Rowitz On Leadership

The field of public health in the United States is changing as you read this blog posting. The profession of public health was very organization focused in the past. It was perceived through the lens of a governmental public health agency that not only concentrated its activities on clinical services into the 1990s but also talked of prevention and a population-based focus. Being healthy is not a silo-based activity. It requires not only the involvement of each person, it involves the support , collaboration, and involvement of many other people and organizations. I believe health promotion is a leadership issue always with an eye on future behavior. Over the last several decades, we have set health goals for the Nation for each decade. A new decade appears and we seem to start all over again with a new set of goals and expectations. For every step forward, we seem to take two steps backward. Unexpected health crises, a new pandemic, or a new problem to be addressed seems to shift our health priorities. Each type of event becomes tied to a specific health profession or health organizational silo. For example, the events of September 11, 2001 seemed to be a public health crisis and much money was allocated to build public health infrastructure through the advocacy of a preparedness approach to emergencies and other public health crises . And yet, subtle and not so subtle shifts occurred in which emergency preparedness and response seemed to become the domain of law enforcement and fire departments with public health often appearing to take a back seat.

Whether we want to admit it or not, It is not only the public health professions and their organizations that define public health. Public health is defined by the economic climate of the country, politics, economics, culture, and the possibility of global pandemics. In addition, today’s health issues also define what public health agencies are supposed to be doing today. It is also true that these contemporary issues help define our field although we sometimes drop the ball and some other profession or organization picks it up. For example, violence has been seen as a public health issue and yet we did not know how to address this issue. Public health leaders often let law enforcement, schools and other organizations pick up our dropped ball.

The field of public health is expanding in the face of health reform by governmental officials at the federal and state level. Funded public health workforce and leadership development programs are being asked to consider the training of health professionals in preventive medicine, HIV health professions , emergency preparedness, maternal and child health professionals, and community health center administrators. The argument being made is that people working in health and community clinical areas are beginning to carry out public health work at the population-based community level. This expansion of the purview of public health means that we need to reevaluate our training, research, service, community engagement activities and leadership activities in this ever changing public health environment. We need to create alliances and other mechanisms for the discussion of these issues. It will be necessary for governmental health professionals to talk to academic and public health practice leaders in concert with their professional organizations to aid in the redefining of public health in a rational manner. Business and citizen involvement may also be necessary. Our decisions today will have an impact on the future of public health for many years to come.

It seems that managers and leaders solve problems and make decisions from different thinking mindsets. Managers and leaders must be resilient and flexible enough to use the thinking approach most appropriate to a given context and set of issues. This article will explore three thinking mindsets which we can view as a continuum.

l__________________________l_______________________l

Linear                                     Systems                            Complexity

Linear thinking is dance floor thinking(See Heifetz and Linsky’s book LEADERSHIP ON THE LINE). When you are on the dance floor, you are concentrating on your partner and the dance steps. You are being careful to not bump into other couples who are dancing. This form of thinking is very detail oriented and also very structured. The linear thinking mindset tries to make connections between things. Cause and effect approaches predominate. Managers tend to use this approach on a regular basis. It is their responsibility to keep an organization running in a smooth way. They operate within the strict boundaries of the organization. It is their job to take the ideas of the leaders and make them fit into the structure of the organization. On a day to day basis, most people function in a linear world.

According to Heifetz and Linsky, when you go up to the balcony, you can see the whole dance floor. You can see the band and you can see all the dancers. In other words, you get the big picture view. You can see all the interacting parts. You can see the dancers who stumble and have difficulty with the dance steps. You are a systems thinker. The systems thinker not only sees how his or her organization is functioning, but can also see how the organization functions within the context of the community in which the organization is embedded. Managers may have trouble seeing the big picture because they are dealing with the details of the organization. Leaders are systems thinkers who see the importance of various structures on the overall functioning of the system as a whole. In my February, 2009 posting on the Leadership Change Cycle, I discussed the move from being a manager to being a leader with a stop at managerial leadership where the manager is moving beyond traditional management activities to a more people-based approach. In systems thinking, relationships become important although the relationships may carry the baggage of position, agency priorities, or cultural barriers.

Complexity thinking recognizes that most of our reality is messy and somewhat chaotic. Systems thinking concentrates too much on structure and not enough on the relationships that guide our lives. In their book A SIMPLER WAY, Wheatley and Rogers make the point that people need organization in their lives, but it takes messes to get there. Positions and structure often hold us back because they are so inflexible and rules and regulations limit our creativity. Resilience is a necessary component in complexity. Purpose and not intention drives action. Purpose brings us together and helps us to develop new relationships. It is only out of these evolving relationships that structure can play a role. Whenever new players enter a group, the structure by necessity must change. Thus, the system is a growing thing and it is ever changing. Leadership in a complex world must be synergistic and be able to adapt on a regular basis since change is the driving force in our lives.

These three thinking approaches guide us in our daily activities. A leader must understand the evolving context of his or her reality and be able to work in environments that are sometimes linear, sometimes systemic, and most often very complex.

It seems that it is necessary to stay on my soapbox for another month with another issue. Workforce development in public health and other human services fields is clearly important if our health professionals are to remain current, proactive, and improve community health outcomes over the long run. Collaboration is necessary if we are to address the critical concerns of training our colleagues. Workforce development does not belong to any one organization. Expertise does not exist in only one organization, in one consulting firm, or in one professional organization. Training needs to be seen as an evolving system like building an onion layer by layer. Each set of trainers adds a layer to the onion that leads to a more comprehensive approach to training with its important practice orientation. Thus, training and workforce development specifically must be viewed as a collaborative activity. Personal organizational agendas must not predominate in these workforce discussions. I have personally seen some governmental agencies, consulting firms, and organizations claim that they are the workforce development organization. At the federal level, each agency clearly has a role to play in adding another layer to the onion. At the professional organization level, an agency must work with multiple partners to make workforce development comprehensive and collaborative.

I have worked for almost twenty years on the training of public health leaders. Leadership development is clearly a critical component in workforce development. As health professionals, we are educated at the technical level to be expert in our chosen health professions. We are not trained to be managers or even leaders. We look for programs to teach us these skills when we move into higher administrative positions. I cannot understand how some of my professional colleagues do not see the connection between training managers and leaders as being a workforce development issue. All training is about being better at what we do. As mentioned above training of our professional colleagues is also a collaborative activity. We all learn from each others. Our training partners teach us new skills and approaches to leadership development. They teach us about new tools and resources. They offer us insights into new books with innovative approaches. I have tried to share my own experiences on this blog as well as books I have found useful, new tools that I have created for training, and special resources that my colleague friends may not know about. I also alert colleagues to other blogs and websites they may find useful. How can I be an effective trainer if I do not collaborate or learn from others.

The secret is in the collaboration if training programs are to be effective in training our colleagues. Personal agendas need to be pushed to the back burner. We need to build the workforce development onion together . We need to understand that management and leadership development programs are part of our overall workforce development agenda.

Over the last twenty years, there has been an increasing recognition that collaboration is an important component in leadership. Many training programs have added a collaboration component. A few years ago, the Robert Wood Johnson Public Health Turning Point Initiative released a training program on collaborative leadership. Over the last couple of years, I have written a couple of postings on meta-leadership which has a component stressing the need for leaders to work across organizations during emergency events. At a community level, successful change generally involves leaders from neighborhoods as well as community organizations working together. Collaboration between leaders has a synergistic effect in that the sum total of activity of these leaders tends to lead to change greater than any one leader can create. Synergistic leadership is about both short term and long term change needed to lead to improvements in the health of community members. Synergistic leaders move beyond limited collaborative activities at a local level to expanded collaborative activities using all sorts of social networking tools. True collaboration must be built on trust and a full commitment to the collaborative enterprise. Collaborators who view community from a wide angle lens have a systems view of community that aid in seeing all of the factors that impact on health and improved health outcomes.

With the importance of collaboration in mind, it is important to recognize that collaboration must be real and not just a promise without a foundation in reality. I have seen trainers and collaboration proponents who do not practice what they preach. One individual I know has built a reputation on proposing a collaboration model that many people find useful. Yet, he is so wedded to his model that he makes his approach so inaccessible to others who wish to apply his approach without his approval. He appears threatened by others who want to modify the model to better fit their reality. He preaches collaboration but is not a collaborator himself. I have also observed professional organizations who argue that the organization should promote collaboration and also speak in a unified manner to other groups and organizations. Individuals who belong to these organizations then push individual agendas which undermine the unified approach that has been proposed. I have seen academics who go into communities for research and argue that they are there to collaborate with the community and then the academic leaves when the study is over. So much for collaboration.

Collaboration has to be more than just a word. It is the essence of how we should work . As leaders, we must practice what we preach. Leadership cannot exist in a vacuum. Collaboration creates models and allows us to build on each other’s work. Collaboration then allows us to turn ideas into action. We must not diminish the work of others. Collaboration can be energizing. It can also be fun.

We need champions. When we have an idea, a new program, a cause , a new paradigm for action, we want to see these things work. We jump in immediately and do the detail work necessary to bring these processes to life. Some of the ideas work and some don’t. Even when they work, outsiders may or may not buy these processes, ideas and techniques. We need to convince people inside our organizations and outside why this new thing is useful and worth supporting. We need champions. Champions are leaders who will support our cause and who think what we are doing and developing needs a wider audience. These champions fight for us. They talk to politicians, foundations, government agencies, community leaders and others to make our new thing work and become valued. They sell our ideas and programs.

Who are the champions? They are people who are respected and trusted in their communities and social networks. The Centers for Disease Control and Prevention Foundation has recognized the importance of champions and looks and recruits them in all states and localities where they are planning Meta-Leadership Summits. The champions become true believers because meta-leadership as an approach taps into their person skills as people who work across organizations and communities. Advocacy is exciting for them. They rise to the challenge of convincing others about the things and ideas that they promote. They are meta-leaders who work not only across organizations but work well within the organizations that they serve. They are systems thinkers who always view the big picture. They tend to leave the details to others. They are visionary in that they see the value of a new idea and program as well as their impact over the long run. Clearly long term adaptation is important to them. They spend more time on the balcony than on the dance floor. The champions have a strong worldview and tend to be positive about their communities and society.

The champions are your supporters. Search them out. They are critical to making your programs and ideas sticky—make your ideas and programs work and get supported .

As leaders, we commit ourselves to lifelong learning at a personal, team, organization, community, and professional level. I discuss these levels in the book PUBLIC HEALTH LEADERSHIP: PUTTING PRINCIPLES INTO PRACTICE(2009). Each leadership level requires a portfolio of learning activities to enhance our leadership. In this posting, I will explore creating a personal leadership portfolio which helps the leader to better understand how they lead. A personal leadership portfolio contains all the results of various leadership instruments that a leader takes to learn more about his or her leadership strengths and skills. The portfolio also documents key leadership decisions made in different settings. Part of lifelong learning approaches is to continue learning as much about yourself as a person and as a leader as it is about determining the new skills you need as you move along in your career. I discussed some of these issues in the posting on ecological leadership. In order to develop your strengths and skills, there are some personal tools you can use. First, many leaders keep a leadership journal in which they record their personal experiences and reflections as a leader. They often record things they want to remember from conversations, talks, workshops, books and articles read, and so on. Second, write a legacy statement once a year about what you want people to remember about you. Third, many leaders develop yearly individualized leadership learning plans about things they will do over the next year to enhance their skills and abilities.

I recently put together a graduate level course on personal leadership development for public health professionals who want to create a personal leadership portfolio. The course involves each working professional completing a number of instruments related to personal leadership. Each session of the class involves an interactive session on each of the instruments and how to use the results of the instrument to enhance leadership work. I have chosen a number of instruments which I think will give each professional a well-rounded view of their leadership. This is not meant to imply that the instruments I chose could not be replaced with others that would not be useful to the leader. At the end of the course, each leader gets a personal coaching session for an hour to tie the pieces of their profile together.

I assume you might like to know the instruments that I chose. Since this is a course for public health leaders, one of the instruments is a public health leadership profile. This can be substituted with an instrument developed for educators, human services professionals, or business executives. I have included in the profile an instrument on leadership style and one on time spent in management in contrast to leadership activities. I also include the Emergenetics instrument which deals with thinking preferences and behaviors associated with thinking. Some leaders would include the Myers-Briggs instrument instead. However, I find that people like the color-oriented approach to Emergenetics than the letter approach of Myers-Briggs. I also include an instrument on Emotional Intelligence(Bradberry and Greaves). There are the two excellent instruments developed by the Gallup Organization(Strengths Finder 2.0 and Well Being Finder). Finally, I include two excellent leadership instruments from Discovery Learning—Public Health Leadership Profile(360 degree instrument) and Change Style Indicators. As you can see, these instruments provide a well- rounded view of the personal leadership skills of the public health professional. What are some of the leadership assessment tools that you would include?

Whatever set of instruments you choose, it is important to examine your leadership skills and how you employ these skills in the real world. Leaders need to be sensitive to the ways that they impact others.