Feature Article:

Emotionally Intelligent Leadership: Assessing Your Leadership Style

By Shelley Simon, RN, DC, MPH, EdD
Founder, Beyond Practice Management

When you think of great leaders, who come to mind? Are they leaders in your own field . . . gifted clinicians or, perhaps, one of your mentors? Are they leaders in business, politics, education, or religion? Are they social activists, explorers, or philosophers? What do you think are the common characteristics of great leaders — intelligence, charisma, integrity, original thinking, the ability to articulate ideas, or powers of persuasion?

By the time you read this newsletter the bru-ha-ha of the 2006 mid-term elections will have come and gone. But as I write this, it is Election Day eve and the issue of leadership is weighing heavily on my mind. Often, when I ask practitioners about their role as a leader or about their leadership style, they respond hesitantly or ambivalently. Some sound a shade like Alfred E. Newman: “What me worry?” Some don?t even consider themselves leaders; “I have a small practice,” they?ll say.

The pertinent question, however, is not whether you are a leader in your practice (you are); the question is what kind of leader you are (or want to be). What is your leadership style and how successful are you at using that style to establish mutually beneficial relationships? That is the essential question to ask yourself because, at the end of the day, leadership is all about relationships.

A brief recap

In the October issue of Practice Your Way, we highlighted the EQ domain of personal competence, specifically the skills of self-awareness and self-management and their importance for practice success. If you missed that issue, click here to read it now. It provides a good foundation for the content of this article in which we explore the domain of social competence in EQ and how it is related to quality leadership. In both personal and social domains, EQ — not IQ or technical competence — is the key to outstanding leadership performance, to executing your vision, and to achieving business results.

As you read on, keep in mind that the main elements of emotional intelligence include the capacity to recognize and understand one?s own feelings and the feelings of others, the ability to be self-motivated, and the competency to manage one?s emotions. These core competencies and the skills of emotionally intelligent leadership, which we?re about to discuss, can be learned and further developed if they are practiced regularly.

Social competence and emotionally intelligent leadership

Social competence — how you behave with and influence others — is more than simple friendliness and caring. It is friendliness with a purpose and includes the ability to manage conflict, move people and projects in a desired direction, build trust, and work collaboratively. Social awareness, which is essential for interpersonal effectiveness, includes demonstrating empathy, having the ability to read others accurately, putting mutual goals above self-interest, and sustaining a service orientation.

Leadership that is grounded in good EQ is built on a foundation of both self-awareness and self-management (personal competence) and on interpersonal effectiveness (social competence). When you understand and manage yourself, you can more effectively and confidently manage and influence others.

The business case for emotional intelligence is undeniable. Emotionally intelligent leadership is said to be key for high performance teams, and practices at all levels and sizes. According to author Daniel Goleman, “Managing for financial results begins with the leader managing his inner life so that the right emotional and behavioral chain reactions occurs.? This single sentence makes it abundantly clear that developing EQ competencies are directly connected to your financial and business success.

The impact and influence you have on your team and your patients is greater than you might imagine. Your mood as a leader is contagious. It has the greatest impact on performance and outcomes when it is upbeat and in tune with the people around you. According to recent business research, a leader?s actions account for up to 70% of employees? satisfaction, perception of their workplace, and how they feel about working with you.

Growing research in neurobiology and affective science increasingly demonstrates the importance of the leader?s mood or tone in terms of results. Successful leaders are able to create a positive emotional environment in which others are inspired and motivated to achieve a shared vision, goal or mission. Artful leadership occurs when head and heart come together — when “leaders execute a vision by motivating, guiding, inspiring, listening, and persuading — and, most crucially through creating resonance,” according to Goleman.

Emotionally intelligent leaders build resonance by tuning into both their own and other?s feelings, needs, and perspectives. They lead and guide people in the right direction by demonstrating authenticity, mental clarity, concentrated energy, an optimistic outlook, a sense of purpose, and the ability to see the big picture. By doing this, a leader is able to inspire, motivate, arouse commitment, and sustain momentum. Emotionally intelligent leadership is key to creating an environment in which employees are nurtured and encouraged to give their best. This enthusiasm arouses a similar response in patients, which can lead to better patient compliance and improved outcomes.

To put EQ-based leadership into perspective, consider the following scenarios. Even though these are dramatized to drive home specific points, you may catch a glimpse of yourself in one or more of them.

Dr. A — The commanding leader who tends toward anger. Dr. A is often annoyed or frustrated and doesn?t mind letting everyone know it. He offers feedback only when someone does something wrong. His modus operandi is: Do what I say to do for the right reasons (i.e., my reasons). When anything goes wrong someone else is to blame. He doesn?t like to collaborate or even listen to the opinions of others. His communication skills are, at best, marginal and self-serving. On his worst days he “tosses trays” and/or chastises staff in front of patients. He has little awareness of how his moodiness and anger impact his staff and wonders why turnover is so high.

What would Dr. A gain by building self-awareness and being less demanding and angry? By becoming aware of his own inner signals and triggers, and assessing his strengths and weaknesses accurately, he would more effectively manage himself in the best interests of those he serves (staff and patients). Rather than losing his temper and having little understanding of his impact on others, he would learn to keep himself in check emotionally, ask for and listen to feedback, and begin to build better relationships with staff and patients. This would ultimately benefit him and his practice.

Dr. B — The driven leader. Dr. B, in an effort to be successful and grow her practice, has a pacesetting management style. She works almost to the point of exhaustion and assumes that others want to do the same. She drives her staff too hard and can be coercive and manipulative if she thinks it will get her what she wants. She micromanages and is rarely satisfied with the quality or quantity of other?s work. When a staff member or patient doesn?t follow her lead she quickly (though silently, thank goodness) deems them wrong or stupid. Dr. B is self-absorbed and when things don?t go her way she tends toward fight or flight reactions, either attacking or withdrawing.

What would Dr. B gain by controlling her perfectionism and relentless drive for success? By keeping disruptive emotions and impulses under control, and by displaying honesty, integrity and trustworthiness (by speaking and acting congruently), Dr. B would improve her own self-esteem and enhance the likelihood of staying motivated to work on her practice even during challenging times. She would become less demanding, learn to depend on others more, and relate more effectively when difficult situations arose in her practice. She would be more positive, better able to see the up side of things, and experience what it would be like to have others respond to her requests willingly rather than begrudgingly.

Dr. C — The leader lacking in social awareness. Dr. C manages his practice based on vision and purpose, which is obviously a smart idea. Dr. C, however, takes this approach to the extreme. He becomes overzealous in trying to achieve his vision and patients wonder whose needs he is looking out for — theirs or his own. He has difficulty reading social cues and doesn?t listen to his patients. He thinks he already knows what they are going to say and what they need. He?s primarily focused on what he wants them to do. When he has patients who question his recommended course of treatment or have too many questions or objections, he dismisses them as non-compliant or not smart enough to understand what they need. His style is off-putting and his patient retention rate is low.

What would Dr. C gain by developing better social awareness? He would develop more resonance with the people around him, most importantly his patients. He would learn to listen and see things from his patient?s point of view. By being attuned to how others are feeling, Dr. C would learn to say and do what is most appropriate rather than resorting to a script or reacting in a habitual way. This would allow him to more effectively guide his patients and care for them in accordance with their needs, desires, and values.

Different circumstances call for different styles

An emotionally intelligent leader is one who can move flexibly and appropriately between different styles in order to effectively manage and respond to any situation. Resonant leadership is a great model for practitioners and for anyone in a position to influence others. The primary or “primal” task of leadership is to drive resonance. This means expressing your message in a way that moves others and elicits optimism and a sense of connection. As Goleman says, “resonant leaders know when to be collaborative and when to be visionary, when to listen and when to command.” What are your primary leadership styles? Can you identify yourself here?

It can be particularly useful to assess your style when you find yourself in stressful situations or during challenging interactions. This “under fire” assessment will yield the most helpful and accurate feedback. Ask yourself how you tend to respond to or relate with staff, patients, and colleagues when you are in a challenging situation? If you are only comfortable in one or two of the above styles, you will not necessarily have the best outcomes, particularly if you tend to overuse or default to the commanding and/or pacesetting styles. While these styles are useful and necessary in certain situations (i.e., in a crisis, breakdown, or with a chronically problematic employee), they create dissonance when relied upon to the exclusion of more positive styles.

Having access to the full range of styles — specifically mastering four or more of the above styles — will create a consistently positive experience in your practice. Though we all have natural preferences, we can learn the behavior and skills of other leadership modes or styles. The best leaders maintain flexibility, switching easily between visionary, coaching, affiliative, and democratic, and make only rare, strategic use of the less effective pacesetting and commanding styles.

To build the skills needed to use each of the six styles, here are some ideas about what to do in specific situations. Experiment with these to develop your style repertoire and flexibility in application.

In healthcare, a primary measure of success is the way your patients, staff, and community perceive you. Your ability to attract and retain patients requires more than competent clinical skills and simple patient satisfaction — it requires quality leadership skills. Leadership is quite simply about developing and maintaining relationships — with patients, with staff, and with the community.

Emotional competence is a common characteristic in great leaders, performers, and teams. Those leaders who have genuine enthusiasm and resilience for executing their vision and the skills to invigorate others exude resonance. EQ is at the core of all relationships and quality leadership is about having relationships that resonate. Now that you have basic information to assess your role and style as a leader, you can begin to consciously develop and strategically apply those skills that will more positively impact your practice. Rather than adopting the Alfred E. Newman approach to leadership and management, you can use these tools to be proactive — to manage your team by managing yourself.

Book Recommendation:

Primal Leadership: Learning to Lead with Emotional Intelligence

Primal Leadership opens with the following passage: Great leaders move us. They ignite our passion and inspire the best in us. When we try to explain why they are so effective, we speak of strategy, vision, or powerful ideas. But the reality is much more primal: Great leadership works through the emotions.

This opening passage succinctly reveals the premise of the book. The science of emotional intelligence and the neurobiology of resonance — ideas comprehensively explored in this book — should prove interesting to practitioners as pertinent to the healing encounter, as well as to staff relationships and patient outcomes. The authors make a compelling case for developing emotionally intelligent leadership and explore what contributes to and detracts from resonant, effective leadership. They cover how to develop EQ competencies and then put them to work using a variety of leadership styles. There are numerous case studies and research cited that can assist the reader in a number of ways — from developing the initial motivation for change to creating a development plan, experimenting with new behaviors, and getting the support needed for sustainable growth and change.

While this book is targeted primarily for an organizational audience, I find that the leadership model, learning and change agenda, and central thesis of emotional intelligence is relevant for healthcare practitioners and offers much to support any practice that intends to develop, grow, and make a contribution to the patients and staff that it serves.

Primal Leadership, 2002, Harvard Business School Press. Paperback edition $17.

Client's Corner:

Case Study: Reducing Staff Turnover with Good Communication and Leadership

Gale Campbell is a dentist in private practice in Washington. His wife, Vickie, is the office manager and they have ten employees. They have a high volume practice and were experiencing high staff turnover.

When I was initially contacted by Gale and Vickie, their request was for me to come to Washington and “fix this team.” I explained that the fix had to start at the top and that meant with the two of them. “I had it all figured out,” says Gale, “that a few people were causing problems and I wanted to hire Shelley to fix the staff. She said ?Doctor, let?s heal you first?.”

For several months, I held weekly coaching sessions with them — sometimes together, other times separately. We also used the EQ In-Action Profile to enhance their understanding of how they communicated with one another and their staff. Once we felt closer to understanding the likely reasons for the turnover problem, we scheduled a Renewing Teams workshop for the entire staff. This turned out to be a challenging day, and a turning point for the group.

The problem turned out to be, as is so often the case, one of communication and leadership style. Vickie and Gale made good business decisions but did not always present their decisions to the team effectively. By becoming more attuned to their own management and communication styles and incorporating more of the affiliative, coaching, and visionary strategies, team members began to respond more positively. For their part, staff became aware of and addressed their tendency to make assumptions and jump to conclusions. A major piece of this puzzle was helping Gale and Vickie learn to communicate more effectively with one another. They were both open to learning and to change and that openness, in large part, was what made the coaching successful.

As a result of the honest discussion during the Renewing Teams workshop and the trickle down effect of Gale and Vickie?s improved communication, the staff gained awareness about the impact of their behavior, began to work more cohesively, and became more considerate of one another. In other words, the team became resonant. At both the behavioral and operational levels, lists were created during the workshop of specific behaviors and ways of working together that the staff wanted to see changed or improved upon. After the workshop the team adopted a democratic approach and team “champions” were appointed to take responsibility for follow-through in each area. “Moving forward,” says Gale, “we have a six month horizon mapped out. We?re moving out of this poor functioning phase we are in now and it?s going to take probably a year. We?re using Shelley as a sounding board to help us meet the goals we?ve agreed to.”

“Working with Shelley arms you with the tools needed to get through life on a personal and professional basis and she does it without judging. If you truly want to grow as a person while growing your practice, she?d be the one to talk to.”
— Vickie Campbell

“After years of hiring different consultants and ending up with same problem, I am delighted with the results after working with Shelley. It?s so unusual to find someone who can truly help with the real problem. My practice is better and my personal life is better.”
— Gale Campbell, DDS

To read more case studies like this one click here.

What's New:

BPM Featured in Chiropractic Economics

Be sure to pick up the November issue of Chiropractic Economics. The feature article, “21 Practice Consultants Give Sound Advice,” includes an offering from Dr. Shelley Simon, founder of Beyond Practice Management. In response to the question: “What?s the single most important thing you can do to build your practice?” Dr. Simon offers advice on building a healthy and sustainable practice by making professional development a priority.

Upcoming Issues:

Watch for the remaining articles in this series on EQ:

December — Team EQ: Getting Your Staff Involved