We were sitting by the lake, catching up on each other’s lives while the kids did cannonballs off the swimming float. Suddenly, my old friend Michelle picked up a stick and began drawing a diagram in the sand to illustrate a story.
She's an ER nurse at a small hospital in an industrial town and told me about an incident that wouldn’t let her alone. A few weeks back, Rob (a worker from the plant) came in, having scraped himself on a piece of something jagged. Rob’s wound needed to be cleaned up and documented for any workers' compensation claim. A couple hours later he came back with the wound much more inflamed and sore.
Michelle guessed it was a flesh-eating disease and shared her diagnosis with the on-duty intern, Steve. But Steve, an “almost-doctor," hadn’t seen it before, so he discounted it, changed the dressing, gave Rob antibiotics and sent him home. But Rob came back again, this time with fever, chills, spreading redness and swelling. Again, Michelle made her case to the new “almost-doctor” on duty, Emile (different shifts), but Emile rejected Michelle's diagnosis. Ultimately, Rob was flown by air ambulance to the nearest major hospital for surgery on the flesh-eating disease, which had taken a good part of his arm.
As Michelle recounted the story she became more and more angry, trying to understand how this happened and what she could have done differently. Just so you know, Michelle’s a pretty forceful person, so it wasn’t reticence that tanked her.
What dynamics jump out at you in this story? Some are obvious, others less so. But this is an all too familiar case where leaders can’t get out of their own way because they are blinded by their own power. The real challenge for organizations and the leaders that run them is to create a culture that encourages all team members to use their expert power and credibility to make things better. Organizations that can leverage the knowledge and experience of all their employees have a huge competitive advantage because knowledge is constantly making itself obsolete, but the people who possess it aren’t.
To influence and transform the prevailing way of doing things, we need to look at power. Power, such as positional power and expert power, underpins every interaction and social relationship in organizations. Power is the ability to mobilize resources to get things done. Effective leaders positively use their power to influence the behaviors, intentions, attitudes, beliefs, emotions and values of their team members. In an environment such as healthcare — with its distinct hierarchies, inter-professional turf wars and credential one-upmanship — it’s even more difficult to engender the kind of leadership that would have made the difference in this story.
It’s definitely worth leaders valuing and relying on the knowledge and expertise of their direct reports. There is a positive relationship between expert power and the knowledge, usage and acquisition of team members. In other words, when leaders use their credibility rather than their positional power to foster an environment where their direct reports are encouraged to use their expertise, experience and credibility, more knowledge is created, used and shared. This ultimately leads to a competitive advantage over other organizations.
So what were the factors that gave the flesh-eating disease an open highway? Both Steve and Emile, the “almost-doctors," relied on their positional power and ignored the expert power of their colleague, Michelle. When leaders insist that their organization runs more smoothly with everyone staying in their own place, knowledge usage stagnates, positive power diminishes, and negative power takes over. Instead, leaders must leverage their personal power -- specifically their credibility -- and encourage their teams to use their own skills, talents, and expertise to generate new knowledge and share it with their colleagues. This creates a sustainable competitive advantage.