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Monday, September 28, 2015

What exactly is "Leadership," anyway?


I'll be there starting Sunday. There will be Tech and "Thought Leaders" and "Futurists" galore to regale, wow, and inspire us.

On "leaders." I'm sure it's not news to you that we in the U.S. are now in the tediously extended and overwhelmingly melodramatic throes of vetting the myriad candidates for our next change in national political "governance." "Leadership" is probably too strong a word. Hell, even "governance" begs a question. Many of our national "leaders" and those who cyclically propose to succeed them seem increasingly less interested in actual (frequently boring) governance and more interested in endlessly campaigning for positions of authority. At the national level, it seems as though we pay for four incremental years of federal governance, but only really get one. The rest of the time is spent on ever-expanding periods of campaigning, first for the subsequent bi-yearly congressional mid-term election cycle, then for the next Presidential cycle.

Whatever. That will be what it will be. Much of it unfortunately in the form of crass, lowbrow "entertainment."

More broadly, what of "leadership" across socioeconomic and cultural domains writ large? I've reflected on the topic a lot across the years, and written about it here on KHIT a good bit. See, e.g., "If you're 10 feet ahead, you're a 'Leader.' If you're 100 feet ahead, you're a Target." - Brent James, MD, M.Stat, and "The "Talking Stick" and the three-legged stool of sustained, transformative healthcare QI. See also my posts on the 2015 Lean Healthcare Transformation Summit.

"Leadership." We toss the word about cavalierly. We have an entire industry devoted to it. Do we all mean the same thing? Hell, even Forbes is confused.
"I’ve now written several books on leadership for employee engagement, and yet it occurred to me that I never actually paused to define leadership."
Seriously, dude?
What is Leadership?
Kevin Kruse, Forbes Contributor

What is leadership, anyway?

Such a simple question, and yet it continues to vex popular consultants and lay people alike. I’ve now written several books on leadership for employee engagement, and yet it occurred to me that I never actually paused to define leadership. Let’s start with what leadership is not…

Leadership has nothing to do with seniority or one’s position in the hierarchy of a company. Too many talk about a company’s leadership referring to the senior most executives in the organization. They are just that, senior executives. Leadership doesn’t automatically happen when you reach a certain pay grade. Hopefully you find it there, but there are no guarantees.

Leadership has nothing to do with titles. Similar to the point above, just because you have a C-level title, doesn’t automatically make you a “leader.” In all of my talks I stress the fact that you don’t need a title to lead. In fact, you can be a leader in your place of worship, your neighborhood, in your family, all without having a title.

Leadership has nothing to do with personal attributes. Say the word “leader” and most people think of a domineering, take-charge charismatic individual. We often think of icons from history like General Patton or President Lincoln. But leadership isn’t an adjective. We don’t need extroverted charismatic traits to practice leadership. And those with charisma don’t automatically lead.

Leadership isn’t management. This is the big one. Leadership and management are not synonymous.  You have 15 people in your downline and P&L responsibility? Good for you, hopefully you are a good manager. Good management is needed. Managers need to plan, measure, monitor, coordinate, solve, hire, fire, and so many other things. Typically, managers manage things. Leaders lead people...
Better late than never, one supposes. Write the books first, clarify the core definition later. As we used to joke in my radlab in Oak Ridge, "the flowchart comes last."


"A person who directs a military force or unit ... a person who has commanding authority or influence."
Interesting. I was once "a first or principal performer of a group." A "bandleader." Not sure whether "herding cats" counts much. But, seriously, "leadership" goes more to "influence" and "guiding" and "persuasion" than it does to outright "power" and "authority."
See, e.g., Howard Gardner's "Changing Minds" and Robert Cialdini's "Influence."
I recently binge-watched the entirety of the excellent, sobering HBO "docu-drama" series Band of Brothers.

One thing that jumped out at me was the repeated multi-tiered ad hoc examples of "leadership" at every level above the rank of Private. While the military is the prime exemplar of the vertically integrated "command and control" organizational architecture, wherein dereliction and insubordination are dealt with quickly and severely, "leadership" initiative is cultivated and rewarded at every level -- at least in combat theatres. While perhaps "there are no atheists in foxholes," neither are there any bureaucratic "managers."

"If you're 10 feet ahead, you're a 'Leader.' If you're 100 feet ahead, you're a Target."

Love that quote.

Brings me to my next read, just finished. An incredible, bracing, iconoclastic take-no-prisoners book. Scholarly writing with a delightful Lewis Lapham edge.


...I began the writing of Leadership BS with a simple, albeit ambitious, goal: to cause people to rethink, to reconceptualize, and to reorient their behaviors concerning the important topic of leadership. My purpose in all of this is for the next decades of what goes on in workplaces and in people’s careers to be, optimistically, a lot more humane and beneficent than the last decades have been.

I proceed from a historical analogy. Around the turn of the twentieth century, medical practice and medical education in America were pretty dismal. People were hawking untested and unproven “cures,” with their financial success dependent more on their slickness and persuasiveness than on the actual science or medical efficacy of what they were pushing. Almost anyone could practice medicine, as there was no license required. And while there were some outstanding doctors and scientists building the foundations of modern medicine, charlatans and quacks abounded. Many medical schools were proprietary, for-profit entities with little concern with science, lots of concern for financial gain, and little interest in doing evaluations of what they, or their students, were accomplishing (or, more accurately, the harm they were doing).

Into this morass, the Carnegie Foundation sent Abraham Flexner, who was notably a teacher and not a doctor, to survey the landscape of American medical education. His report, published in book-length form in 1910, transformed the training and also the science and practice of medicine. As a result of that report, one-third of the existing medical schools closed, formal licensing for doctors was instituted, and the biomedical, scientific foundation of medical practice— a goal still not perfectly achieved but widely embraced and something that has been responsible for so much progress in the prevention and treatment of disease— was put into place.

The parallels with the current state of the leadership industry are striking. Want to be a leadership coach? You can go to an institute or enroll in one of many programs, of varying quality and rigor, that train coaches with varying degrees of skill, but you don’t have to even do that. You can be a coach tomorrow.

Want to be an expert on leadership? You could get training and exposure to the relevant research literature, but it’s not necessary. If you are persuasive enough, articulate enough, or attractive enough, if you have an interesting enough, uplifting story or some combination of these traits, you are or can be a very successful leadership blogger, speaker, and consultant—consultant— whether or not you have ever read, let alone contributed to, any of the relevant social science on the topic.

To be sure, these days there are many fabulously fantastic people with exceptional credentials and ethics working mightily to improve organizational workplaces and leaders’ careers. But the leadership industry also has its share of quacks and sham artists who sell promises and stories, some true, some not, but all of them inspirational and comfortable, with not much follow-up to see what really does work and what doesn’t. And much like the field of medicine prior to Flexner, what speaks the loudest in the leadership industry seems to be money, rather than evidence-based, useful knowledge. The way leadership gurus try to demonstrate their legitimacy is not through their scientific knowledge or accomplishments but rather by achieving public notoriety— be it the requisite TED talks, blog posts, Twitter followers, or books filled with leadership advice that might or might not be valid and useful.

Pfeffer, Jeffrey (2015-09-15). Leadership BS: Fixing Workplaces and Careers One Truth at a Time. HarperCollins. Kindle Edition.

CHAPTER 8: Fixing Leadership Failures: You Can Handle the Truth

It’s September 2013, and I am giving a talk to alumni and other executives on some of the material covered in this book. About forty people are gathered at the newly opened Vlerick Business School facility in Brussels, Belgium. A hand goes up and an experienced senior executive comments, “I have seen everything you have described and can vouch for its accuracy. But this is depressing, even if it is true.”

In my reply, I acknowledge that what one finds depressing is a relative concept, and that while this individual may find my description of the work world quite sobering, a sentiment I can certainly understand, I don’t. Instead, I say, “I find it even more depressing that talented, earnest, young, and for that matter, not-so-young entrepreneurs and leaders in all types of organizations all over the world lose their jobs and their companies at unacceptably high rates.”

I continue, “I find it depressing that after decades of books, lectures, leadership-development programs, and all the other components of the large leadership industry, virtually every shred of evidence shows most workplaces filled with distrustful, disengaged, dissatisfied, despairing employees. And,” I conclude, forgoing any pretense of political correctness, “I find it depressing that we would want to discuss the state of leadership in organizations from the perspective of what feels good and uplifting, rather than what the evidence shows to be true.”

This executive’s comment is not all that unusual. After a talk about this book to an academic audience in Spain, I get a similar response— the material is provocative and probably true, but not “uplifting.”

The difference between management science and medical science is telling. “Depressing” may be an emotion felt by medical researchers and by practitioners confronted on a daily basis by the inevitable limitations of current treatments, and certainly people would love to be “uplifted.” But “depressing” or, conversely, “uplifting” are almost certainly not how doctors and other medical researchers evaluate evidence or figure out how to make progress in treatment. Averting our eyes from the facts may provide solace, but it does so at the price of progress. There is no theory or evidence that suggests that improvement comes from ignoring bad news, paying inordinate attention to rare, exceptional cases, or from failing to measure base rates for how often something occurs. No wonder medical science has made significant strides in treating many diseases while leadership as it is practiced daily all over the world has continued to produce a lot of disengaged, dissatisfied, and disaffected employees.

So we end where we began, with the pragmatic question of whether all the inspiration and feel-good stories produced over the decades have done any good. This is not a question about competence, motive, purpose, intentions, sincerity, or even hypocrisy (which there is in abundance). It is a simple question about the state of the world of work and leadership after the expenditure of so much time, effort, and money with so few results. Yes, some people would argue that things might even be worse without all these efforts. But holding aside the impossibility of empirically demonstrating the truth of that counterfactual argument, it is a tough argument to accept, given the dismal data on employee engagement, job dissatisfaction, trust in leaders, and career catastrophes.

The discussions about leadership often seem sort of like being under the effect of nitrous oxide (laughing gas) or other forms of mild anesthesia. By leaving people feeling good while somewhat uninformed about reality, the leadership enterprise helps produce people happily oblivious to many important truths about organizational life in the real world. In this zoned-out, semiconscious, blissful state, people are insufficiently prepared for what they will encounter at work and, most important, insufficiently energized to accurately diagnose and change that world of work. That’s because people think everything is just peachy fine, or soon will be. But if the world of work in a few more decades is to look any different— or better— than the one today, people need to understand the world not as we might want it to be, but as it is. To get from one place to another, you need to know as best as you can where you are, where you want to go, and, most important, the obstacles and barriers you will likely encounter en rout
[ibid, pp. 193-195].
Yikes. I bought my wife a hardbound copy for her convenience (so I can quit interrupting her and reading excerpts to her). She's a C-Suite exec at the top of her game, and an astute observer of and adroit survivor of carnivorous corporate politics. She'll dig it. She likely could have written it.

So, what of it, as it goes to things like process QI? Dr. Pfeffer cites Deming:
If leaders are, as everyone I know would admit, inevitably imperfect and impermanent, there are two possible solutions for the problems this fact causes for those who work for such leaders. The first solution is an approach advocated by many leadership-development practitioners and teachers: do a better job of developing, training, educating, and selecting leaders so we change the distribution of the leaders we have in the talent pool from selfish versus selfless, competent versus incompetent, egotistical versus modest, trustworthy versus untrustworthy— you get the picture.

This is a nice sentiment, and one that animates the leadership industry and its many practitioners, but one that, for all of the psychological and social psychological reasons already covered in this book, is not very likely to work, at least on a consistent basis. There is, however, a second approach worth considering, one that grew out of the quality movement; it’s an approach that helps explain why flying in an airplane has become so incredibly safe.

Whenever there is an airplane accident, or for that matter, a number of near-accidents or other problems, the customary response is to try to redesign the plane to make such problems less likely to occur in the future. This may entail changing the controls or the guidance systems, or increasing mechanical or other system redundancies— in short, doing things that make it easier for the people flying and servicing the plane to do the right thing and more difficult for them to screw up. Such an approach is completely consistent with the principles of the quality movement, which promotes fixing the system rather than relying on the skills of individuals— to produce, in other words, an environment in which ordinary, albeit conscientious, people can reliably produce desirable results.

The lesson of W. Edwards Deming and his peers in the quality movement is that relying on individual motivation and acts of great competence is a singularly unreliable way to produce consistently high levels of system performance. Deming argued that if there are performance problems and quality defects, one needs to understand how those problems arise almost naturally as a consequence of how a system has been designed— and then fix those design flaws. Put simply, attack the problems by fixing the system, not scapegoating the necessarily fallible human beings working in and operating that system— whether or not they deserved it.

Inside organizations of all kinds, there are many ways to redesign governance that would reduce the dependence of employee well-being on the vagaries of people’s doing a better job of selecting and training all-powerful leaders. Such solutions mostly entail building work systems that are less leader-dependent, and instead devolve more power to a wider set of organizational constituents, particularly employees. Such systems include employee ownership; building in formalized countervailing power, such as that provided by works councils in some European countries or unions in other places; building employment systems with more distributed power by having people elect their leaders, as occurs in some partnerships; and so forth. With more distributed and balanced power, the ability of a single individual to do remarkably good— or remarkably harmful— things becomes diminished. Interestingly, these approaches seldom get much attention. Instead, we hear more pleas for better leaders— pleas that have produced little improvement in any aspect of workplaces or leader tenure in the past fifty-plus years. But never mind, maybe the future will be better.

In the absence of any sustained movement to create better management and organizational governance systems that rely more on the “wisdom of crowds” and less on the hope that one’s leader is better than average and not overly self-interested, it seems sensible to look out for oneself [ibid, pp. 185-186].
I know the docs all hate the frequently-cited aviation allusion. Beyond that, though, this stuff goes straight to the heart of things like the Lean methodology and David Marx's Just Culture principles. Click here for more on my prior Marx cites. There's also some Maccoby in that post. He is also cited in Leadership BS.
[A]s Michael Maccoby notes in his book The Productive Narcissist, the pioneering innovation that, almost by definition, breaks with convention and reinvents products, industries, and business models requires the kind of disdain for the constraining views of others and persistence in the face of adversity and naysaying that characterize narcissists.  Indeed, Maccoby almost equates visionary leadership with leaders who have at least some reasonable degree of narcissism.

While there is not much research evidence about modesty and its effectiveness as a leadership quality, there is an extensive literature on a very closely related, albeit opposite, concept: narcissism. Studies of narcissism can help us evaluate the usefulness of prescriptions for leaders to be modest and also see the extent to which leaders are narcissistic on the one hand or modest on the other.

Although sometimes considered a form of personality disorder, narcissism and narcissistic behaviors are quite common, particularly among leaders. Michael Maccoby has noted that many of the most well-known and well-regarded CEOs, including Bill Gates of Microsoft, Steve Jobs of Apple, and Jack Welch of General Electric, exhibited narcissistic traits and behaviors. Maccoby also includes John D. Rockefeller; Robert Johnson, the founder and leader of Black Entertainment Television; J. Craig Venter, the CEO of Celera Genomics; and Jim Clark, the founder of Silicon Graphics and the onetime CEO of Netscape among a long list of narcissistic business leaders. Other narcissistic leaders include David Geffen (cofounder of the Dreamworks movie studio), Michael Eisner (Disney), Kenneth Lay (Enron), and many politicians, including Joseph Stalin and President George W. Bush. For all these individuals, attention-seeking and a sense of entitlement nearly define their personalities.

Narcissism has been defined in the psychology research literature as a grandiose sense of self-importance; arrogant behavior or attitudes; a lack of empathy for others; a preoccupation with fantasies of unlimited success or power; belief in one’s special or unique status, including a fixation on associating with high-status people or organizations; an unreasonable sense of expectations or entitlement; and a desire for excessive admiration from others, among other characteristics. Narcissism can be measured by a validated paper-and-pencil measure, the Narcissistic Personality Inventory (NPI). It can also be assessed indirectly and unobtrusively. For instance, one study of the effect of CEO narcissism on companies examined the prominence of the CEO’s picture in the annual reports, the CEO’s use of the first-person singular pronoun (“ I”) in interviews, the CEO’s prominence in the company’s press releases, and the CEO’s compensation compared with the number-two ranking executive’s to assess narcissism. The use of first-person pronouns can be particularly revealing of narcissism, such as CEOs talking about themselves when they should be referring to their companies or executive teams.

You can use these and other similar indicators of immodesty and hubris to help structure your observations of the leaders you encounter, and to help answer the question for yourself: How does hubristic self-absorption affect the careers of people in work organizations? I believe that your own observations can be at least as convincing as any evidence I present. If you become attuned to assessing narcissism as exhibited in natural settings, you can learn a great deal about when, how, and why self-aggrandizement is or is not effective... [ibid, pp. 69-71].
A compelling read, this book.


October 1st. The author was interviewed on KQED's "Forum."


apropos of the military, ran across this Atlantic article this morning:
The Military Isn’t Preparing People for Private-Sector Success
And that’s a good thing: Thriving in business requires a shallow, materialist outlook that is out of place in the armed forces.

Those considered successful in America seem, at least superficially, to cover a fairly broad spectrum: the business entrepreneur, the pop star, the professional athlete, perhaps a surgeon. Yet while their success derives from very different activities, one feature they all share in common is wealth. To be successful in America means to be rich, and much of our culture is monomaniacally focused on getting rich.

There is one major subset of Americans for whom this is not the case, who have not put making money at the center of their lives: service members. And it shows: Many retired service members are not doing well once they enter the private sector. As former Federal Reserve Chairman Ben Bernanke said at a Brookings Institution event last month, “If you go into the military at age 18—versus an identical person who stays in the private sector and takes a private sector job—10 years later, if you leave the military, your skills and wages are probably not going to be as quite as high on average as the private-sector person.” Living as we do in a climate where to say anything that could be vaguely construed as “anti-troop” is anathema, his remarks were quite controversial...
Good piece.

Also apropos of the military...

Couldn't resist. The four-deferments Vietnam war dodger recently insisted that he felt as though he'd actually been "in the military," given that his parents had sent him to a military-themed prep school prior to college. Yeah, Commander-in-Chief / Foreign Policy chops, yeah, forged in the crucible of a dress-up-like-a-West-Point-cadet private high school. Right.

Also apropos of "BS," as I've noted elsewhere:
Why is there so much bullshit? Of course it is impossible to be sure that there is relatively more of it nowadays than at other times. There is more communication of all kinds in our time than ever before, but the proportion that is bullshit may not have increased. Without assuming that the incidence of bullshit is actually greater now, I will mention a few considerations that help to account for the fact that it is currently so great. Bullshit is unavoidable whenever circumstances require someone to talk without knowing what he is talking about. Thus the production of bullshit is stimulated whenever a person’s obligations or opportunities to speak about some topic exceed his knowledge of the facts that are relevant to that topic. This discrepancy is common in public life, where people are frequently impelled—whether by their own propensities or by the demands of others—to speak extensively about matters of which they are to some degree ignorant. Closely related instances arise from the widespread conviction that it is the responsibility of a citizen in a democracy to have opinions about everything, or at least everything that pertains to the conduct of his country’s affairs. The lack of any significant connection between a person’s opinions and his apprehension of reality will be even more severe, needless to say, for someone who believes it his responsibility, as a conscientious moral agent, to evaluate events and conditions in all parts of the world…
Referencing another great book.

BTW: Pfeffer on the military:
Leaders who have come up through the ranks and have done many if not most of the organization’s jobs are much more likely to look out for the interests of those they lead because they have been there themselves. That is one plausible explanation for why, in general, leadership in the military is not just better but why senior military officers typically show a higher level of concern for the well-being of their people than do leaders in many companies. Military leaders come up through the ranks, so they once were in the positions of the people they lead, and therefore have much more empathy for and understanding of their subordinates. Outside succession, and particularly succession by industry outsiders with limited frontline experience, exacerbates the tendency for leaders to not give the interests and well-being of others much priority. [op cit, pp. 166-167].
He goes on to give good discussion of the civilian corporate difference, in particular the leadership liabilities of "outside succession" (e.g., think the likes of a Carly Fiorina).


In my mail today, a postcard conference pitch from my professional society:

Theme and Focus Areas
Leadership at Every Level
We all strive to achieve results, and each of us strives to sustain the results we gain. There are a lot of factors that play into the level of success or failure that organizations achieve, whether it be the culture we work in, how aligned our efforts are, or the ability we have to deal with and mitigate risk. But out of all the factors at play, leadership is among the most critical. Studies show that anywhere from 50 to 95 percent of improvement programs fail. There are differing opinions as to just how high that number is, but also overwhelming consensus that leadership is a key component in avoiding such failures. Leadership through action, leadership with purpose, and leadership at all levels of an organization are critical to achieving and sustaining results.  

The efforts made to embrace and implement lean and Six Sigma methodologies can provide individuals with the tools they need to achieve results. However, sustaining those results is often a challenge that requires commitment, a culture of improvement, and most of all leadership. It requires leadership that goes beyond the top of the organization and spreads out to all levels of it; and it involves leadership that is both nurtured and sustained.
"Leadership," baby. It's not just for breakfast anymore Who can argue with those last two sentences?

Let the ongoing monetization of "leadership" proceed apace. Early Bird registration fee here for ASQ members, a mere $1,195 for the two-day conference.

Speaking of Health IT "Leadership,"


PDF copy here (50 pages). When I'm pressed for time and have too much contending stuff to read, many times I'll do a keyword search of high-priority terms and phrases to get a sense of relative emphasis, and scan a few excerpts prior to subsequently devoting time to close front-to-back study. A quick selective rank-ordered tally here:
  1. "Standards" - 42
  2. "Value" - 29
  3. "Interoperability" - 26
  4. "exchange" - 20
  5. "EHR"  - 18
  6. "mobile" - 13
  7. "usability" - 9
  8. "telehealth" and "seamless" (a tie) - 8
  9. "patient-centered" - 6
  10. "performance" - 4
  11. "governance" - 2
  12. "portal" - 1
  13. "leadership, API(s), HL7, HL-7, FHIR, use case(s), ACO, PCMH" - 0
Interesting. Particularly #13.


The incredible 15-part Steve Brill "Docu-Serial" on Johnson & Johnson and their Risperdal Rx is now complete.


More to come...

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