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In college, I had ambition. I wanted to be the best in my field and rise to the top. I was involved in a focus group and, one day, we were assigned a project. I was so excited that I blurted out "I'm in charge!" and ran to the front of the room to try and orchestrate the situation. To this day I've maintained friendships with many people in that group. We often laugh about that day when I tried to assert my influence and accomplished the exact opposite.
After college I assumed a position in management at work, and, it turns out, I was not qualified for the job. I only got there because I knew the right people. I made many mistakes in those early years. I terminated the wrong people at the wrong time in the wrong manner. I tried to implement new projects and initiatives without getting proper buy-in from the team. Over time I realized that my title meant almost nothing, and influence was really what I needed.
Your department may consist of seasoned leadership veterans, new managers, and professionals who have no desire to lead. Regardless of your situation, all of us seek having some level of impact or significance in our healthcare organization. At every level of the organizational chart, a healthy department functions best when the goal is influencing others to operate at maximum effectiveness because they want to--not because they have to do it.
We would never expect a physician to start treatment on a patient without properly diagnosing the situation. Yet many of us try to manage with the same broken approach I attempted in college. There is a similar frustration for a parent when a young child asks "why," and all we can say is "because I'm the parent and I said so."
Leadership with influence is a continual journey. We are always growing, ever learning and never arriving. Whether we are a laboratory director or simply a bench tech right out of school, the higher we climb the leadership ladder will determine how far we lead and influence our team.
 First, it's important to assess where we stand with both the individual and the organization, and then learn how to take that next step up the ladder. Below are four steps up the leadership ladder--specific markers you can define with individuals and your department as a whole. You might be at a level three with one group of colleauges, while only level one with another staff. Once you indentify your place, you can take active steps to move further up the ladder with that individual or group.
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Step one: positional influence -- people follow you because they have to
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Step two: personal influence -- people follow you because they like you
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Step three: professional influence -- people follow you because of your accomplishments
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Step four: parental influence -- people follow you because you have invested into their growth
Step One: Positional Influence
At this level of leadership, people follow you because they have to. The reality is if you have a certain title, you can tell someone what to do. That's about it. If you are the manager or director, people will follow your marching orders. Staying at this level usually produces the bare minimal acceptable effort. There is nothing wrong with leading at this level, but remember: the faster you can get to level two, the more you will achieve together as a team.
Step Two: Personal Influence
This is the critical step on the leadership level. If there's one thing you take away, take this: The faster you can get from step one to step two, the better the relationship will be.
Zig Zigler says: "If you go looking for a friend, you're going to find they're very scarce. If you go out to be a friend, you'll find them everywhere."
How can you get to step two? Getting people to follow you because they like you sounds simple, but sometimes we have to be strategic about winning over certain team members. Perhaps you took over a situation where the former director was well liked and they didn't want to see them go. Maybe you were hired in from the outside, and an internal team member really wanted a shot at being the manager. Sometimes leading in a union environment can create extra layers of complexity, and you need to influence them well beyond what their minimal requirements call for.
Here are some tools to help you grow into the level of personal influence.
- Always use the sandwich method. When reading a book or watching a movie, the beginning and the end are the most important parts of the story. Will you ever forget the opening credits of Star Wars or the surprising twist ending in The Sixth Sense? When speaking to your team, always remember to use the sandwich method. Start with some positive affirmation. Always catch them doing something right before pointing out what they are doing wrong. Finish the conversation with specific examples of how their contribution makes a difference in the outcome of the patient. It's easy to neglect this principle when we get overly comfortable with a colleague over time, or we are overly confident in our positional authority. Either reason is a wrong excuse to neglect positive affirmation.
- Lead with questions. Most people prefer to feel like they are part of the decision-making process vs. being told what to do. As you continue to experience a wide range of generation gaps on this team you will notice this is especially important as the emerging generations rise through the ranks in your staff. You can often accomplish the same directive, with better outcomes using a question in place of a statement. Even if you have the right to tell someone what to do, many times they will appreciate if you ask them. This also opens doors for further in-depth dialog. Imagine yourself as Larry King on CNN. Your job is to interview a guest and take full interest in who they are. You can interview your subordinate, your boss or your physician. Ask them about their hobbies, family, where they grew up, sports and music. Try to find a point of commonality with them. This may sound simple to those with natural people skills, but many technical professionals were put into management for their clinical expertise with little regard to their people skills.
- Treat your employee like a customer. If we want our employees to go above and beyond their job description, we must support and encourage them above our job description. If you don't know how to grow in your support for you team, simply ask this question on a regular basis. "What can I do to help make your job better?" It's amazing what you will learn when you ask the right questions.
- Lead by example. Albert Schweitzer says: "Example is not the main thing in influencing others. It is the only thing."
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