A cornerstone of leadership is the mastery of techniques for convincing people to pursue your vision. Sometimes, provided you imbue those who report to you with a sense of urgency and shared passion, your ministrations will be enthusiastically supported. But most of the time such unanimity of purpose is lacking. Some of those you direct will actively dispute you, while others will be passively aggressive. Still others will be diffident or confused about what you mean and what they should do. And among your staff there will inevitably be rivalries, petty jealousies yet also productive teamwork. So how do you manage such a variety of attitudes, questions, initiatives and complaints, each of which is, in either a small or large way, a test of your capabilities as an executive?
Dialectics: Inducing Respect and Harmony
There is a range of personal styles you can bring to the task, many of them ultimately deleterious to your success. You can be overbearing or standoffish, over-forgiving or hypercritical. But one approach I have found that more often than not engenders respect and augments harmony is to couch discussion in dialectic terms.
What is "dialectics"? I am not referring here to the term dialectic materialism, a tenet of Marxist ideology. Rather I use the word in an apolitical context, defined as a dialogue between two or more people who may hold differing views, yet wish to pursue truth by seeking agreement with one another. Dialectic must be strenuously distinguished from debate, which could be defined as a dialogue in which two or more people who hold differing views wish to persuade or prove the other wrong. Characteristically, if not always formally, a debate ends in a decision. There is a loser and a winner as decided by individuals deputised for the occasion. In a debate the object is victory, whereas in a dialectic interchange the object is accommodation, consensus and acknowledgement of the legitimacy of differing positions if not the establishment of agreement.
Applying Dialectics in the Hospital
Technique One: Distinguish Between Deliberate Intention and Accidental ConsequenceHow does dialectics play out in the day-today work of a department head or manager in a hospital or any organisation for that matter? Let me give some examples. Consider the terms unfair and unfortunate. They are often used interchangeably by an aggrieved petitioner. A tendency is for a bad outcome to be designated as unfair. Therefore it is to be rectified by an exaction of some sort, often in the form of blame or the issuance of a penalty. But frequently what actually went wrong is a consequence of bad luck and not mean-spiritedness. In an unfortunate circumstance, the adverse consequence is not directly a result of purposive human activity or intention but of factors inherently beyond conscious direction or manipulation. Making such a distinction is crucial in reaching agreement or at least reducing tension.
The role of the chairman is to elucidate this distinction when discord is about to be sowed so that potential combatants seeking redress come to realise that an unpleasant condition or outcome is no one's fault even if it is everyone's concern. In this situation the dialectic interjection moves the dialogue forward, avoiding unnecessarily persistent or recurrent recriminations.
Technique Two: Downplay Destructive Hyperbole Another technique of dialectic correction concerns the management of metaphor. This imposition of responsive and responsible leadership is used to manage arguments specifically to downplay the destructive intrusion of hyperbole. How many of you have heard an event characterised as a "disaster" or a "nightmare" when in fact it was only an annoyance readily endured and often correctible and corrected. But if you allow the inflammatory metaphor to be accepted not as merely referential for narrative effect but as a representative articulation of truth, then all further deliberations will be based on its supposed veracity in defining the tenor of the discussion.
Metaphor management is crucial for the focusing of ensuing exchanges because it encloses and delimits the terms of engagement. Reminding one that his or her use of such an arresting but invidious metaphor is a rhetorical extravagance that is inappropriate to form the basis of bargaining, will catch its articulator off guard. Almost always he or she will reluctantly but assuredly acknowledge that the hyperbolic reference is not a reflection of reality but instead just an emphatic statement of position. And by delegitimising the melodramatic metaphor, the discussion can proceed along a less contentious path. And by dampening the emotional byplay through an insistence on "unembroidered" claims, perhaps an understanding between the parties in dispute may be easier to achieve and a sense of congeniality more easily restored.
Technique Three: Offer Thoughtful Responses Rather than Abrupt Declarations A third example of the gentle introduction of a dialectic modus operandi upon which structured understandings can be erected is the purposeful management of conversations in which you are the protagonist. It can be accomplished by a progression of tenses in your sequential responses. The choice of verb can be vital for a productive give and take between leader and staff.
Often a Chair will not be perceived to provide full attention or adequate time to respond to entreaties and suggestions either earnestly or deviously offered by trainees, faculty or staff. Some of these proposals may be truly innovative whereas others seem helpful but are really only self-serving and still others are just ridiculous. A temptation of the Chair is to make definitive pronouncements on the spot, typically in a declarative mode. Mostly, such abruptness makes the leader seem to be brusquely dismissive or less often uncritically receptive. A frequent result is that when a proposal is given short shrift it discourages the petitioner unnecessarily and when approved hurriedly, careful thought is not given to an estimation of its unintended consequences. Physicians are typically very good at rapid decision- making with little information but often not very good when measured deliberation is called for so that a novel suggestion is given its due dispassionately. How can one avoid the pitfall of rash judgment using dialectics as an argumentative device?
First instead of declaring approval or rejection outright, cast your replies in the subjunctive tense. For example if you say: "If I do what you say, then what would happen?" is a more inviting and less threatening response than the categorical decree "No, I do not like it and that's that!" The proponent seeking your favour is not offended by the need to develop a concept further. Moreover continued discussion might engender ideas neither of you had thought about initially. And if some merit is elucidated through these subjunctive musings, then it might be profitable to move to sentences rendered in the conditional sense. For instance the next step in the evaluation may be "this notion could result in such and such" or "we should consider its anticipated and hidden eventualities." And if the examination of the initial proposal is still promising, then hortatory statements are in order in which the effort for continued development of the idea is joined but still contingent on further activity. The key words now are "let us", as in "let us investigate it some more".
Careful Phrasing Means Greater Accord
Along such a "path of tenses", an ultimate decision on merit may be delayed but the rhetorical paradigm is no longer so disconcerting or devastating as an outright rejection or as reckless as an immediate acceptance. Amity is maintained through this progressive analytic process navigated with the use of the key words such as "if then" followed by "could or would" and then by "let us". Under this schema the Chair becomes respected for his empathy, if not his eventual agreement. In this way the dialectic process helps you all get along and sometimes even get ahead.
Dialectics, of course, is not a panacea or even an anodyne for the pain of confrontation between your staff and you or between employees under your charge with you as mediator. Yet it is often a good way to avoid the destructive effects of immediate discord and prolonged resentment. Moreover, it is an effective way to get your points across while leaving your ethos as leader intact or even enhanced.