Tuesday, November 23, 2010
Our team at OPEN MINDS has recently been having some robust discussions about the challenges to building a service delivery organization with a good management team and experienced clinical staff. The theme of many of our discussions is that most managers in the field don’t seem to know what management is. . . (FYI, the Drucker definition of management is that managers are the “dynamic, life-giving element in every business” who are “specifically charged with making resources productive”)
I think one of the reasons for the management deficit in the field is the widespread belief that it is more important for managers to have clinical knowledge than management knowledge. This leads to the promotion of staff members to management positions based on their clinical skills – not on their potential to be great managers.
Many sets of regulations contribute to this problem. Often licensing requirements demand that administrative positions be filled by someone with a clinical degree and/or credentials. This creates a natural organizational “preference” for managers with a clinical background. Unfortunately, I’ve never seen licensing criteria that require managers and administrators have formal management education.
At the same time, current fee-for-service reimbursements are reinforcing the clinician-to-manager career path. An organization can maximize their profits by using the lowest paid clinical team member to provide the service. From a profit perspective, an organization is better off hiring new inexperienced clinical team members at entry-level salaries, rather than increasing the salaries of its more experienced team members.
This leads clinical staff to conclude (and rightly so) that the best way to increase compensation is to seek a “promotion” to a management position – even if they lack the appropriate skills or an interest in management. It is a perverse self-reinforcing cycle. The solution is that management teams need to step back and look at the organization’s “big picture” – realize the ‘cost’ of promoting managers who can’t manage and the loss of clinical talent that happens without a clinical career ladder.
I appreciate your thoughts about the impediments to creating great managers in the field, and your suggestions for addressing this critical issue – please contact me at firstname.lastname@example.org.
Vice President of Business Operations,
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