Liked or In Charge: The Womens' Management Dilemma


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Are you their buddy, or their boss? Sometimes have difficulty separating the two? The role of women in the workplace as employer and employee is fraught with difficulty as we lack the tools to comfortably be in charge, when we really want to be friends. The socialization of women in childhood to play well together, and to avoid being labeled ‘bossy’, causes women physicians to have experience conflict in the estrogen-laden hierarchy of medicine.

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Liked or In Charge: The Womens' Management Dilemma

  1. 1. Passionate HealthCare… Love caregiving, just for the health of it! Sign up today for a FREE subscription to our eZine, with monthly medical humor and simple tips to enjoy your career!
  2. 2. Liked? Or In Charge? Effectively Managing Your Staff Patricia L. Raymond MD FACP FACG
  3. 3. Leader or Dominatrix? <ul><li>Imperfections are magnified by authority </li></ul><ul><li>Few great female role models </li></ul><ul><li>Easier to name those that society found fault with skills… </li></ul><ul><li>In ten seconds , name 5 role models for women leaders who are or were both liked AND in charge </li></ul>
  4. 7. Women in medicine have few role models <ul><li>Physicians rise to leadership via seniority, not meritocracy </li></ul><ul><li>Few women physicians to model women leader behavior to trainees </li></ul>
  5. 8. When a woman behaves like a man, why doesn't she behave like a nice man? ~ Edith Evans Women Doctors Verses the Nurses, or Apple a day
  6. 9. The Data: Lady Docs vs. Lady Nurses <ul><li>94.1% of nurses are women </li></ul><ul><li>42% medical school graduates are women (2000), 5.7% in 1960 </li></ul><ul><li>Changing gender dynamics of the MD-RN relationship </li></ul><ul><ul><li>Nursing as archetypical female occupation, </li></ul></ul><ul><ul><li>Dominant-subservient relation with a man-woman constellation </li></ul></ul>Academic Med 2004;79:291-301
  7. 10. The Data: Lady Docs vs. Lady Nurses <ul><li>28 female nurses, 21 female residents in various specialties in large Midwest teaching hospital </li></ul><ul><li>Interviewed separately in groups, clustered by department </li></ul>Academic Med 2004;79:291-301
  8. 11. The Comments: Lady Docs on Lady Nurses <ul><li>A large majority of the residents across all departments firmly believed that they had to be ‘nicer’ and ‘more accommodating’ to nurses than did their male colleagues. </li></ul><ul><li>“ I have to be ten times more efficient, ten times nicer, ten times more interested in their personal lives and what's going on with them than my male counterparts… to get the same job done. I think that is because I am female and they expect not necessarily a social interaction but a different interaction …it has a completely different tone to it.” </li></ul>Academic Med 2004;79:291-301
  9. 12. The Comments: Lady Docs on Lady Nurses <ul><li>…when she said something that might be construed as short or to the point, the female nurses “ act like we’re being real snippy, real snotty . I always feel like I have to be sure they know that I’m not upset with something that happened.” </li></ul><ul><li>…female physicians were…viewed by nurses as more approachable, but with that comes being more “ attackable ” </li></ul>Academic Med 2004;79:291-301
  10. 13. The Comments: Lady Docs on Lady Nurses <ul><li>“I feel like I have to work overly hard to get their respect and establish that when I write an order, its an order, not a suggestion or a request…” </li></ul><ul><li>“I have to be super nice to people. Not that I’m not a nice person, but I do feel like to get things done, I have to be a certain person that I’m not…I need to get into this big social interaction with them…” </li></ul>Academic Med 2004;79:291-301
  11. 14. The Comments: Lady Nurses on Lady Docs <ul><li>Female nurses mostly positive </li></ul><ul><li>“ Less intimidating”, “a common bond”, “easier to get along with”, “a team atmosphere” </li></ul><ul><li>More likely to do things for themselves than male physicians </li></ul><ul><li>“ I have high expectations of female physicians. I always want them to be more competent, better practitioners, better at their bedside manner…I guess when I evaluate them I’m a little rough…I want them to shine .” </li></ul>Academic Med 2004;79:291-301
  12. 15. I don't mind living in a man's world as long as I can be a woman in it. ~ Marilyn Monroe How did this happen? Pimping, ‘fella’, deb tannen, pat heim
  13. 16. When women are depressed they eat or go shopping. Men invade another country. It’s a whole different way of thinking.   ~  Elayne Boosler ‘ make it happen’, labs, 301.3 quarrelsome, neurosurgeon
  14. 17. I have many regrets, and I'm sure everyone does. The stupid things you do, you regret if you have any sense, and if you don't regret them, maybe you're stupid. ~ Katherine Hepburn
  15. 18. 1. Cut yourself some slack <ul><li>Leadership is too complex to do perfectly </li></ul><ul><li>The key to being a better boss is accepting that fact </li></ul><ul><li>Leadership is a learned skill </li></ul><ul><li>We will learn some tools today </li></ul>
  16. 20. I'm working my way toward divinity. ~ Bette Midler
  17. 21. We don't care. We don't have to. We're the phone company. ~ Lily Tomlin (as Ernestine)
  18. 23. <ul><li>IQ does not correlate well with success </li></ul><ul><ul><li>Correlation of IQ with career success 4-25% </li></ul></ul><ul><li>Women are not ‘smarter’ than men re EQ </li></ul><ul><ul><li>Men and women do have a shared, gender-specific profile of strong and weak points </li></ul></ul><ul><li>Frequently as IQ rises, EQ falls </li></ul><ul><li>EQ is a learned behavior, not fixed or genetically predisposed. Growth of EQ= maturity </li></ul>2. Understand IQ verses EQ Daniel Goleman, Working with Emotional Intelligence, 1998
  19. 24. <ul><li>what you got , * what needs work </li></ul><ul><li>8-10 You got it </li></ul><ul><li>4-7 Neutral </li></ul><ul><li>1-3 A definite blind spot </li></ul>2. EQ: Grade your strengths (& recognize your weaknesses)
  20. 25. Emotional Awareness <ul><li>Know what emotions you are feeling and why </li></ul><ul><li>Realize the links between your feelings and what you do, think, or say </li></ul><ul><li>Recognize how your feelings affect your performance </li></ul><ul><li>Have a guiding awareness of your values and goals </li></ul>
  21. 26. Accurate Self-Assessment <ul><li>Aware of your strengths and weaknesses </li></ul><ul><li>Reflective, learning from experience </li></ul><ul><li>Open to candid feedback, new perspectives, continuous learning, and self development </li></ul><ul><li>Able to show a sense of humor and perspective about yourself </li></ul>
  22. 27. Self-Confidence <ul><li>Present yourself with self-assurance; have presence </li></ul><ul><li>Can voice views that are unpopular and go out on a limb for what is right </li></ul><ul><li>Are decisive, able to make sound decisions despite uncertainties and pressure </li></ul>
  23. 28. Self-Control <ul><li>Manage your impulsive feelings and distressing emotions well </li></ul><ul><li>Stay composed, positive, and unflappable even in trying moments </li></ul><ul><li>Think clearly and stay focused under pressure </li></ul>
  24. 29. Trustworthiness and Conscientiousness <ul><li>Act ethically and are above reproach </li></ul><ul><li>Build trust through your reliability and authenticity </li></ul><ul><li>Admit your own mistakes and confront unethical actions in others </li></ul><ul><li>Take tough principled stands even if unpopular </li></ul><ul><li>Meet commitments and keep promises </li></ul><ul><li>Hold yourself accountable for meeting your objectives </li></ul><ul><li>Are organized and careful in your work </li></ul>
  25. 30. Innovation and Adaptability <ul><li>Seek out fresh ideas from a wide variety of sources </li></ul><ul><li>Entertain original solutions to problems </li></ul><ul><li>Generate new ideas </li></ul><ul><li>Take fresh perspectives and risks in your thinking </li></ul><ul><li>Smoothly handle multiple demands, shifting priorities, and rapid change </li></ul><ul><li>Adapt your responses and tactics to fit fluid circumstances </li></ul><ul><li>Are flexible in how you see events </li></ul>
  26. 31. Achievement Drive <ul><li>Are results-oriented, with a high drive to meet your objectives and standards </li></ul><ul><li>Set challenging goals and take calculated risks </li></ul><ul><li>Pursue information to reduce uncertainty and find ways to do better </li></ul><ul><li>Learn how to improve your performance </li></ul>
  27. 32. Commitment <ul><li>Readily make sacrifices to meet a larger organizational goal </li></ul><ul><li>Find a sense of purpose in the larger mission </li></ul><ul><li>Use the group’s core values in making decisions and clarifying choices </li></ul><ul><li>Actively seek out opportunities to fulfill the group’s mission </li></ul>
  28. 33. Initiative and Optimism <ul><li>Ready to seize opportunities </li></ul><ul><li>Pursue goals beyond what is required or expected </li></ul><ul><li>Cut through red tape and bend the rules when necessary to get the job done </li></ul><ul><li>Mobilize others through unusual, enterprising efforts </li></ul><ul><li>Persist in seeking goals despite obstacles and setbacks </li></ul><ul><li>Operate from hope of success rather than fear of failure </li></ul><ul><li>See setbacks as due to manageable circumstance rather than a personal flaw </li></ul>
  29. 34. Understanding Others <ul><li>Are attentive to emotional cues and listen well </li></ul><ul><li>Show sensitivity and understand others’ perspectives </li></ul><ul><li>Help out based on understanding other peoples needs and feelings </li></ul>
  30. 35. Developing Others <ul><li>Acknowledge and reward people’s strengths and accomplishments </li></ul><ul><li>Offer useful feedback and identify peoples needs for further growth </li></ul><ul><li>Mentor, give timely coaching, and offer assignments that challenge and foster a person’s skills </li></ul>
  31. 36. Service Orientation <ul><li>Understand patient’s needs and match them to services </li></ul><ul><li>Seek ways to increase patient’s satisfaction and loyalty </li></ul><ul><li>Gladly offer appropriate assistance </li></ul><ul><li>Grasp a patients perspective, acting as a trusted advisor </li></ul>
  32. 37. Leveraging Diversity <ul><li>Respect and relate well to people from varied backgrounds </li></ul><ul><li>Understand diverse worldviews and sensitive to group differences </li></ul><ul><li>See diversity as opportunity, creating an environment where diverse people can thrive </li></ul><ul><li>Challenge bias and intolerance </li></ul>
  33. 38. Political Awareness <ul><li>Accurately read key power relationships </li></ul><ul><li>Detect crucial social networks </li></ul><ul><li>Understand the forces that shape views and actions of patients, coworkers, and competitors </li></ul><ul><li>Accurately read organizational and external realities </li></ul>
  34. 39. Influence <ul><li>Skilled at winning people over </li></ul><ul><li>Fine-tune presentations to appeal to the listener </li></ul><ul><li>Use complex strategies like indirect influence to build consensus and support </li></ul><ul><li>Orchestrate dramatic events to make a point </li></ul>
  35. 40. Communication <ul><li>Effective at give-and-take, registering emotional cues in attuning your message </li></ul><ul><li>Deal with difficult issues straightforwardly </li></ul><ul><li>Listen well, seek mutual understanding, and welcome sharing of information fully </li></ul><ul><li>Foster open communication and stay receptive to bad news as well as good </li></ul>
  36. 41. Conflict Management <ul><li>Handle difficult people and tense situations with diplomacy and tact </li></ul><ul><li>Spot potential conflict, bring disagreements into the open, and help de-escalate </li></ul><ul><li>Encourage debate and open discussion </li></ul><ul><li>Orchestrate win-win solutions </li></ul>
  37. 42. Leadership <ul><li>Articulate and arouse enthusiasm for a shared vision and mission </li></ul><ul><li>Step forward and lead as needed, regardless of position </li></ul><ul><li>Guide the performance of others while holding them accountable </li></ul><ul><li>Lead by example </li></ul>
  38. 43. Change Catalyst <ul><li>Recognize the need to change and remove barriers </li></ul><ul><li>Challenge the status quo </li></ul><ul><li>Champion change and enlist others in its pursuit </li></ul><ul><li>Model the change expected by others </li></ul>
  39. 44. Building Bonds <ul><li>Cultivate and maintain extensive informational networks </li></ul><ul><li>Seek out relationships that are mutually beneficial </li></ul><ul><li>Build rapport and keep others in the loop </li></ul><ul><li>Make and maintain personal friendships among work relationships </li></ul>
  40. 45. Collaboration and Cooperation <ul><li>Balance a focus on a task with attention to relationships </li></ul><ul><li>Collaborate, sharing plans, information, and resources </li></ul><ul><li>Promote a friendly, cooperative climate </li></ul><ul><li>Spot and nurture opportunities for collaboration </li></ul>
  41. 46. Team Capabilities <ul><li>Model team qualities like respect, helpfulness, and cooperation </li></ul><ul><li>Draw all members into active and enthusiastic participation </li></ul><ul><li>Build team identity, esprit de corps, and commitment </li></ul><ul><li>Protect the group and it’s reputation, share credit </li></ul>
  42. 47. There might be false starts and do-overs. You are entitled to experience and experiment before you find your calling. ~ Jane Pauley
  43. 48. 3. Self awareness & regulation <ul><li>The Four Agreements, Ruiz </li></ul><ul><ul><li>Be impeccable with your word </li></ul></ul><ul><ul><li>Don’t take anything personally </li></ul></ul><ul><ul><li>Don’t make assumptions </li></ul></ul><ul><ul><li>Always do your best </li></ul></ul>Dad, Endo: harsh words, probably deserved it
  44. 50. Women complain about premenstrual syndrome, but I think of it as the only time of the month that I can be myself. ~ Roseanne Barr
  45. 51. 4. Acknowledge parallel medical tracts Personal shopper, spoons
  46. 52. You can stand tall without standing on someone. You can be a victor without having victims. ~Harriet Woods
  47. 53. I call everyone 'Darling' because I can't remember their names. ~ Zsa Zsa Gabor
  48. 54. 5. Use positive reinforcement <ul><li>I praise loudly; I blame softly. ~ Catherine II </li></ul>Horse training, praise undeserved, lead from behind, j Haidt
  49. 55. 6. Request feedback <ul><li>The skill of giving and receiving constructive criticism </li></ul><ul><li>Clearly tell subordinates what you really think </li></ul><ul><li>Describe the facts that led to that opinion </li></ul><ul><li>Honestly ask to be told where you’re wrong </li></ul>
  50. 56. Good communication is as stimulating as black coffee, and just as hard to sleep after. ~ Anne Morrow Lindbergh
  51. 57. A good leader inspires others with confidence in him; A great leader inspires them with confidence in themselves. Buddy or Boss? Or Between? Neither. Be a Leader.
  52. 58. I am not afraid of storms, for I am learning how to sail my ship. ~ Louisa May Alcott
  53. 59. 7. Implement It Immediately
  54. 61. Passionate HealthCare… Love caregiving, just for the health of it! Sign up today for a FREE subscription to our eZine, with monthly medical humor and simple tips to enjoy your career!
  55. 62. Liked or In Charge, Part II: Engage Your Staff Patricia L. Raymond MD FACP, FACG
  56. 64. Do you have enough staff to accomplish your job? <ul><li>Receptionist/Check out 1 </li></ul><ul><li>Medical Records 0.4 </li></ul><ul><li>Managed Care 0.2 </li></ul><ul><li>Business Office 0.6 </li></ul><ul><li>Registered Nurse 0.4 </li></ul><ul><li>Medical Assistant 0.7 </li></ul><ul><li>Ancillary Technicians 0.5 </li></ul>J Med Pract Mgmt 2002 Jan/Feb
  57. 65. Staff Satisfaction vs. Engagement <ul><li>Why? An ounce of retention is worth a pound of recruiting. </li></ul><ul><li>If you can’t be a good example, </li></ul><ul><li>then you’ll just have to be a horrible warning. </li></ul><ul><li>~ Catherine Aird </li></ul>
  58. 66. Hawthorne Effect <ul><li>1920’s study at Hawthorne plant, Cicero Il. </li></ul><ul><li>Increased lighting, shorter workdays, other worker friendly fixes to improve productivity </li></ul><ul><li>Boosted performance noted, but due to changes in social environment, not physical. Increased attention led to happier and more effective employees. </li></ul>
  59. 67. Engagement <ul><li>Diagnosis </li></ul><ul><ul><li>Is there an incipient problem? </li></ul></ul><ul><ul><li>What are your facilities strengths and weaknesses? </li></ul></ul><ul><ul><li>Do you have EQ? </li></ul></ul><ul><ul><li>Do you understand leadership of women? </li></ul></ul><ul><ul><li>Are you open to give/receive criticism? </li></ul></ul><ul><li>Treatment </li></ul>
  60. 69. Why are some work groups more effective than others? <ul><li>Gallop Organization 1998 </li></ul><ul><li>Extensive interviews with highly productive workers </li></ul><ul><ul><li>5.4 million employees at 474 organizations </li></ul></ul><ul><li>Developed 12 statements to measure happiness with work=“engagement” </li></ul><ul><li>Sept ’04: 29% engaged, 55% not engaged, 16% actively disengaged </li></ul>
  61. 71. Q12 of Employee Engagement <ul><li>Do you know what is expected of you at work? </li></ul><ul><li>Do you have the materials and equipment you need to do your work right? </li></ul><ul><li>At work, do you have the opportunity to do what you do best every day? </li></ul><ul><li>In the last seven days, have you received recognition or praise for doing good work? </li></ul><ul><li>Does your supervisor, or someone at work, seem to care about you as a person? </li></ul><ul><li>Is there someone at work who encourages your development? </li></ul>
  62. 72. Q12 of Employee Engagement <ul><li>At work, do your opinions seem to count? </li></ul><ul><li>Does the mission/purpose of your company make you feel your job is important? </li></ul><ul><li>Are your fellow employees committed to doing quality work? </li></ul><ul><li>Do you have a best friend at work? </li></ul><ul><li>In the last six months, has someone at work talked to you about your progress? </li></ul><ul><li>In the last year, have you had opportunities at work to learn and grow? </li></ul>
  63. 74. Rx 1: Know your staff, and what they’d like to motivate them <ul><li>1. Start a preference book for staff </li></ul><ul><li>What makes a perfect day at work? </li></ul><ul><li>What has made you the most satisfied? </li></ul><ul><li>What does success mean to you? </li></ul><ul><li>2. Three wishes </li></ul>
  64. 75. Rx 1: Know your staff, and what they’d like to motivate them <ul><li>3. Passion breakfast: </li></ul><ul><li>“What do you love to do: </li></ul><ul><li>a) at work, b) outside of work” </li></ul>
  65. 76. Rx 1: Know your staff, and what they’d like to motivate them <ul><li>4. Ask each for 6 ways they’d like to be rewarded </li></ul><ul><li>3 must be low/no cost </li></ul><ul><li>5. Build a culture that says ‘Thank you’, a lot. </li></ul>
  66. 77. Prevention: “Elevation” J. Haidt, UVa
  67. 79. Some Exercises for “Elevation” <ul><li>“Make a Change” </li></ul><ul><li>“Pass it on” </li></ul><ul><li>The “put-down, put-up bean jar” exercise </li></ul><ul><li>Are your staff suffering from O.R.? </li></ul><ul><ul><li>“Bell-Ringers” </li></ul></ul><ul><li>“Give Up the Chip” </li></ul>
  68. 80. More Exercises for “Elevation” <ul><li>Recognize Positive Behaviors </li></ul><ul><ul><li>NorthShore Regional Medical Center, Slidell Lo. </li></ul></ul><ul><ul><li>Vote for awards for MDs with positive behaviors and attitudes </li></ul></ul><ul><ul><li>Congeniality, most compassionate, best dictation, best teacher, best penmanship, best bedside manner, best phone etiquette </li></ul></ul><ul><li>Begin an epidemic of elevation in your office or unit! </li></ul>
  69. 81. Few things are harder to put up with than a good example. -Mark Twain 1835-1910
  70. 82. Rx 2: Recruit, Promote, Coach <ul><li>No matter how big or warm or soft your bed is, you still have to get out of it. ~Grace Slick </li></ul><ul><li>Opportunity Hit List: Grow, stretch, & learn </li></ul><ul><li>Give good feedback, weekly or monthly </li></ul><ul><ul><li>Set written goals and deadlines </li></ul></ul>
  71. 83. Rx 3: Retain Mature Staff or Those with Family Responsibilities <ul><li>1. Build a flexible staff </li></ul><ul><li>Cross trained </li></ul><ul><li>Part time </li></ul><ul><ul><ul><li>Half shifts and 4-10 hr days </li></ul></ul></ul><ul><li>2. Address concerns re physical or emotional hazards of job </li></ul><ul><li>Zero lift policy/ tolerance for patient to staff abuse </li></ul>
  72. 84. No, I don’t understand my husband’s theory of relativity, but I know my husband, and I know he can be trusted. ~ Elsa Einstein
  73. 85. Rx 4: Professional Development <ul><li>Sometimes I worry about being a success in a mediocre world. ~ Lily Tomlin </li></ul><ul><li>Journal club </li></ul><ul><li>Tuition reimbursement </li></ul><ul><li>Financial assistance for certification </li></ul><ul><li>Differential pay </li></ul>
  74. 87. There are two things that people want more than sex and money… recognition and praise. ~Mary Kay Ash
  75. 88. Rx 5: Showcase Your Staff <ul><li>Newsletters </li></ul><ul><li>Thank you cards </li></ul><ul><li>Display accomplishments in office/unit </li></ul><ul><li>Spotlight and encourage their volunteerism </li></ul>
  76. 90. Some cause happiness wherever they go. Others, whenever they go. -Oscar Wilde 1854-1900
  77. 92. Implement It Immediately
  78. 93. Be a Leader <ul><li>Be…Visible </li></ul><ul><li>Accessible </li></ul><ul><li>Involved </li></ul><ul><li>Responsive </li></ul>
  79. 94. If the first woman God ever made was strong enough to turn the world upside down, these women together ought to be able to turn it right side up again. ~ Sojourner Truth
  80. 96. Passionate HealthCare… Love caregiving, just for the health of it! Sign up today for a FREE subscription to our eZine, with twice monthly medical humor and simple tips to enjoy your career!