What distinguishes ideal practice or organizational leaders from those associated with complaints of dysfunction or toxic groups are certain behavioral traits. Whether the positive or negative traits are due to ignorance, modeling, or maturity is controversial. Although when we look at practices with a history of ease of communication, low staff turnover, and flexible but wise strategic decision -- and high partner satisfaction -- we find “ideal” leader behavior.

On the other hand, when we look at practices fueled by distrust, gossip, contentious meetings, disorganization, favoritism, and disruptive behavior, we find “dysfunctional” leaders. Staff turnover, absenteeism, and seeming inability to learn, not to mention unhappiness, are associated. Partners distrust each other, constantly complain, build alliances to support differences, and disclose low physician satisfaction.

As you offer feedback to current or potential leaders, use this list to facilitate a dialogue. As your practice considers recruitment to leadership positions, consider these traits as behaviors to notice in your selection process. Determine which of these traits are the most important and build them into your principles of practice. Remember -- noticing the presence or absence of traits you desire is a basic building block for a healthy practice.

Communication:

• Ideal:    Exchanges appropriate feelings, seeks feedback regularly, direct and open
• Dysf:    Avoids open expression or procrastinates, “skirts” issues, assumes responsibility for decisions without communicating and checking

Delegation:

• Ideal:    Trusts others, provides follow-up, able to relinquish control
• Dysf:    Retains control (often at serious costs), unable to let go of responsibility of areas, uses avoidance and accommodation as normative style

Conflict Management and Collaborative Team Building:

• Ideal:    Able to use conflict resolution skills appropriately to gain closure, flexible and able to juggle and consider small and big picture consequences
• Dysf:    Again, uses avoidance and accommodation as normative style

Motivation and Visionary Modeling:

• Ideal:    Understands needs of people, rewards performance, understands and uses appropriate feedback techniques, especially supports imagination
• Dysf:    Expects absolute compliance with policies, offers limited negotiation, uses standards to model and direct behavior

Leadership:

• Ideal:    Flexible, provides and encourages visionary direction, helps to assist in task structure and task design, remains considerate, uses praise well
• Dysf:    Rigid, tends to micro-manage and get caught in details, has unrealistic expectations of associates, assumes caretaker role rather than mentor/developer role

Use of Power and Authority:

• Ideal:    Uses power for organizational – not personal – security, understands interdependencies, open to confrontation or use of coaching to direct associate’s deficits
• Dysf:    Seeks control for personal gain and security, finds difficulty in dealing with uncertainty. Eventually dissatisfaction, turnover, absenteeism, declining performance and burnout will become endemic. Never lets mistakes show and denies self-doubts. Consistently uses blame-casting on others rather than acknowledging authority and ownership.