He who has no faith in others shall find no faith in them.—Lao Tzu
We hear a lot about leading. There are best-selling books on the topic, courses in leading, articles on leading, and admonishments to lead. But is there an art to following? Many of us work on our leadership skills. We spend time trying to better understand those around us and their motivations and interests. We attempt to identify their strengths and engage them in projects that match their skills. We learn to give feedback in constructive ways so that others can improve. We try to understand the other’s perspective.
But when it’s our turn to follow, are we as diligent?
Regardless of our role at the hospital, within our group or in our medical community, we need to follow as well as lead. We may be a leader of our group, but a follower with the rest of the medical staff. We may lead some aspects of patient care, but follow on other aspects. How does our performance as a follower affect the group’s outcomes? Does it matter?
Some would say that there are four fundamental responsibilities of a follower.
Responsibility #1: Don’t act like a victim
As a project or program gets underway don’t be defensive or whine. Attempt to understand the rationale behind the project. Most leaders don’t wake up and invent things to keep people busy. They have a goal that usually addresses underperformance in some area. Operating room turnaround time may not seem important to you—discover why it matters to someone else. When a plan is presented, approach it with an open mind and suggest ways to improve the plan or its implementation. Even if the advantages of change are not apparent to you, give them a try before you make up your mind; you might discover that the new way is an improvement. Be straightforward with your concerns, but once the decision is made, play with the team.
We all knew families of brothers who seemed to fight among themselves. But if an outsider picked on one of them, the group banded together to defend each other. Make sure your team knows that they can count on you. Withdrawing from participation is certain to sabotage a project. Once your behaviors establish your reputation as a person who acts like a victim, you can be sure to be excluded from future projects or participation.
Worse than withdrawing is commiserating with others about your bad situation and demoralizing the group you are in. If you believe that the activity is unfair or dishonest, get outside opinions from other colleagues. Someone who is in another group or another field can be very helpful. In other disciplines (business, agriculture, manufacturing, and law), what you are being asked to do may be accepted as part of change. Solicit several opinions (and not just your family members). And when all is said and done, give it a try. Nothing is forever and every great journey starts with a single step—you might be in for a pleasant surprise.
Responsibility #2: Engage Yourself
Almost no one gets it right from the start. If you have ideas on improvement, not only speak up—take responsibility. Work with the project leader to supervise some part of it or assist in creating a monitoring tool or feedback loop. Every project has a number of tasks that need to be completed; volunteer to take responsibility for some part.
Engage others in finding ways to improve the process. Hospital-based processes are extremely complex and involve many stakeholders, entities, and professions. A number of pieces usually need attention. As the project progresses, be creative. Solve problems with open discussion and make improvements along the way. Focus on the end goal and suggest, implement, and monitor adjustments. Any sizable project will take time. Hospitalists and other physicians are used to seeing action and immediate reaction: Lasix relieves heart failure; nebulizers relieve shortness of breath. However, projects that really change organizations are long and arduous. They are multimonth and many times multiyear. This is quite a learning curve for many practitioners.
Responsibility #3: Do What you say
We certainly expect this of our leaders; we should expect it of ourselves as followers. It is difficult to lead a project when others on the team are late on deadlines or fail to show up. Volunteer to do only what you can. If you are overextended and don’t complete your part, the project can be crippled. Budget your time and energy to successfully meet expectations. If you get stuck on an assignment, ask for help. Delaying until the project is greatly behind can result in loss of your credibility and the whole project coming to a halt. Identify what you don’t know and identify ways to get the information you need. Many facilities and groups have a number of resources to assist you. They have members with experience expertise and other references available. SHM provides resources and online help at your fingertips.
Responsibility #4: stay the course
As mentioned above, the timelines on many projects take weeks and months. Don’t be discouraged if your progress is not as smooth as expected. Remember, you are remaking healthcare. Focus on your strategic priorities: Are they aligned with your patient care values? If you are off track, reanalyze. Look for the ways that the process is failing and revise the process. Maybe the wrong person is assigned to a task that is not to their strength. Review what you were trying to achieve. Maybe there is another path to get there. Follow directions and processes and support the design.
These are some ideas about the responsibilities of a follower. Keep in mind that others need you to follow just as you need them to lead. Performing as a good follower has some outcomes that help you. You can learn important successes with the right leader. The group’s goals can be accomplished more readily. If you can follow others and assist them in being successful with their goals, you can expect them to follow you in return. Have some faith in your leader; work at being a good follower and then you’ll be leading, too!
I would like to recognize the Petrous Group (www.petrous.net) for sharing their material for this column. TH
Dr. Gorman is the president of SHM.