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Saturday, February 27, 2016

#HIMSS16, up next

On my way shortly over to my old stomping grounds Las Vegas and the HIMSS 2016 Conference. Should be an interesting week. I'll be particularly interested in topics such as
  • Data exchange / "Interoperability";
  • Health IT Usability ("UX" and UCD");
    Security and Privacy;
  • Markets / Venture Capital in HIT;
  • Workflow;
  • "Omics" / "Precision Medicine";
  • Policy trends;
  • Clinician burnout;
  • "Leadership"
to cite just a few.

Speaking of "leadership," just read this in my New Yorker:

Shut Up and Sit Down
Why the leadership industry rules.


...For a long time, leadership experts remained nostalgic for old-type leaders. In the nineteenth century, books such as Thomas Carlyle’s “On Heroes, Hero-Worship, and the Heroic in History” attempted to isolate, through historical surveys, the character traits of “great men”; well into the twentieth century, many scholars elaborated on a “trait model” of leadership. They proposed that leaders possessed certain personality traits—courage, decisiveness, intelligence, attractiveness, and so on—that made them intrinsically followable, bureaucracy be damned. A great deal of time was spent thinking about how leadership qualities might be detected, so that leaders could be identified in advance of their elevation.

The trait model endures. Many leadership gurus talk about Jack Welch and Steve Jobs as people with the right stuff to lead. But plenty of people with the right stuff fail as leaders. In a 2002 book called “Searching for a Corporate Savior: The Irrational Quest for Charismatic C.E.O.s,” Rakesh Khurana, a professor at Harvard Business School, took stock of corporate America’s investment in the trait model of leadership. Khurana found that many companies passed over good internal candidates for C.E.O. in favor of “messiah” figures with exceptional charisma...

By the mid-twentieth century, alternatives to the trait model of leadership emerged. Experts have studied leadership psychologically, sociologically, and even “existentially-experientially.” Many have settled on a “process-based” approach. They’ve come to see leadership as something that unfolds in stages. A problem emerges, a leader is selected, a goal is developed, a team is assembled, the goal is reĂ«valuated, and so on. From this perspective, the working life of an organization begins to look like an unending sequence of leadership events. A leader’s job is to shepherd the team through the leadership process.

Process models favor the bureaucratic over the charismatic, and have a number of advantages over trait models. For one thing, they suggest that leadership is learnable: you just observe the process. For another, they’re capable of differentiating between the designated leader—often a broad-shouldered white guy with a power tie and a corner office—and the actual, “emergent” leaders around whom, at particular moments, events coalesce. (Research shows that workplaces often function because of unrecognized emergent leaders, many of them women.) Most fundamentally, process models acknowledge that “being a leader” isn’t an identity but, rather, a set of actions. It’s not someone you are. It’s something you do...
Nice that he cites Stanford's Dr. Jeffrey Pfeffer, whom I cited at some length in a prior post, "What exactly is "Leadership," anyway?"
Reading “Indispensable” and other works from the field of leadership studies, you can get the impression that leaders, like authors, have been deconstructed. Leaders used to be titanic and individual; now they’re faceless guiders of processes. Once, only the people in charge could lead; now anyone can lead “emergently.” The focus has shifted from the small number of people who have been designated as leaders to the background systems that produce and select leaders in the first place.

Leaders, moreover, used to command; now they suggest. Conceptually, at least, leadership and power have been decoupled. In 1927, Personnel Journal cited an expert who defined leadership as “the ability to impress the will of the leader on those led and induce obedience, respect, loyalty, and cooperation.” But after the Second World War the concept of leadership softened. Leaders, it was said, weren’t dictators or tyrants; instead of ordering us around, they influenced, motivated, and inspired us. A distinction began to emerge between leadership, which was said to be inspirational, and management, which was seen as more punitive. (As the business books have it, “Managers require, leaders inspire.”) The distinction persists today. On diagrams of the leadership process, “punishing disobedient subordinates” rarely appears.

This development has helped make the leadership industry possible, by making the idea of leadership more appealing. The notion that you don’t have to be officially powerful to lead has allowed more people to think of themselves as leaders. Leaders, it’s said, “elevate,” “empower,” and “inspire” those around them to do “extraordinary” things. But not everyone is happy with this cheerful vision. In “Leadership BS,” a book published last year, Jeffrey Pfeffer, a professor at Stanford’s Graduate School of Business, identifies five virtues that are almost universally praised by popular leadership writers—modesty, authenticity, truthfulness, trustworthiness, and selflessness—and argues that most real-world leaders ignore these virtues. (If anything, they tend to be narcissistic, back-stabbing, self-promoting shape-shifters.) To Pfeffer, the leadership industry is Orwellian. Its cumulative effect is to obscure the degree to which companies are poorly and selfishly run for the benefit of the powerful people in charge. That’s why bosses spend billions on leadership seminars: they make corporate life look like “The West Wing,” even though, in reality, it’s more like “House of Cards..."
apropos of our current mauldlin Presidential primary election campaign season,

People who fetishize leadership sometimes find themselves longing for crisis. They yearn for emergency, dreaming of a doomsday to be narrowly averted. Last month, Donald Trump’s campaign released its first official TV advertisement. The ad features a procession of alarming images—the San Bernardino shooters, a crowd at passport control, the flag of Syria’s Al Nusra Front—designed to communicate the idea of a country under siege. But the ad does more than stoke fear; it also excites, because it suggests that we’ve arrived at a moment welcoming to the emergence of a strong and electrifying leader. (Trump, a voice-over explains, will “quickly cut the head off ISIS—and take their oil.”) By making America’s moment of crisis seem as big (or “huge”) as possible, Trump makes himself seem more consequential, too.

Many of today’s challenges are too complex to yield to the exercise of leadership alone. Even so, we are inclined to see the problems of the present in terms of crises and leaders. “Crises of leadership are the order of the day at the beginning of the twenty-first century,” Elizabeth Samet writes, in the introduction to “Leadership: Essential Writings by Our Greatest Thinkers” (Norton). “If we live in a world of crisis,” she continues, “we also live in a world that romanticizes crisis—that finds in it fodder for an addiction to the twenty-four-hour news cycle, multiple information streams, and constant stimulation.” Samet believes that our growing addiction to the narrative of crisis has gone hand in hand with an increasing veneration of leadership—a veneration that leaves us vulnerable to “the false prophets, the smooth operators, the gangsters, and the demagogues” who say they can save us. She quotes John Adams, who suggested, in a letter to a friend, that there was something both undemocratic and unwise in the lionization of leadership. The country won’t improve, Adams wrote, until the people begin to “consider themselves as the fountain of power.” He went on, “They must be taught to reverence themselves, instead of adoring their servants, their generals, admirals, bishops, and statesmen.” It can be dangerous to decide that you need to be led...
Good article, read all of it.
...sociologist Max Weber distinguished between the “charismatic” leadership of traditional societies and the “bureaucratic” leadership on offer in the industrialized world. In the past, Weber wrote, the world revolved around “old-type” rulers, who could be “moved by personal sympathy and favor, by grace and gratitude.” Modern rulers, by contrast, are supposed to be emotionally detached; they work within a network of laws and systems designed to eliminate nonrational considerations like love and hatred. Weber was getting at a core problem for modern leaders. How can the performance of bureaucratic tasks (such as the design of a health-care overhaul) be infused with charismatic warmth?

Also, reflecting on Tomasello, where does the adaptive utility of prosocial, empathic behavior fit in to the "leadership" concept?

Hope to see you at #HIMSS16.

Are we "Transforming Health through IT"? Or do things largely remain "Free Beer Tomorrow?"

I guess "Incremental, Albeit Lucrative Improvements in Our Vexingly Fragmented Shard-Ridden Health Care System" wouldn't cut it as a tagline.

More to come...

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