The Charismatic Leader in a Healthcare Organization - Term Paper Example

? The Charismatic Leader The Charismatic Leader Health care, one of the largest and most important industries today requires strong leadership in order for it to maintain its current success. Yet, developing new leaders in clinical practice is not so easy. Ann McAlearney (2006) says that because of the nature of the industry, it has special challenges related to leadership and leadership development. For example, clinical practice is strictly regulated. This complicates their very operational processes, and can cause confusion on organizational priorities. Should the organization focus on reducing medical errors or developing leaders first? Should they focus on financial sustainability or create a process of leadership development? In many instances, health organizations address issues which are most pressing before they deal with issues with long term impacts, such as in the case of leadership. Moreover, leaders are faced with complicated internal dynamics between administrations and clinicians, physicians and nurses, pharmacists and physicians (McAlearney, 2006), etc. which in turn, makes it difficult to implement new policies. In a research conducted by Ann McAlearney (2006), it was discovered that many health practitioners realize that the industry is lagging in the case of leadership development. There are many reasons cited for this lag: there is no real commitment to leadership development, professional conflicts (there is a call to separate leadership development programs for nurses from physicians and administrative staff, etc.), time constraints (many practitioners cannot participate in leadership development programs because of their work schedules), technical constraints (the organization does not have the technical capability to create their own leadership development program) and budget constraints (creation and implementation of leadership development programs will cut into the organization’s already limited operation budget). Yet despite these issues in leadership development, practitioners realize the need for better leaders to ensure that current issues, particularly the cultural chasm between various professional groups, are resolved. For the health care sector, a strong leader can correct the chaos in internal organization and coordination, as well as create policies that will close gaps in service delivery. There is a need for leaders who can represent the medical community and the patient population – leaders who can “respond to multiple stakeholders and meet performance goals across multiple dimensions of effectiveness” (McAlearney, 2006, p. 967). The question now is: what kind of leader can motivate people to work together towards a common goal? Literatures on management and leadership refer to transformational leadership based on idealized influence (charisma) may be an appropriate style. What is charismatic leadership? Bud Haney (2012) calls charismatic leaders, the beacons of positivity, “charismatic leaders impact others with the power of optimism…To get team members to go the extra mile and engage with their work” (p.18). Meredith Babcock-Roberson (2010) shares the same view, but adds: “a [charismatic leader] provides clarity when the situation is unclear, resolves shortcomings and motivates change by articulating a strategic vision…[they] communicate high performance expectations, exhibit con?dence, take risks that oppose the status quo, and emphasize a collective identity…[they set] personal examples and [make] personal sacri?ces” (p. 314). A charismatic leader’s is able to bring people to work together by providing his subordinates a clear view of the group’s vision and the role of each individual in the achievement of such vision. Because the emphasis of charismatic leadership “is on people of vision who are creative, innovative, and capable of getting others to share their dreams while playing down self-interest; and who are able to cooperate with others in reshaping the strategies and tactics of the organisation” (Tichy & Devanna, 1986), leaders are able create solutions for a fast-changing world. They are able to impart accountability to their followers, hence ensuring that solutions developed are properly implemented and adhered to. Moreover, a charismatic leader’s pursuit for high standards and his ability to take calculated risk, he is able to question and change organizational processes that no longer serve the larger vision (Bass, 1990). By displaying personal and professional proficiency, his authority is rarely questioned and followers strive to emulate his example, which in turn assures exceptional work in his/her followers. J.G. Hunt (1996) summarized the characteristics of a charismatic leader and its effects on followers (see table 1) to better understand the advantages this style provides to organizations. Table 1: Charismatic Leadership Characteristics Personality Characteristics Behavior Effect on Followers Dominant Desire to influence Confident Strong Values Sets strong role models Shows competence Articulates goals Communicates high expectations Expresses confidence Arouses motives Trust in leader’s ideology Belief similarity between leader and follower Unquestioning acceptance Affection towards leader Obedience Identification with leader Emotional involvement Heightened goals Increased confidence How Does Charismatic Leadership Affect Nursing and Health Care? With the many changes happening in the health care industry, the ever-present conflict among different professional groups, the increased expectations for improved service delivery, the greater pressure for clinicians to incorporate technology to measure results, it seems that charismatic leadership is the best style for health care and nursing contexts. This claim is supported by D. Brown and D. Sofareli (1998) who believe that the nurse leader needs to utilize a leadership style that focuses on people and solving problems. Charismatic leadership is a difficult style mainly because it subjects the leader to various uncertainties. Health professionals have to deal with individuals who have differences in culture, personality, preferences, etc. so they have to be ready to utilize different approaches to treat the same illnesses. Moreover, health professionals themselves come from different backgrounds, and they have their own set of skills that the leader does not have. In this case, the leader must be ready to surrender decision making to his follower in order to benefit everyone. In short, processes developed by the leader have to be flexible enough to incorporate individual needs, but it must also be effective to ensure high quality of service delivery. In order to do this, a charismatic leader has to be ready to have conversations with different types of people to get different viewpoints. The advantage here is that the leader gains a holistic understanding of his organization and will be able to predict how one policy can affect all departments and individuals. Because a charismatic leader is not afraid of change, his leadership style encourages innovation among its followers and enables medical professionals to think more creatively to resolve a problem. “This will become increasingly more important as nurses leave the traditional hospital setting and expand their practices into the community. The ability to find innovative solutions, to extend beyond their boundaries of comfort, and to test new ways of doing old things, will move nursing further into the centre of the arena of the new health care services" (Brown & Soferelli, 1998, p. 203). Through charismatic leadership, service delivery can be transformed from a patient-centered health care (which has a focus on treatments) to a patient-directed health outcomes (focus on disease prevention). Charismatic leadership takes into consideration the complexity of individual needs, as well as the changes in the environment which can affect the health of patients, the delivery of health services, and the preferences, personalities and skills of health care professionals. In this sense, old frameworks for process creation can no longer work and have to be adapted depending on patient and clinician needs and technology available to them. In a sense, this makes the world more complicated, but then, it also provides health professionals to do what they think is best, as long as it benefits their patients and it serves its purpose in the larger vision. Charismatic leaders, together with their followers, are able to create working environments based on processes that actually work. The disadvantages of charismatic leadership While it is clear that charismatic leadership will greatly benefit health care and nursing, one must realize that the very strengths of a charismatic leader can become a weakness. R. Davidhizar (1993) mentions three instances when charismatic leadership can backfire: (1) if the goals of the leader is contrary to the needs of the society; (2) when emotions become irrational; (3) when the leader is judged by exceptional standards which the followers are unable to meet. These disadvantages will be discussed further in the context of health care. Sometimes, a charismatic leader may fail to address the needs of the community if he creates goals without consulting other stake holders. By saying this, one has to say that charisma is not enough to ensure success of the health industry. Instead, the leader must exert efforts to involve the whole organization before changes are instigated. One may look at the success and failure in the implementation of computer physician order entry (CPOE) in various health organizations. In some health institutions, CPOE implementation was a success, because all stakeholders were involved in all aspects – from design, testing, implementation, and even in assessment. Meanwhile, there are stories of CPOE implementation failures, one notable case is that of Cedars Sinai Medical Center – one of the top hospitals in the country. Case studies show that implementation of CPOE at Cedars Sinai was a decision made only by the administration and did not consult physicians, pharmacists, nurses or support staff. Moreover, design of the program did not reflect the actual processes used by different professional groups so that there was confusion on form filling when the CPOE was implemented. In the end, Cedars Sinai had to pull out the use of the software because of the increases in medical errors (Connolly, 2005), wasting a huge amount of resources. Of course, there are instances when the differences in the goals of the community and the leader are not so apparent. When that happens policies may continue to be implemented and disadvantages to patients and other stakeholders continue to build. This can either go on for a long time (which leads to a breach in ethics) or it can lead to bigger trouble for the organization. The second disadvantage of charismatic leadership the tendency for followers to become irrational because they are too attached to the leader. When criticisms on a certain policy enacted by a leader are offered, followers may not see the value in such criticism because they hold a strong belief in the decisions of their leader. Or it is possible that because there is so much trust in the leader that followers will just concede to his own decisions without bothering to deconstruct the advantages and disadvantages of a policy. In this case, the leader fails to get a holistic understanding of the organization. The third disadvantage is due to the unnecessary pressure followers bring on themselves because they want to emulate their leader. Because people have different capacities, it is possible that they where will be gaps in their performance especially when they compare it with their leader’s work. This leads to disappointments and personal reproach which can then cause emotional and physical stress. Conclusion Having discussed the different advantages and disadvantages of charismatic leadership, I personally believe that it is still the best approach for leading health professionals. I no longer believe in the top-down approach wherein a single administrator makes a decision for everyone else because the administrator does not understand what is happening in the ground. Moreover, we have seen the effect of so much centralization in health institutions. It has lead to competition among colleagues, distrust among co-workers because one has to be correct and the other, wrong. With charismatic leadership, everyone can begin to appreciate not only their roles, but also the role of other professional groups in the achievement of organizational vision. When this happens, everyone is satisfied – the leader is rewarded by a more orderly organization, his followers find meaning in their work and they discover new friends, and patients can take advantage of improved health services. In the case of the disadvantages, I believe that charisma is an inherent trait, but being a leader is a skill. Charisma enables people to believe in his capabilities, while leadership should enable followers to realize that are leaders on their own right. True charismatic leadership, therefore, is less on the management aspect. It does not seek to make changes based only on the leader’s decision. Instead, the leader is only a facilitator for other people to determine what they want and need and to enable them to act on it. References Babcock-Roberson, M. E. (2010). The Relationship Between Charismatic Leadership, Work Engagement, and Organizational Citizenship Behaviors. The Journal of Psychology, 144(3), 313–326. Bass, B. M. (1990). From transactional to transformational leadership: Learning to share the vision. Organisational Dynamics, 18, 19–31. Brown, D., & Soferelli, D. (1998). The need for nursing leadership in uncertain times. Journal of Nursing Management, 6(4), 201–211. Connolly, C. (2005, March 21). Cedars-Sinai Doctors Cling to Pen and Paper. Washington Post, p. A01. Los Angeles. Retrieved from http://www.washingtonpost.com/wp-dyn/articles/A52384-2005Mar20.html?sub=AR Davidhizar, R. (1993). Leading with charisma. Journal Of Advanced Nursing, 18(4), 675–679. Haney, B. (2012, November). Charismatic Leaders: They are Beacons of Positivity. Leadership Excellence. Hunt, J. G. (1996). Leadership: A New synthesis, London. London: SAGE Publications. McAlearney, A. S. (2006). Leadership development in healthcare: a qualitative study. Journal of Organizational Behavior, 27(7), 967–982. doi:10.1002/job.417 Tichy, N. M., & Devanna, M. A. (1986). Transformational Leader. New York: Wiley. Read More