanding performer updates his or her resume and prepares to depart.

With rare exceptions, the bits and bytes crowd won't adapt. Managers must to get results. Here's why. People who must adapt their thinking to the rigidity of math, logic, and the laws of physics and chemistry are not taken with bosses who sway in the political winds. They despise truckling, toadying, and other forms of displayed weakness. When going along is vital, ask for indulgence and/or a favor and reward it lavishly.

Techies are grateful for straight-line thinking and subject/verb/object sentences. Other employees share this sentiment. Techies, however, are more likely to bolt when ambiguity and inchoate direction are piped in through the heat ducts. Don't hint. Give specific instructions.

Finally, don't try to compete. If you try to stay on top of your technical people by duplicating their knowledge, you'll have neither the time nor the stamina to manage. Cut them some slack, monitor, smooth over differences with the rest of the organization, and press them relentlessly for increased results. They'll campaign to work for you. For an overview of technical workers and their impact on the economy see the August 22, 1994, issue of Fortune. The cover story, "The New Worker Elite," is worth reading.