One of my very first managers had a little catchphrase she liked to use whenever she assigned out a new tasks. Without fail, she would tell us, “I won’t ask you to do anything I wouldn’t be willing to do myself.”
It was a nice sentiment, but the truth of it was, sometimes she delegated tasks for which she was not qualified. Usually, these had to do with specific machines or computer tasks, but more than a little bit of the time, she was asserting she had the will, when my coworkers and I knew she didn’t have the way–outside of asking one of us. At the time, it didn’t rankle us, but I’ve had more than my share of experiences since then where this issue got blown way, way up. In every industry, in every organization, and among every department, I’ve witness this same conflict:
People get really uptight about being told what to do by someone in management who doesn’t share their responsibilities.
Try as we might to present leadership as an integral part of any operation, too often there is a disconnect between managers and the managed. Broadly, this can be referred to as Production and Management.
Probably no one has captured this tension better than the old medical sitcom, Scrubs. If you have ever watched Scrubs, you ought to be familiar with the ongoing conflict between two of its most memorable characters, Dr. Cox and Dr. Kelso, who loosely represent clinical medicine and administration, respectively. Their conflict goes through everything from lightsaber duels to fistfights, and near-constant verbal sparring. It also perfectly captures the tension between two halves of a whole. They need each other–their work requires them both–yet find themselves constantly at odds as to how to balance their roles and their contributions.
Besides reaffirming the relevance and comic genius of Scrubs, I like to use this example because healthcare is particularly guilty of this disconnect. Doctors are constantly complaining that administration is micromanaging how they do their jobs–practicing medicine–without any appreciation for how difficult it is to be a doctor in the first place.
Administrators, under a combination of federal and financial pressure, are constantly struggling to get doctors and other caregiving staff in line with new initiatives, practices, and operational considerations.
Ironically, despite this hostility we are constantly losing doctors to the administrative world. The promise of better pay, more stable schedules, and relief from the many burdens of clinical medicine is drawing doctors into the administrative sector–though not in sufficient numbers that hospitals and medical systems have been able to limit recruitment to experienced physicians. This leads us to the first challenge of bridging the divide between Production and Management: training.
Training for Silos
The demand in government and in the private sector for more business sense in healthcare is driving the trend of bringing on admins with applied business experience, but not necessarily any clinical background. The pay is lucrative, the demand only growing, and opportunities opening up everywhere. Business schools are hopping on board with specialized MBA programs for Healthcare Administration–again, clinical experience is beneficial but seldom required for admission.
The same trends that make specialized MBA programs popular is also at the heart of complaints about the growing administrative class: these are business leaders, not caregivers. How can they manage a workforce they don’t understand? How can they respect an individual’s operational perspective, when they are preoccupied with the organizational, top-level perspective?
All of these challenging questions will often get condensed into one dismissive slogan:
Don’t tell me how to do my job.
Any good onboarding system–whether for C-Suite leadership or entry-level roles–should incorporate cross-training on the different departments and functions of an organization. More than that, though, there should be pathways for communication at all times. Angry slogans and and dismissive attitudes last longer when they go unchallenged; getting these people to talk through their grievances and understand the different perspectives the led to the division can force both to reconsider animosity and adopt more solutions-focused attitudes going forward.
Through better communication, you can turn “Don’t tell me how to do my job!” into “How can we help make each other’s jobs easier?”
Divisive mindsets are as much a chronic risk as they are an acute problem during onboarding.
Does “climbing the rungs” of the administrative ladder necessarily mean less engagement, more Us and Them conflict? No–quite the opposite, in fact. Employee engagement has been shown to increase along with career advancement. However, level of engagement and focus of attention are not the same thing, and moving into a new role very often carries some need to shift gears and change priorities. This, unfortunately, is where some of the tension arises.
Developing leadership, curating management, and empowering administration can all happen in a vacuum entirely isolated from the production side. After all, as we see in so transparently in healthcare, the sorts of skills required for admins are different from those that make for effective client-facing performers. The interests, risks, and considerations can be profoundly distinct, and lead to disconnect higher up the food chain without constant assessment and discussion.
The more an organization allows–or even encourages–different groups to retreat into narrow definitions of their roles, the more they support silo-formation around each function, each task, as well as each department. It might happen between sales and marketing; it might happen between the C-Suite and the entry-level. Wherever it occurs, it spreads like a virus and undermines everything.
Deconditioning this habit of mind and behavior has to remain a priority. Again, communication is the best antidote to disconnection and resentment, and it is best applied as a preventative, rather than as a reaction to interdepartmental strife. Whether leadership and other new roles are filled through advancement, or targeted recruitment, getting teams to work together requires them to communicate, empathize, and understand one another’s roles, challenges, and contributions.
Every member of the team has an important role to play. They may not be capable of doing each other’s jobs, but they can certainly help make each other’s lives easier.
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