Rural Physician Leadership Curriculum

Rural Physician Leadership Curriculum West Virginia University Rural Family Medicine Residency Program

Rural Physician Leadership Curriculum Module 3 Servant Leadership in a Rural Clinic

Rural Physician Leadership Curriculum Description • Funded by HRSA Grant D22HP00306 • Objective 1 • Develop a competency based longitudinal curriculum in Rural Physician Leadership Konrad C. Nau, MD Principle Investigator Chair, Dept of Family Medicine-Eastern Division WVU Rural Family Medicine Residency Program

Rural Physician Leadership Curriculum Learning Objectives : Module 3 • Understand the characteristics of the Leader as Servant • Identify the steps in creating a meaningful clinic vision statement • Understand the six most powerful employee opinion questions that will determine your clinic’s success • Know how to give negative appraisals and fire employees as a Servant Leader

Servant Leadership • “spirit of work” • Deeper connection with our work • Connection that transcends power/money • Attitude • Behavior • Relationships SERVICE James A. Autry The Servant Leader , 2001, Prima Publishing.

Servant Leadership • The servant leader is a servant first, it begins with a natural feeling that one wants to serve, to serve first. Then conscious choice brings one to aspire to lead. Robert K. Greenleaf Servant Leadership Paulist Press, NY: 2002.

Five Ways of Being/Servant Leader Be Authentic Be Vulnerable Be Accepting Be Present Be Useful

Be Authentic : Servant Leader • Be who you are • Be the same person in every circumstance • Hold to the same values in your various roles

Be Vulnerable : Servant Leader • Be honest with your feelings in the context of your work • Openly admit mistakes in your own performance • Realize that you can’t be in total control / depend on others • Note: you can express anger – but you can’t act in anger

Be Accepting : Servant Leader • Accept ideas as valid for discussion and review • Focus on the ideas themselves – not the person • Embrace disagreement as a human part of the process of work • Avoid making everything Win/Lose

Be Present : Servant Leader • Having your whole self available at all times • Available to yourself • Available to others as you respond to problems • Remain centered and grounded in the midst of perceived crisis

Be Useful : Servant Leader • Care about people and be a useful resource for them • Be present for people and building a community at work • Let go of your ego, and bring your best self to work • Create a place where people can find meaning in work, and bring their spirit to work

For Discussion • “Business is about people. Business is of, by, about, and for people.” • Being vs Doing : “What you do at work is a direct reflection of you are.” • “Efficiency is not the same as effectiveness” – and history has shown many examples of efficiency becoming the enemy of effectiveness.

“The Vision Thing” • The confluence of three aspects of an organization • Purpose • Mission • Values • Can inspire people about the clinic • Defines what your clinic does • Defines your workplace culture

Purpose • “Why are we here ?” • Use language that helps everyone involved with the organization understand and focus on why they themselves are here

Mission • “What do we do ?” • What do we do to fulfill our purpose

Values • “How are we together as we go about performing our mission in order to fulfill our purpose ?” • Fundamentally about how we will behave toward one another • Framework for creating your “community of work”.

Bring it Home • Meet with the employees of your clinic and as a group create your vision • Consider using an outside facilitator • Consider the several hours used in this process as an investment in the most challenging part of your job : the people.

Building your Clinic Vision • Purpose: Why are we here ? • Mission: What do we do to fulfill our purpose ? • Values: How do we behave at work ? • “We want to work with people who value….? • Record on a 1 – 2 page document that all employees sign in orientation.

Building your Clinic Vision • Record on a 1 – 2 page document that all employees sign in orientation. • Consider review and revision as a group every several years – or in times of great change

Leadership Comparison McGee-Cooper, G. Looper. The Essentials of Servant Leadership , 2001, Pegasus Communications Inc. p 3.

Servant Leadership in your Clinical Workplace • 1999 Gallup Organization study of a wide variety of business work environments • Over 2,500 businesses • 21% were health care • Over 100,000 employees surveyed • Meta-analysis of 13 employee questions M Buckingham , C Coffman First Break All the Rules The Gallup Org, Simon & Shuster: 1999.

Servant Leadership in your Clinical Workplace • Correlated 13 core item measures of a strong workplace to: • Customer satisfaction/loyalty • Profitability • Productivity • Employee Turnover M Buckingham , C Coffman First Break All the Rules The Gallup Org, Simon & Shuster: 1999.

Servant Leadership in your Clinical Workplace • Six most powerful employee questions • Do I know what is expected of me at work? • Do I have the materials and equipment I need to do my work right ? • Do I have the opportunity to do what I do best every day ? M Buckingham , C Coffman First Break All the Rules The Gallup Org, Simon & Shuster: 1999.

Servant Leadership in your Clinical Workplace • Six most powerful employee questions • In the last seven days, have I received recognition or praise for good work ? • Does my supervisor, or someone at work, seem to care about me as a person ? • Is there someone at work who encourages my development ? M Buckingham , C Coffman First Break All the Rules The Gallup Org, Simon & Shuster: 1999.

Landmark Gallop Findings • Definite link between employee opinion and business unit performance • The employees manager was the critical player in building a strong workplace M Buckingham , C Coffman First Break All the Rules The Gallup Org, Simon & Shuster: 1999.

Landmark Gallop Findings • The managers role is to reach inside each employee and release their unique talents into performance. • The manager role is best played one employee at a time • Multiplied = company power supply M Buckingham , C Coffman First Break All the Rules The Gallup Org, Simon & Shuster: 1999.

Core Activities of Catalyst Manager • Select a person • Select for talent …not simply experience • Set expectations • Define the right outcomes…not steps • Motivate the person • Focus on strengths…not weaknesses • Develop the person • Find the right fit…not just the next rung M Buckingham , C Coffman First Break All the Rules, The Gallup Org, Simon & Shuster: 1999.

I. Select a person for talent • Talents are recurring patterns of thought, feeling, or behavior that can be productively applied. • 3 types of Talent • Striving talent – why you get out of bed • Thinking talent – how you think & decide • Relating talent- whom do you trust, confront, build relations M Buckingham , C Coffman First Break All the Rules, The Gallup Org, Simon & Shuster: 1999.

II. Set Expectations : Outcomes • People need to know how to do a core set of things for accurate, safe work • Defining the work OUTCOMES relieves you from having to micromanage every step of every process • Have employee sign off on expectations M Buckingham , C Coffman First Break All the Rules, The Gallup Org, Simon & Shuster: 1999.

II. Set Expectations : Outcomes • Customer Dissatisfaction can be prevented by following standard processes. • True Customer Satisfaction/Loyalty requires 4 expectations be met • Accuracy - Partnership • Availability - Advice M Buckingham , C Coffman First Break All the Rules, The Gallup Org, Simon & Shuster: 1999.

II. Set Expectations : Outcomes • Insurance company Gallop investigation of core emotional outcomes that patients truly value • I feel my doctor is competent (accuracy) • Kept waiting not more than 20 minutes (availability) • Doctor explains my condition in words I understand (partnership) M Buckingham , C Coffman First Break All the Rules, The Gallup Org, Simon & Shuster: 1999.

II. Set Expectations : Outcomes • Insurance company Gallop investigation of core emotional outcomes that patients truly value • Someone in the office cares about me, doesn’t always have to be the doctor (partnership) • Doctor gives me something I can do for myself at home to help my condition (advice) M Buckingham , C Coffman First Break All the Rules, The Gallup Org, Simon & Shuster: 1999.

III. Motivate : Focus on Strengths • Spend the most time with your best people • Paint a picture with your most talented as to what excellence looks like. • If you spend most of your time with your worst performers you send a message • “Better performance means less time and attention from my manager” M Buckingham , C Coffman First Break All the Rules, The Gallup Org, Simon & Shuster: 1999.

III. Motivate : Focus on Strengths • Poor Performance • Is the poor performance trainable ? • Is this caused by me tripping the wrong trigger as to what motivates them ? • Is this a nontalent/weakness issue ? • Is it mechanical (inadequate tools) ? • Is it personal (emotional/health) ? M Buckingham , C Coffman First Break All the Rules, The Gallup Org, Simon & Shuster: 1999.

III. Motivate : Focus on Strengths • Nontalent • Behavior that always seems to be a struggle • A thrill that is never felt • An insight recurrently missed • Weakness • A role where success depends on excelling in your nontalent M Buckingham , C Coffman First Break All the Rules, The Gallup Org, Simon & Shuster: 1999.

III. Motivate : Focus on Strengths • Ways to quickly turn weakness into success • Devise a support system • Find a complementary partner • Find another role/job • Correct your casting error • Stop trying to fix the person M Buckingham , C Coffman First Break All the Rules, The Gallup Org, Simon & Shuster: 1999.

IV. Develop the Person: The right fit • Don’t always promote people out of excellence to the next rung • Promote people to where they can succeed • Use creative trials to develop hidden talents • Mentor • Special projects M Buckingham , C Coffman First Break All the Rules, The Gallup Org, Simon & Shuster: 1999.

IV. Develop the Person: The right fit • One rung on the ladder does not necessarily lead to the next • Each rung is not a slightly more complex version of the last one. • Different talents are often needed – not just more training. M Buckingham , C Coffman First Break All the Rules, The Gallup Org, Simon & Shuster: 1999.

IV. Develop the Person: The right fit • Create heroes at every rung • Make every role performed with excellence a respected profession • Reward value/excellence • Money • Titles • Meetings • Do not simply reward years of service M Buckingham , C Coffman First Break All the Rules, The Gallup Org, Simon & Shuster: 1999.

Servant Leadership: Negative Appraisals • If you see one coming set up a meeting asap • Goal = give person a chance to improve and avoid probation/firing • This is “the caring confrontation” • Do not show anger or agitation • This is a “do not disturb” event James A. Autry The Servant Leader , 2001, Prima Publishing.

Servant Leadership: Negative Appraisals • “_____ you are not accomplishing what we agreed upon, and the quality of your work is not up to our standards. • Why ?” (Then be quiet !) James A. Autry The Servant Leader , 2001, Prima Publishing.

Servant Leadership: Negative Appraisals • “ I didn’t know that I was supposed to do/say that ! “ • RESPONSE • Review the values/performance/outcome expectations James A. Autry The Servant Leader , 2001, Prima Publishing.

Rural Physician Leadership Curriculum