The major challenges facing Dr. Harris and her department are low morale and malaise among staff, high turnover and lackluster departmental performance. The root cause of this has been identified as problems with promotion and career development (Groysberg, Leffert, Herman, & Williams, 2011). The major barriers that Dr. Harris must overcome in order to strengthen these aspects of operations are a promotion system with little transparency, and an organizational culture that is averse to providing feedback and constructive criticism (Groysberg et al., 2011). This is compounded by a lack of mentorship or career guidance as those who would provide such a role are themselves in the same position of striving for promotion or distinction themselves with little understanding of how that might be achieved (Groysberg et al., 2011).
I think that Dr. Harris failed to capitalize on the greatest threat and the biggest opportunity in her new role when she chose to focus on conferences and supplementary activities to support career development rather than performance excellence. One of my greatest concerns would be the focus on promotion rather than performance in the role and contribution to departmental and organizational objectives. This is required to support a world class setting, which is the setting that physicians expected to be in; the excitement should be in the research, but also in making the connections to support an evidence-to-practice pipeline. The network, in combination with robust recognition systems, should have a social result. There should be an audible cheer in the building when the unit or department is exceeding previous performance. It is in fact less about goals, and more about understanding one’s own performance and that of others in context, and using that insight for self-directed continuous improvement.
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The goal that Dr. Harris set of career development created essentially vacant positions as the concern was the future, rather than the present. It was the career development achievements and instincts that brought these physicians together as leaders in their field, and they needed a setting that allowed them to develop that leadership. In fact, this would contribute more broadly to career development as a secondary byproduct of excellence in performance and contribution to the organization. The survey and other supports which are being provided to the physicians are deficit focused, rather than focused on developing strengths, building better communication and networking within the organization, and building systems of recognition that reinforce internal commitment and world class expectations (Groysberg et al., 2011). This is problematic, and reflects a transactional leadership style rather than one focused on transformation.
By focusing on progression, there is the idea that everyone moves up a ladder, and that is not really the paradigm of promotion which should be in place. All physicians should already be where they want to be in their careers, that being in a position to make a difference in research investigation, clinical care or teaching. Comparative research to determine whether there is an opportunity cost to accepting a position at North Atlantic Hospital may be warranted, and perhaps gradients that reflect a long trajectory of even two or three decades of progression in terms of financial compensation could be implemented to provide a standardized approach to progression within the position. The idea that progression is promotion to the scarcer associate positions should be corrected. In fact, they are expected to focus significantly on their current role. Of these leaders, those with the meta-level of leadership, with the capacity of leadership of leaders, may be offered the associate professor position. The supply and demand aspects of such positions should be clear so that there is transparency regarding potential upcoming opportunities for promotion. There should also be a competency profile which reflects the leadership of leaders, and clearly one of the important skill areas will be not only providing feedback and constructive support to physicians, but also guiding physicians to be able to do the same.
- Groysberg, B. Leffert, L., Herman, K. & Williams, L.. (2011). Development and Promotion at North Atlantic Hospital. Harvard Business School Case 411-018. Harvard Business Review.
