I stumbled upon an absolutely brilliant TED talk about how we need to forget about the “pecking order” within workplaces and how we need to focus on team social connectedness as a strategy to enhance teamwork and productivity.1 I found the analogy in the presenter’s talk so incredibly poignant for the work we do every day in hospital medicine. As we work to solve incredibly challenging problems daily, we do so among continuously changing and highly charged teams. How can we create our teams to be the most effective and productive to serve the greater good?
The speaker, Margaret Heffernan, is an entrepreneur and former CEO of five companies. She tells a story about a study performed by an evolutionary biologist by the name of William Muir of Purdue University in West Lafayette, Ind.2 Muir undertook a series of studies evaluating the social order and productivity of chickens (as measured by egg production) and the team characteristics that make chickens more or less productive. After watching flocks of chickens for several generations, he picked out the most productive chickens and put them all together in a “super flock.” He then watched their productivity over the next several generations and compared their productivity to those in the regular flock.
What he found was that the regular flock became more productive and most of the members of the super flock were dead!
The most productive members of the super flock had essentially pecked the other members to death. He surmised that the only reason the super chickens were initially productive was by suppressing the productivity of the original flock members. The chickens in the regular flock that were initially less aggressive (and less productive) over time sustained fewer injuries and were able to be more productive in the absence of super chickens. The energy that the animals had previously invested in negative behaviors (pecking, injuries, and healing) was redirected into positive behaviors (making eggs).
Muir and his team have gone on to research a tool to predict social aggressiveness and social agreeableness in individual animals. Those high on the socially agreeable scales (and low on the socially aggressive scales) are more valuable for producing highly effective teams of agricultural animals by enhancing group dynamics, social interactions, and actual productivity.
Heffernan argues that we have run most businesses (hospitals included) and many societies (at least capitalistic ones) in the super chicken model. In this model, we view leadership as a trait to be individually owned and perfected, and we think that leaders are supposed to have all the answers. In order to determine our leaders, we charge highly competent people to compete against one another as if in a talent contest. It has long been thought that to be successful as teams, we should recruit the best and brightest, pit them against on another, and see who wins, then promote the winner, put them in charge of everything, and give them all the resources they could want or need to be a super chicken.
But this model inevitably suppresses the remainder of the flock and leads to aggression and waste.
In many scenarios in our hospitals, physicians view themselves as and act like super chickens; we try to be the hardest working, the brightest, and the most powerful. How many times have we heard of or witnessed circumstances where a physician suppresses the candor or opinion from other disciplines on the care team? I think we all know physicians (ourselves included) who demand the role of decision maker and ignore the opinions or needs of the remainder of the team, including patients or their family.