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As a manager you’re expected to be many different things – the master problem-solver, the coach and nurturer of talent, the ambassador of change and above all, the inspiring leader. Your list of responsibilities can be overwhelming and it’s hard to know whether it’s best to be an autocratic manager (“Do as I say!”) or laissez-faire (“If you need help, you know where to find me!”).
The answer is: there’s no right answer. The appropriate style will vary depending on the team you are managing, your personality, the wider organisation, and the particular problem you’re facing. Generally, the problems you face as a manager can be categorised into three groups – critical, tame and wicked.
Once you identify what type of problem you’re facing, you’ll be able to match it with the best management or leadership style.
The classic example of this, in a healthcare setting, is cardiac arrest: you don’t have time for someone to say, “Now, I’d like to hear everybody’s thoughts on how we’re going to handle this.” The leader’s task is to ensure everyone understands their role in the team and is ready to act immediately.
Critical problem = commanding style
The roles and steps required to solve the problem can be assigned and practised in advance, and they respond best to a commanding style.
A tame problem might be a complicated discharge for an elderly patient. Ensuring that all the relevant agencies are involved to meet their complex needs might be a headache, but you know it can be done, and you will reach a stage where the task is complete. The leader’s task is to ensure everyone understands exactly what support they need to provide, and when.
Tame problem = managerial style
To solve a tame problem you’ll need to balance different concerns and work out how multiple strands relate, in what order they need to be tackled, and by whom. Tame problems respond best to an organised managerial style.
This problem might be managing a patient with multiple co-morbidities, or redesigning a service in a deprived area where many of the patients’ needs are as much social as they are medical. It may not be possible to solve this problem completely, but you can improve it.
Wicked problem = leadership style
These problems respond best to a “leading” style which emphasises team members’ autonomy and responsibility. This might mean empowering different professionals to try different approaches, assessing their success, then bringing people together to discuss and establish best practice. The leader’s task is not to solve the problem directly, but to ensure the right people are focussed on the problem and to facilitate cooperation.
What kinds of problem do you face in your role, and are they changing? Write your comments below or join me at a BMA Management Essentials workshop which is a space to discuss your challenges with other clinicians and to pick up tips, models and ideas to help you improve your management practice. Book a place today.
Mary Macfarlane is a medical careers consultant at the BMA.
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