As someone who creates transfusion-related case studies, including those in soft sciences* such as management and education (e.g, Case A8: Severe hemolytic transfusion reaction involving a student), I was naturally drawn to the journal's case study.
* disciplines based on qualitative (not quantitative) analysis of data or research that uses more subjective and difficult-to-control measures and designs and depends on conjectureEach issue JBSM will feature a fictional case based on real events with analysis by invited blood center managers and others. The purpose of the cases is to foster professional development for new and experienced managers.
"The Case of the Overworked Technical Director"
The first case—The Case of the Overworked Technical Director—illustrates the challenges that can occur when employees with technical backgrounds make the transition to management. Based on the discussion, the case could just as easily been called "The Case of the Incompetent Technical Director."
I encourage readers to obtain a copy of JBSM to review the case in depth.
In brief, CM, a lab technologist with 12 years experience at a blood center, has been in the job of Director of Technical Operations for 6 months with responsibility for four areas: testing, manufacturing, hospital services, and the reference lab. He is performing poorly. He is late with numerous managerial reports, budgets, performance evaluations, etc., and spends time on the bench after hours and on weekends helping out with three unfilled staff vacancies.
The JBSM editor invited three people** to analyse the case by responding to these questions: What do you see as the problem in this case? What advice would you give CM's immediate supervisor, the blood center Chief Operating Officer (COO)?
** two presidents & CEOs of blood centres and a member of the US Army's Medical Service Corps taking a PhDThe commentators have much to say, which can be distilled to
- set clear performance expectations and provide timely feedback for failures
- reinforce confidence in the person
- provide training, coaching, and mentoring
- reassign if performance does not improve
The case's commentators present the standard menu of how to improve staff performance. Moreover, they take it for granted that managers are expected to set priorities and meet deadlines regardless of events around them.
- No one questioned whether the facility was understaffed and if there were casual or part-time staff whom CM could ask to cover vacancies until they were filled.
- No one wondered whether the center's organizational chart had significant gaps at the supervisory level and whether there were supervisors between CM and the trench workers who could be asked to help prepare reports.
- No one discussed whether the COO performed incompetently by not providing adequate expectations, feedback, and training and allowing this to continue for half a year. They said that the COO "should have" set expectations, etc., but that's as far as they go. Perhaps the COO needs training?
- No one asked if the CEO knew that the COO had been ignoring a problem for 6 months.
When things go wrong, those at the top often tend to focus on the failings of those at the middle and lower echelons without questioning the related performance of top managers, i.e., themselves. It's human nature but not productive. Dilbert's view:
The commentators also tended to focus on the individual and his shortcomings rather than considering a root-cause-analysis approach to assess if there were systemic failings in the organization. In this case, it's likely that there are systemic problems.
Musings On Incompetence in General - The Peter Principle (PP)
This case models the PP developed by education professor Dr. Laurence Peter that "every employee tends to rise to his or her level of incompetence."
Peter's Corollary: The PP has a corollary, roughly stated as,
"In time, every position tends to be occupied by an employee who is incompetent to carry out duties and thus work is accomplished by those who have not yet reached their level of incompetence."
In the TM lab world the PP is seen in two areas:
- As in this JBSM case study, technical staff who are promoted to management on the basis of longevity and a history of sound technical performance, regardless of leadership, managerial, communication, and people skills.
- Pathologists, sometimes anatomic pathologists with little or no clinical pathology training and experience, and PhD scientists who direct and manage clinical laboratories and blood centres, regardless of any aptitude for, or education in, management and leadership.
As for management and leadership skills, think of all the pathologists and PhD level doctoral scientists that you know who direct blood centres and clinical labs. They are usually very competent physicians and researchers. But what about management skills? For example:
- Do they typically have strong interpersonal and people management skills?
- Exemplary oral and written communication skills, which includes listening not just telling?
- Are they good motivators of people?
- Team players who value the experience and expertise of other health professionals?
- Passionate about the vision they see for the organization, a vision that captures the imagination of employees?
Just like technical staff, MDs and PhDs were not educated and trained in these skills and are unlikely to gain them by osmosis from merely being in the job.
BOTTOM LINE
Challenges can occur when employees with technical backgrounds make the transition to management AND also when employees with clinical and scientific backgrounds make the transition to management.
- Incompetence is an equal-opportunity failing that knows no professional boundaries.
- Our little boxes, whether technical, medical, or scientific should not constrain us from examing the big picture and critically analysing our role in contributing to any systemic management problems.
When discussing the PP and incompetence, one cannot help but mention the DP, a satirical observation by Scott Adams that companies tend to promote least-competent employees to management to limit the damage they can do. In the Dilbert strip of February 5, 1995 Dogbert expresses the DP in its extreme:
Just for Fun: A few of my favorite Dilbert strips
Multitasking (Aug. 3, 2009)
First human to fail the Turing Test (Mar. 30, 2008) [ Turing test ]
Passwords for morons (Jan. 17, 2007)
Joy of training (Dec. 26, 2006)
Abuse of meetings (Aug. 16, 2004)
Dealing with managers (Aug. 7, 2003)
How to thwart useless meetings (Aug. 26, 2001)
LITTLE BOXES
Finally, here's an old ditty sung by Pete Seeger, an American folk music legend.
As always, the views expressed are mine alone. Comments are most welcome BUT, due to excessive spam, please e-mail me personally or use the address in the newsletter notice.
