UO > Feature > Are You a Bad Boss?

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Good bosses, in Woods’ experience, understand teamwork. “Physicians usually assume they’re solely responsible for patient satisfaction, for example,” he says. In reality, the number one person who determines patient satisfaction, his studies show, is the receptionist. If the physician barely says ‘hi’ to the receptionist, or if she’s not rewarded appropriately, he’s toast. “Whether I’m an employed physician or have my own practice, I’m still responsible for the people who have anything to do with helping me carry out my job,” he says.

Mark Pettus, MD, FACP, points to his bookshelf as a gauge of what he strives for in his leadership skills. The nephrologist’s titles last decade leaned toward the classics: tomes on disease, anatomy, medications, and treatments. Today, this chief of staff for the department of medicine at the University of Massachusetts Medical School in Worcester, reaches for best-sellers like Good to Great, Getting to Yes and books on emotional intelligence.

For Lynagh, changing his leadership direction boils down to one elemental question: Are you open to feedback?

Perhaps that’s why consultants and coaches promote the 360-degree feedback program as the place to begin if you want to improve your performance as boss. Well-known in business circles, 360 is a methodology of collecting feedback from peers, employees, and superiors to form a snapshot of how the world sees you. Anonymous participants score you in various categories using a 1 to 10 scale, with room for comments after each section. The form also includes a few open-ended questions, such as “What is this person’s greatest strength? Weakness?”

Woods learned about this useful tool in 1998 when he briefly quit medicine for a stint in research at Johnson & Johnson. The corporation put him through the 360-degree exercise, where he learned to his surprise that he wasn’t communicating nearly as effectively as he assumed.

Pettus received the same shock when he introduced it to his office two years ago. “Now I end a lot of my conversations with ‘Is there anything I said that wasn’t clear?’ or ‘Could you just paraphrase briefly what my expectations are?’” he says. He also learned his informal sense of humor left more than one bystander wondering if he’s more interested in being a stand-up comic than a doctor.

But 360 isn’t a magic wand, warns Ken Blackwell of Team Builders Plus training firm in Cherry Hill, New Jersey. “I liken it to a scalpel,” he says. “In the right situation and in the hands of a trained individual, it can save your life. But wielded indiscriminately, and for the wrong reasons, it can make things worse.” For instance, practices going through a merger/acquisition or heavy lay-offs should stand down from this approach. Offices with fewer than 10 people can’t realistically offer anonymity.

And remember, Lynagh says, you need to cultivate a culture where feedback is considered a gift or the results are skewed. “The first comments people give aren’t the true nuggets. They’re testing you until they feel safe,” he says.

When any of these disqualifying conditions apply, Blackwell recommends implementing alternate behavioral tools, like the less invasive DISC instrument that measures personality traits. These questions reveal whether a person is more task-oriented or people-oriented to open up dialogues.

If you do plan to use the 360-degree program, pay a professional (consultant, trainer, career coach) to administer it. For starters, these folks customize the questions to target your practice. Woods literally sat down to write out all the dysfunctional behaviors he’d seen in his medical career, then sorted them into categories to create seven top traits doctors need to be effective bosses in their world:

4the ability to seek win-win outcomes

4consistent respect for all individuals

4personal leadership

4flexibility

4teamwork

4the interest in developing others (e.g. actively teaching nurses more about specific disease issues)

4being open to change

Woods’ 360-degree program concentrates on these skills alone, and then Doctors in Touch uses the feedback to develop a coaching/mentoring program for the physician to shore up weaknesses. This step, says Blackwell, is crucial. “People make two mistakes with 360: They don’t educate employees on the process and they hand somebody the feedback report and say, ‘Go develop yourself and let us know how you make out,’” he says. “This should be a launching point to determine an individual’s core needs, and then construct an action plan that targets those gaps.”

In search of a good boss (sidebar)
Defining a good boss can be as difficult as being one. Here’s how various consultants tackle the question:
Name & title	A good leader...
Steven L. Katz, Management consultant	Displays some degree of maturity, respect and communication.
Bill Lynagh, MD, Founder/President, Center for Holistic Leadership	Has a clear sense of purpose and the values he holds. Is open to feedback. Seeks guidance and direction.
Bernhoff A. Dahl, MD Author/Founder of Trionics USA	Knows himself and hires associates that complement his weaknesses.
Robert Hogan, PhD Founder/President Hogan Assessment System	Demonstrates integrity by keeping his word. Treats everybody equally. Answers questions and solves problems quickly. Projects a sense of idealism and vision.
Michael Woods, MD Founder/President, Doctors in Touch	Listens, learns, loses arguments, and admits mistakes.

However, physicians can’t survive on tests alone, says Bernhoff Dahl, MD, the author of Optimize Your Life (Wind-Breaker Press, 2003) and a retired pathologist who lives in Winterport, Maine. He built a 12-physician pathology practice by hiring people in tune with his synergy model. “We never fought over power, money—the only thing we fought over was how to define a summer in Maine so we could get our vacation schedule!” he says.

That means, of course, that physicians must be the ones to confront bad boss colleagues within their groups, not the employees, Katz interprets. Dahl agrees. “My problem over the years: I believe so much in synergy I would allow things to go on. I’d move physicians from one hospital to another trying to make things work. That was a mistake,” he says. “Not everybody fits in—sometimes people simply have to be fired.”

Still, Hogan holds out little hope that MDs as a rule will accept the message that they lack good leadership skills in the first place. “They’re quite arrogant,” he says. Most consultants, even those with medical degrees, sadly agree, though in more sugar-coated terms.

But while Dahl can put names to that accusation, he points the finger at risk tolerance. “Many people want to change, yet a vast majority will not take the risk,” he says. To illustrate: He once flew to Los Angeles to attend a personal awareness seminar. Before returning, he sat at the airport writing letters to each of his associates expressing his appreciation. “It was just short of ‘I love you.’ They were so uncomfortable only two of the 11 ever thanked me for the note. One did say, ‘We can’t send Bernie to California any more,’” he says.

Will you be among those pioneers, or remain lumped in with the masses losing both money and face? g

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