I work in healthcare. Specifically, I work as an Insurance Coordinator for a very large international dialysis provider. Basically, I help patients in our clinics get insurance if they need it, apply for grants to help them afford it, manage the grants to make sure they get paid on time, and apply for indigent waivers for those that don’t qualify for anything. The point of my job to the patients is to benefit the patient’s health both physically and financially. The point of my job to my employer is financially healthy dialysis clinics. The point to me is both; I really do care about both. While the specifics of what I do everyday and I how I feel about them are not necessarily pertinent to this blog topic, my position within the company really got me thinking about the different team dynamics I deal with on daily basis and the enormous challenges that make leading a team within such an organization a Sisyphean task.
Northouse defines a team as “a type of organizational group that is composed of members who are independent, who share common goals, and who must coordinate their activities to accomplish those goals” (2016). As anyone who works for a large, complex organization will tell you there is always a common goal, a hierarchical organization of team members, and a multitude of overlapping teams with individual goals designed to ultimately meet the common goal, usually whatever the companies mission statement is on their web page. This type of complexity can either be incredibly efficient, or completely inefficient depending, essentially, on the team leaders. Here’s an example of the type of complexity I’m talking about. I go to 12 different dialysis centers. Each center has a Director of Operations, a Clinic Manager, a Social Worker, a Dietician, a staff of nurses, technicians, and physicians, a medical secretary, and me, the Insurance Coordinator. Within the clinic, all of these disciplines are part of the clinic team. They all report to the Clinic Manager, who reports to the Director of Operations (who reports to a VP etc…). Each clinic staff is a large complex team all by itself. But to complicate the hierarchy even further, each individual discipline also reports to a larger department within the organization. Social Workers report up the Social Work leadership tree, Dieticians up the dietary tree, and me, up the Insurance Coordinator branch of the finance tree. Additionally, there are dozens of different departments that each clinic relies on to function that have their own structures all together, such as centralized billing departments, admissions departments, hospital liaisons, accounting, managed care, real estate, credentialing, human resources, and contracting to name a few. As you can imagine, there can be a lot of conflicting value placed on daily tasks and goals because there are a lot of conflicts within and among team leadership. In order for it all to function, let alone excel, effective teams are really key.
The Hill Model for Team Leadership asserts that a team leader is responsible for the effectiveness of a team and that success begins at the top of the model with leadership decision and results at the bottom of the model in a level of team effectiveness (Northouse, 2016). I do see this model reflected in the various clinics that I work in and in my own branch of the finance department. A team leader’s internal and external action choices, where they focus their energy, how they manage conflict, how they choose to develop their teams skills and performance, whether they are constructive, collaborative, knowledgeable, their level of organization, and the behaviors they model all mean something when it comes to outcomes. It’s very clear when we sit in monthly meetings to discuss quality and performance and every clinic goes through their power point presentation. There are always ebbs and flows in the various categories that we use to measure performance, quality, and patient satisfaction. The challenge for the team leaders is to successfully meet those challenges as they arise and coordinate their teams to function most effectively in as many areas as possible. When I think of the complexity of this task in terms of the larger organizational picture I have a great deal of respect for the team leaders who do it successfully almost in spite of all the interdepartmental push and pull for priority.
The most successful teams have leaders who are process oriented and work to constantly improve processes and address their weak points in their own clinics. They are also strong in at least a few of the Eight Characteristics of Excellence as defined by the Hill Model: having a clear and elevating goal, a results driven structure, competent team members, unified commitment from the team, a collaborative climate, high standards of excellence, external support and recognition, and principled leadership (Northouse, 2016). From my perspective I’m very glad to be able to float from place to place and operate on the periphery of so many teams – some more functional and successful than others. I enjoy being able to operate somewhat independently in an organization in which the sheer volume of department titles comprises a virtual interdepartmental communication nightmare. And I admit it’s very easy to roll your eyes a little when you go to a seminar and they give you the “rah rah, go team!“ speech in a corporate setting, and believe me I have and probably will again. But taking a closer look at the individual team leaders that I work with and what they must contend with to keep a team motivated, focused, structured, and effective is no small task; especially inside the chaos of a giant corporate structure. Especially in the arena of healthcare, where lives are dependent upon the clinic team being on top of their game and running like a well oiled machine.
Northouse, P. G. (2016). Leadership: Theory and practice (7th ed.). Thousand Oaks, CA: Sage Publications.