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I am constantly reminded of the old joke, which asks how many psychologists it takes to change a light bulb. “One” goes the answer, “but the light bulb really has to want to change.” My latest reminder came when I was working with the senior leaders of a health care system. The COO had asked for help. The stated problem: the middle managers were not feeling (or acting) empowered. It’s an interesting and important problem so I decided to help.
I worked with the group of department heads. They had felt as if they had very little voice in the system, with little impact on the issues that mattered to the system. The lack of voice was exacerbated by their sense of isolation from one another. My work thus began by helping them understand several key points: (1) In order to have a voice in the affairs of the organization, they needed to figure out what they would use their voice to say that the system needed to hear; (2) No one would simply hand them the megaphone; they needed to step up into their leadership roles on behalf of system mission and goals; and (3) They needed to do this together rather than separately.
While some of the middle managers understood and accepted these premises more easily than others, the group decided to move ahead. We began by identifying an issue that linked them together, such that they could begin to create the inter-departmental relationships necessary to develop a compelling platform from which to speak collectively. They focused on staff retention. Each department was experiencing a particular problem: they trained good people who then left for higher-paying jobs in nearby health care systems sooner than they ought to have. This was partly a matter of money, yes, but it was also a matter of the leaders not figuring out how to keep talented young people longer by providing them with opportunities for challenge, growth, and leadership. They wanted to create programs and initiatives to strengthen retention.
The work went well. The middle managers started to collaborate effectively, authorizing and staying connected with cross-departmental task forces. The task forces collected and analyzed data, developed recommendations with appropriate financial calculations, and got the buy-in of the larger middle manager group. The group presented their recommendations to the senior managers, who liked the work and the ideas. They then told the middle managers that they were not able to release funds for the new initiatives. I met with the senior managers. They explained that they themselves were not empowered. They felt that they had little voice. They felt isolated and disconnected from one another. It sounded familiar.
I met with the COO. He explained to me that no one was empowered, including himself. The CEO ran “a tight ship.” In fact, it was the CEO’s grip on the system that was tight. I asked the COO if the real reason that I was there was to intervene with the CEO. He admitted that, yes, he hoped that my work with the middle managers would lead to changing the CEO and his style. The open secret in the system was that the CEO—a slash-and-burn corporate savior who saved the system years ago by cutting programs and staff—was the source of disempowerment and disengagement. The underlying wish for bringing me in was that I would expose that secret—to mention to the emperor that he was, indeed, naked.
I met with the CEO. I told him about the work with the middle managers and the response of the senior leaders. And I told him that I seemed to have been brought in partly to help him change his leadership style, from a leader who made hard decision to stem crises to a leader who authorized, engaged and empowered others. I asked him whether he was interested in changing his style along those lines. “No,” he told me, “I am not.” There was more talk, but in truth, the conversation was over. And so was my engagement with the system. The COO was told that empowering the middle managers was no longer the priority, given yet another looming financial crisis. The consultation was terminated several weeks after my conversation with the CEO.
The lesson? My work should have been to help the COO and senior managers get to the place where they could name the open secret and figure out how to help the CEO understand the costs of his leadership style, given the needs of the system. Sure, the consultant is expendable, which is why he or she is hired to say what cannot easily be said. And yes, the CEO—the light bulb in the story—wanted everyone to come to him for money, information, and permission. But unless members become able to name openly what they all know, and work with the fallout, there will always be workarounds, disempowerment, skulking, and a great deal of unproductivity and unhappiness. The light bulb will burn out, cast little light, and trap everyone in darkness. That’s an unpleasant place to live and work.
