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Diversity of thought: a competitive advantage.

Cyrus the Great, the founder of the old Persian Achaemenid Empire, is famous for respecting the customs and religions of the lands he conquered. (1) It is said that Athenians adopted aspects of the Achaemenid Empire. The thinking of Cyrus the Great influenced Western and Eastern thought.

James Kouzes and Barry Posner indicated in The Leadership Challenge (2) that there are several decision-making myths:

1. The chief executive decides.

2. Decisions are made in the room.

3. Decisions are largely intellectual exercises.

4. Managers analyze and then decide.

5. Managers decide and then act.

They point out that decision-making does not follow a linear process; it is often nonlinear, affective and messy.

Kouzes and Posner rediscovered what Cyrus the Great admonished. Seek broad perspectives, then unify and carry out your strategy.

Recruitment for diversity of thought

Recruiters at most health care institutions view diversity recruitment as a business and a social imperative. Although these goals are legally required and laudable, few leaders have considered the benefits of improving the quality and depth of strategic decisions by seeking cognitive diversity.

In "Learning to Live with Complexity," (3) authors Gokce Sargut and Rita McGrath stated that recruiting for cognitive diversity was critical for organizations that deal with complex systems that are characterized by "a large number of interactive, interdependent, diverse elements." (3)

In their Harvard Business Review article, Sargut and McGrath describe the work of Scott E. Page, a social scientist and complex systems expert at the University of Michigan. Page described a counterintuitive strategy of hiring people for maximum cognitive diversity in order to avoid groupthink. (3)

Sargut and McGrath stated the hiring decisions to ensure diversity of thought could help mitigate sound decision-making in the face of rapidly moving, complex systems:

"Who in your company regularly talks to people you might not interact with yourself, comes up with things that area little off the beaten track, and is attuned to underlying risks and trends that your other managers might overlook? In a complex system, finding the right people for the job means seeking out those sorts of thinkers." (3)

What is the real purpose of diversity recruitment?

What might not occur to physician leaders is that recruiting very broadly--accounting for perspectives that include generational, gender, place of origin and socioeconomic differences--can reap unexpected benefits.

For example, American physicians born in the Baby Boom generation from 1946 to 1964 are more likely to share similarities in experiences and shared perspectives than not, regardless of external appearances.

On the other hand, Hispanics are an extremely diverse group, including Mexican-Americans, Cuban-Americans, Puerto Ricans, and foreign-born Hispanics. Would a native-born Hispanic physician from a middle-class family in the Southwest U.S. share similar perspectives compared to a Hispanic physician from South America who is from an upper middle-class family? Yet, to the dominant culture, both would be viewed as Hispanic physicians.

Even recruiting for historically underrepresented minorities may not ensure diversity of thought if all of the potential candidates share the same world view as the physicians already on staff.

Some of the strategies for hiring for inclusion seem wedded to solutions from the 20th century--quotas and hiring physicians based on their external appearance, even though their perspectives may be quite different. Could it be that this approach actually impedes recruiting efforts?

Many generation X and generation Y physicians are beyond this thinking; many have been schooled in culturally diverse environments and they tend to shrug off external differences more readily. In other words, the newer generations are beyond tolerance. They have reached acceptance.

What is the difference?

Tolerance means that physicians of different backgrounds will eat lunch at work with each other. Acceptance means that they are comfortable knowing each other's families and having dinner at each other's' houses.

This certainly doesn't negate current earnest efforts to build inclusion and diversity into the health care workplace. Instead, it strengthens these efforts and gives recruitment efforts focus and urgency.

Thoughtful efforts to optimize cognitive diversity will take into account physicians from many different backgrounds and experiences. Physician leaders who wish to gain the broadest and deepest perspectives from their team will help their human resources departments go beyond standard definitions of diversity.

Cognitive biases and confirmation biases

Experienced physician leaders recognize that they have cognitive biases (the human tendency to make systematic errors in certain circumstances based on cognitive factors rather than evidence) (4) and confirmation biases (a tendency for people to favor information that confirms their preconceptions or hypotheses regardless of whether the information is true). (5) The wisest leaders welcome challenges to their biases.

If leaders recruit for multiple diverse perspectives from many different people, especially if the team members feel safe to speak truth to power, then leaders can increase the likelihood of hiring people who are willing to challenge their biases. (6)

Unity in command

The quality of the group's decisions and the effectiveness of the implementation of the decisions can be enhanced by diversity of counsel, according to Kouzes and Posner. They are reiterating what Cyrus the Great stated. Many perspectives must be sought, but once decisions are made, they must be implemented quickly and effectively.

A competitive advantage

A recent Harvard Business Review article described how a new breed of CEO can build a community of shared purpose by using a higher-ambition approach:

1. Corporate objectives are framed in terms of a common vision and values.

2. Individuals are expected to act in the interests of the company and the community.

3. Business and organizational metrics are clearly linked.

4. Diversity is a source of competitive advantage.

5. Social initiatives aim to create a better world and align and energize the organization. (7)

In this new paradigm employee diversity is not just a legal requirement. It is a new strategy that helps attract and retain the best and the brightest.

People who are attracted to health care want to make a difference in the care of patients. A unifying mission and strategy can be extraordinarily powerful in getting discretionary effort from a diverse group that is united in a common cause.

References

(1.) Cyrus the Great, accessed on August 29.2011, at http://en.wikipedia.org/wiki/ Cyrus_the_Great.

(2.) Kouzes JM and Posner BZ. The Leadership Challenge, 4th ed.; John Wiley and Sons, San Francisco, 2007.

(3.) Sargut G. and McGrath RG. "Learning to Live with Complexity", in Harvard Business Review, Sept. 2011, pp. 69-76.

(4.) Cognitive bias, accessed on August 29, 2011, at http://en.wikipedia.org/wiki/Bias.

(5.) Confirmation bias, accessed on August 29.2011, at http://en.wikipedia.org/wiki/ Confirmation_bias.

(6.) Hernandez JS. "Speak truth to power: the end of bobbleheaded leadership." Physician Exec. 2010 Jul-Aug; 36(4):40-1.

(7.) Foote N, Eisenstat R. and Fredberg T. "The Higher Ambition Leader," Harvard Business Review, Sept. 2011, pp. 95-102.

James S. Hernandez, MD, MS, is medical director of laboratories and chair of the division of laboratory medicine at the Mayo Clinic in Arizona.
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Title Annotation:Management Matters
Author:Hernandez, James S.
Publication:Physician Executive
Geographic Code:1USA
Date:May 1, 2014
Words:1162
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