Leadership Matters (Part I)

By Dana C. Ackley, Ph.D. Originally published by ACT Dental.

For better or worse, you are the leader of your practice. Might as well make it better. Our knowledge of what makes good leadership, like knowledge of dentistry, is based on study and scientific research. There is an army of people who devote themselves to studying what makes leaders effective. Just as they sometimes benefit from what you have learned, by using your services, you can benefit from their efforts. There is one particular study that I would like to bring to your attention this month.

What does the phrase "effective leadership" mean to you? Vance Packard defined leadership as " . . . the art of getting others to want to do something you are convinced should be done." As a dentist, you are probably convinced that at least some of the following items are important and you can't do them all by yourself, so you need your staff to do their part:

  • Patients be made to feel comfortable and safe

  • Cooperate with each other on tasks, even if they don't feel like cooperating

  • Know their technical skills and perform them in a near flawless manner

  • Sell dentistry

  • Keep your schedule full

Studies of leadership demonstrate that the extent to which these activities occur rests in large part on your leadership style.

Among the reasons that your leadership effectiveness matters is that research demonstrates that leadership affects profitability. The research tells us that leadership style directly affects the climate of your practice. The quality of the climate accounts for about one third of profitability. The implication is clear. The better you lead, the more profit you make.

To be clear, climate is not an amorphous, feel-good word. In this research, climate is defined with precision as a comprehensive term to describe six important elements among your workers:

  • how flexible employees are in solving problems (The more flexible staff members are, the wider range of problems they can solve, adding to practice profitability)

  • the sense of responsibility employees feel to the organization (The more your employees feel responsible to your practice, the greater their efforts will be.)

  • the kinds of standards employees have (High standards create high profit.)

  • the effectiveness of the rewards the organization uses (Rewards go way beyond money.)

  • the clarity workers have about the mission and values of your practice (Do you have a clear picture of the kind of practice that you want and have you communicated that picture repeatedly to your employees?)

  • how committed employees feel to common objectives (Do your employees share goals or do they work at cross purposes?)

The study in question, which examined almost 3800 leaders, assessed how each of six leadership styles affects climate, i.e., improves climate which improves profitability. The researchers found that each leadership style is useful under some conditions that your practice may face and less useful under other conditions. Those leaders who had learned more than one leadership style, and shift among them as conditions changed, created the best climate and highest profits. Thus, the issue is not which leadership style is best. Rather, the right question is: "What leadership style is most effective in a given set of circumstances?"

Let's look at each style and its impact on climate (profit):

The Coercive Leader: This person rules by fear. "My way or the highway!" The leader takes charge and invites no contrary opinions. This style had the most detrimental impact on climate in this study. The correlation between the frequency of coercive leader behaviors and climate was -.26. This means that as coercion increased, the quality of climate declined.

This finding does not mean that there is no place for coercive leadership. It actually works well in a crisis. When you have a serious, anxiety arousing dental emergency in your office, take charge! Someone must be clear and direct the activities of others without ambiguity. However, many leaders get hooked on the heady sense of power and control that great results in a crisis provide. Once the crisis is past, they are likely to perpetuate their coercive ways. Such leaders will lose money compared to what they could make with some of the other leadership styles we will consider.

The Authoritative Leader: This leader has a powerful ability to articulate a mission/vision and win people to it with enthusiasm. He makes a clear path for followers, cutting away the confusion that exists in most organizations. Team members do not work at cross purposes because a commitment to a common vision is created. The authoritative leader sets the broad parameter of the vision and then empowers staff to develop their own ways to make the vision come to life.

Authoritative leadership had a +.54 correlation with climate, the highest correlation of any leadership style. As authoritative behaviors increased, so did the quality of the climate. Authoritative leadership has a place in almost all practices.

The Affiliative Leader: This leader is a master at establishing positive relationships. Because the followers really like their leader, they are loyal, share information, and have high trust, all of which helps climate. The affiliative leader gives frequent positive feedback, helping to keep everyone on course. If you are create strong, lasting relationships with patients, you have good potential to be an affiliative leader. Simply practice the same behaviors with your staff as you do with patients.

The correlation of this leadership style with climate is +.46. It would be especially useful to consider increasing the frequency of affiliative behaviors if your practice needs greater team harmony or improved morale. Perhaps you recently bought your practice and find that there is a leftover atmosphere of mistrust. Begin your term of leadership with a high dose of affiliative leadership.

Where the results of affiliative leadership falls down is that it sometimes tolerate poor performance because such intense mutual loyalty has developed between employees and leader. It is important to remember that everyone who works on your team, including you, depends upon the financial health of the practice for their economic livelihood. Poor performance hurts everyone and needs to be addressed.

The Democratic Leader: From time to time, your practice will face significant decisions that must be made. Whereas the coercive-leader-dentist will simply make those decisions on his own, the democratic leader works to create consensus among the team. The advantage of this approach to decision making is that with consensus comes intense employee commitment to goals, strategies and tactics. Trust is a major feature of this leadership style as well.

The correlation of democratic leadership behaviors with climate is a healthy +.43. It works particularly well when the leader is genuinely not sure what to do and has talented employees who can and will make excellent input. Of course, the biggest drawback of this style is that it is time consuming. In that way, it is like some dental procedures. They require a lot of preparation, but the results outlast more superficial approaches. Also, you would never want to use democratic leadership during a crisis that needs rapid action.

The Pacesetter: This leader sets high performance standards for everyone, including himself. He walks the talk. This sounds admirable and has been widely believed to be effective. The data, however, indicate otherwise. There is a -.25 correlation between pacesetter leadership and climate.

Why? Pacesetters tend to have trouble trusting their followers. Their self esteem rests on being smarter, faster and more thorough that everyone else. They unintentionally undermine the efforts and morale of those around them.

The one time that pacesetter leadership appears to be the style of choice is when followers are already highly motivated and have exceptionally strong technical skills. Then a pacesetter can be effective because the followers' styles and competence already fit with the pacesetter's expectations.

The Coach: As the name implies, this leader develops people. He is able to recognize talent and how best to develop it further. He offers developmental plans, including challenging assignments that push people to cultivate new skills. This leader can see the future and bring the best out in followers.

This style has a +.42 correlation with climate. It works best when followers are receptive to personal growth. If your practice is characterized by staff members who are waiting for retirement, coaching will waste your time. If your employees are excited about learning, be sure to include coaching in your leader repertoire. While this will require some investment of non-billable time, the payback is likely to be huge.

Good News: Anyone can improve the fundamental skills that effective leaders need. Those skills fall under the conceptual term emotional intelligence (EQ). Each of the six leadership styles require different EQ skills. In next month's newsletter, I will share with you which EQ skills support each of the styles. This information can help you begin to map out what you can do to build the leadership skills your practice needs most to take it to the next level of climate and higher profitability.

Dana C. Ackley, Ph.D. is a psychologist who provides coaching and consultation to dentists and their staffs. He has been a guest lecturer at the Pankey Institute for Advanced Dental Education and writes frequently for Dentistry Today. He can be reached at dana.ackley@eqleader.net , or 540-774-1927, or EQ Leader, Inc., 2840 Electric Rd, Suite 208, Roanoke, Virginia 24018.

The comprehensive science based EQ Leader Program builds lasting change in EQ skills that make a dramatic difference in performance.


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