Servant Leadership Exemplified by Healthcare Executives? Not So Much.
A Brief History and Recap of Servant Leadership
Rare would be the healthcare executive who is not familiar with one or more versions of the concept of "servant leadership". First coined in the 1970's by Robert K. Greenleaf, a former AT&T executive, "servant leadership" has been variously referred to as principles, characteristics, themes, and qualities -- numbering from 7 to 12 items -- and been adapted, expanded, expounded upon, and reframed over the course of the last 50+ years.
Writing for the Society of Human Resource Management (SHRM) in February 2022, Sarah White describes the origin and subsequent permutations of Greenleaf's notion of leaders putting people first She notes that researchers James Sipe and Don Frick have studied Greenleaf's work and outlined seven pillars of servant leadership that fall within the boundaries of Greenleaf's original theory:
Person of character: A servant leader is someone who maintains integrity, makes decisions based on ethics and principles, displays humility and serves to a higher purpose in the organization.
Puts people first: A servant leader demonstrates care and concern for others and helps employees meet their goals and grow within the organization.
Skilled communicator: Communication skills are integral to servant leadership, and you will need to ensure you can effectively listen to and speak with your employees, while also inviting feedback.
Compassionate collaborator: To be a strong servant leader, you'll need to consistently work with others and work to strengthen relationships, support diversity, equity, and inclusion, and navigate conflict in the workplace.
Has foresight: As a servant leader, you will need to keep an eye on the future and anticipate anything that might impact the organization. You'll also need to have a strong vision for your organization and be the type of person who can take decisive action when needed.
Systems thinker: Servant leaders need to be comfortable navigating complex environments and able to adapt to change. This type of leadership requires strategic thinking and the ability to effectively lead change in the organization.
Leads with moral authority: As a servant leader, it's important to establish trust and confidence in your workforce by establishing quality standards, accepting, and delegating responsibility and fostering a culture that allows for accountability.
Explaining The Burnout-Servant Leader Conundrum
Most of us in healthcare leadership would say we model or at least try to model the qualities of servant leadership in our respective roles as hospital, health system or medical group practice executives.
But if ours is a profession filled with servant leaders, why is there so much staff turnover, moral distress, and burnout among front-line personnel, especially clinicians? The answer in my view is that the qualities, principles or themes ascribed to "servant leadership" are only effective if they are expressed in the form of specific, identifiable, and hardwired practices embraced and modeled by the entire executive team.
It isn't enough to have a servant leader mindset. It isn't enough to have endorsed the qualities and characteristics of a servant leader or to ascribe it to one's leadership style. Rather, if one wants to truly demonstrate by one's actions that they are a genuine servant leader, look for evidence that that leader and their organization --
expect all leaders, but especially senior executives, to do periodic job shadowing of front-line staff
require leader standard work
employ a sophisticated, deeply ingrained, and highly effective daily management system
consistently apply one or more of the improvement sciences (Lean, six sigma, operations research, agile, design thinking) in consultation with front-line staff to improve workflow and reduce delays, waste, inefficiency, and job skill mismatches
invest in AI/ML solutions -- selected, tested, and endorsed by front-line staff -- that eliminate or at least markedly reduce data entry, administrative requirements, and/or repetitive tasks that are non-value add
regard clinicians as knowledge workers who are given significant latitude to make clinical decisions without unnecessary administrative encumbrances or delays
In summary, it's not enough to have a servant leader's mindset. One must demonstrate specific routinized practices that can bring to life the desideratum of 'people first'.
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