The HeartBeat of Case Management The Importance of Leadership Followership Teresa M. Treiger, RN-BC, MA, CHCQM-CM/TOC, CCM
A
bout a year ago, I read an article titled “The Golden Rule of Leadership” in Psychology Today. The following passage struck a chord, or perhaps a nerve, and has remained echoing within me ever since, “Being the leader does not always mean you deserve to be the leader. And just because you are the leader does not mean you have a right to lead others. You have been granted the privilege to lead others. Being the leader means that you have been placed in a position to serve others—your customers, investors, your team” (Sindell & Sindell, 2013). Although these are but a few sentences, the words made me ponder on what real leadership is and how it relates to those of us who identify ourselves as a case manager. For me, I recognize that my clients place me in various leadership positions. A patient-client confers on me the right to foster them and/or their caregiver through the complexity of our health care system. As a consultant, my clients pay me to lead via educational programs and through organizational changes. As a public figure, I was expected to lead by representing a wide spectrum of case managers rather than the concerns of a few or those of special interest groups. I continue to hold myself to that standard to advance the recognition of professional case management rather than focus on a specific brand or market segment. But even more basic to my analysis is how do I personify leadership internally? How do I exhibit leadership in my day-to-day interactions? And Address correspondence to Teresa M. Treiger, RN-BC, MA, CHCQM-CM/TOC, CCM, Ascent Care Management, LLC, 3 Mosesso Drive, Holbrook, MA 02343 ([email protected]).
The author reports no conflicts of interest. DOI: 10.1097/NCM.0000000000000019
subsequently, am I worthy of the privilege of leadership? The more I reflect on these questions, the more I believe them to be essential queries worthy of every case manager’s consideration. Maybe you do not think of yourself as a “leader.” Could it be that you are confined to a traditional bureaucratic definition? Well, it is time to do some reframing. Bona fide leadership has nothing to do with an organizational chart, that reflects only a management structure. We need to deconstruct existing beliefs about leadership, because it is not about being the president or manager or director. It is about the knowledge and qualities you possess that makes you worthy of leading. If you rely on a title as a means to create a locus of power and control, think again. People will not follow you if you do not demonstrate reasons for them to do so. Although they may take a few steps with you, soon enough they will wise up and realize that their loyalties lie elsewhere; they fall off the pace and eventually set a different course. Let us consider what does leadership mean. Chemers (1997) defines leadership as “a process of social influence in which one person can enlist the aid and support of others in the accomplishment of a common task.” Peter Drucker espoused that “management is doing things right; leadership is doing the right things.” I am not sure that management and the word “right” always coexist harmoniously but I do subscribe to Drucker’s perspective. Having worked in a few large corporations, I have witnessed far too many bad managers in action. Some were (and probably still are) candidates for the “Horrible Boss Hall of Fame.” You might recognize some of these archetypes: • The one more likely to throw you under a bus rather than accept responsibility for his or her own mistake • The one taking credit for your hard work rather than sharing it • The one who insists you work over the weekend on a presentation that he or she is responsible to deliver • The one who liberates your innovative idea as his or her own to advance his or her career Vol. 19/No. 2
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Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
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The HeartBeat of Case Management It may help to sharpen our focus if we look at leadership from a different angle. Let us consider it from the perspective of followership. What is followership? Bersin (2013) identifies three points of why we follow others: 1. We follow people with character because they have a moral compass. 2. We follow people who help us grow because they respect and bring out the best in each of us, help us do great things, and help us understand how to overcome our own weaknesses. 3. We follow people who have their own unique strengths and weaknesses, which make them real. Initially, I expect that a client will follow me because of the implied relationship within which we operate. We create a dynamic with our clients to facilitate the process of assessment, planning, implementation, coordination, monitoring, evaluation, and eventually disengagement. As we delve deeper, trust is established. There is mutual discovery of needs, barriers, strengths, and opportunities. Agreement is reached as to a plan and identified deliverables are fulfilled. At some point along the way, the interaction goes from being that of an obligation to one of an authentic desire to follow. When that tipping point is reached, we realize we have a client relationship that is very special. So what does this all mean? Well for me, it means maintaining a level of professional integrity so that
it is worth the time and effort of followership, be it by a peer, a patient-client, or an institutional engagement. If I believe people will accept something simply because of who I am or do something because I tell them to, it is time for me to do a reality check. The present-day client seeks a reason to follow—some evidence that the direction they choose is worthy of their loyalty and commitment. If I do not display character, do not demonstrate respect for others, ignore my own personal shortcomings, or consider myself invulnerable simply because of who I am or the position I occupy, it will lead to my ultimate failure. As professional case managers, we must turn this leadership equation around and consider it from the perspective of followership. Regardless of job, educational background, experience, or setting of practice, instead of thinking you are a good leader consider the question: Are you worthy of being followed?
REFERENCES Bersin, J. (2013). To understand leadership, study “Followership.” Retrieved from http://www.bersin.com/blog/ post.aspx?id=cd24d918-3848-4223-96ee-b01de41 d5eec Chemers, M. (1997). An integrative theory of leadership. Mahwah, NJ: Lawrence Erlbaum Associates, Inc. Sindell, M., & Sindell, T. H. (2013). The golden rule of leadership. Retrieved from http://www.psychologytoday. com/blog/the-end-work-you-know-it/201306/thegolden-rule-leadership
Teresa M. Treiger, RN-BC, MA, CHCQM-CM/TOC, CCM, Principal of Ascent Care Management, LLC, has worked in settings across the health care continuum for more than 25 years. A recognized expert in case management strategies, Teri has published on case management, technology, professionalism, and transition of care. She served as a primary investigator in the 2010 HIT Survey and was a team member for the 2012 survey update. Teri is on the National Transition of Care Coalition Board of Directors and served as the National President of the Case Management Society of America 2010–2011. Her current work encompasses writing, professional education, public speaking, and consulting in the development of integrated care coordination, transition of care, and case management programs and technology solutions.
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Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
HeartBeat.indd 94
1/23/14 2:41 AM
A
bout a year ago, I read an article titled “The Golden Rule of Leadership” in Psychology Today. The following passage struck a chord, or perhaps a nerve, and has remained echoing within me ever since, “Being the leader does not always mean you deserve to be the leader. And just because you are the leader does not mean you have a right to lead others. You have been granted the privilege to lead others. Being the leader means that you have been placed in a position to serve others—your customers, investors, your team” (Sindell & Sindell, 2013). Although these are but a few sentences, the words made me ponder on what real leadership is and how it relates to those of us who identify ourselves as a case manager. For me, I recognize that my clients place me in various leadership positions. A patient-client confers on me the right to foster them and/or their caregiver through the complexity of our health care system. As a consultant, my clients pay me to lead via educational programs and through organizational changes. As a public figure, I was expected to lead by representing a wide spectrum of case managers rather than the concerns of a few or those of special interest groups. I continue to hold myself to that standard to advance the recognition of professional case management rather than focus on a specific brand or market segment. But even more basic to my analysis is how do I personify leadership internally? How do I exhibit leadership in my day-to-day interactions? And Address correspondence to Teresa M. Treiger, RN-BC, MA, CHCQM-CM/TOC, CCM, Ascent Care Management, LLC, 3 Mosesso Drive, Holbrook, MA 02343 ([email protected]).
The author reports no conflicts of interest. DOI: 10.1097/NCM.0000000000000019
subsequently, am I worthy of the privilege of leadership? The more I reflect on these questions, the more I believe them to be essential queries worthy of every case manager’s consideration. Maybe you do not think of yourself as a “leader.” Could it be that you are confined to a traditional bureaucratic definition? Well, it is time to do some reframing. Bona fide leadership has nothing to do with an organizational chart, that reflects only a management structure. We need to deconstruct existing beliefs about leadership, because it is not about being the president or manager or director. It is about the knowledge and qualities you possess that makes you worthy of leading. If you rely on a title as a means to create a locus of power and control, think again. People will not follow you if you do not demonstrate reasons for them to do so. Although they may take a few steps with you, soon enough they will wise up and realize that their loyalties lie elsewhere; they fall off the pace and eventually set a different course. Let us consider what does leadership mean. Chemers (1997) defines leadership as “a process of social influence in which one person can enlist the aid and support of others in the accomplishment of a common task.” Peter Drucker espoused that “management is doing things right; leadership is doing the right things.” I am not sure that management and the word “right” always coexist harmoniously but I do subscribe to Drucker’s perspective. Having worked in a few large corporations, I have witnessed far too many bad managers in action. Some were (and probably still are) candidates for the “Horrible Boss Hall of Fame.” You might recognize some of these archetypes: • The one more likely to throw you under a bus rather than accept responsibility for his or her own mistake • The one taking credit for your hard work rather than sharing it • The one who insists you work over the weekend on a presentation that he or she is responsible to deliver • The one who liberates your innovative idea as his or her own to advance his or her career Vol. 19/No. 2
Professional Case Management 93
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
HeartBeat.indd 93
1/23/14 2:41 AM
The HeartBeat of Case Management It may help to sharpen our focus if we look at leadership from a different angle. Let us consider it from the perspective of followership. What is followership? Bersin (2013) identifies three points of why we follow others: 1. We follow people with character because they have a moral compass. 2. We follow people who help us grow because they respect and bring out the best in each of us, help us do great things, and help us understand how to overcome our own weaknesses. 3. We follow people who have their own unique strengths and weaknesses, which make them real. Initially, I expect that a client will follow me because of the implied relationship within which we operate. We create a dynamic with our clients to facilitate the process of assessment, planning, implementation, coordination, monitoring, evaluation, and eventually disengagement. As we delve deeper, trust is established. There is mutual discovery of needs, barriers, strengths, and opportunities. Agreement is reached as to a plan and identified deliverables are fulfilled. At some point along the way, the interaction goes from being that of an obligation to one of an authentic desire to follow. When that tipping point is reached, we realize we have a client relationship that is very special. So what does this all mean? Well for me, it means maintaining a level of professional integrity so that
it is worth the time and effort of followership, be it by a peer, a patient-client, or an institutional engagement. If I believe people will accept something simply because of who I am or do something because I tell them to, it is time for me to do a reality check. The present-day client seeks a reason to follow—some evidence that the direction they choose is worthy of their loyalty and commitment. If I do not display character, do not demonstrate respect for others, ignore my own personal shortcomings, or consider myself invulnerable simply because of who I am or the position I occupy, it will lead to my ultimate failure. As professional case managers, we must turn this leadership equation around and consider it from the perspective of followership. Regardless of job, educational background, experience, or setting of practice, instead of thinking you are a good leader consider the question: Are you worthy of being followed?
REFERENCES Bersin, J. (2013). To understand leadership, study “Followership.” Retrieved from http://www.bersin.com/blog/ post.aspx?id=cd24d918-3848-4223-96ee-b01de41 d5eec Chemers, M. (1997). An integrative theory of leadership. Mahwah, NJ: Lawrence Erlbaum Associates, Inc. Sindell, M., & Sindell, T. H. (2013). The golden rule of leadership. Retrieved from http://www.psychologytoday. com/blog/the-end-work-you-know-it/201306/thegolden-rule-leadership
Teresa M. Treiger, RN-BC, MA, CHCQM-CM/TOC, CCM, Principal of Ascent Care Management, LLC, has worked in settings across the health care continuum for more than 25 years. A recognized expert in case management strategies, Teri has published on case management, technology, professionalism, and transition of care. She served as a primary investigator in the 2010 HIT Survey and was a team member for the 2012 survey update. Teri is on the National Transition of Care Coalition Board of Directors and served as the National President of the Case Management Society of America 2010–2011. Her current work encompasses writing, professional education, public speaking, and consulting in the development of integrated care coordination, transition of care, and case management programs and technology solutions.
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Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
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1/23/14 2:41 AM
