Over the past decade, our nation has become increasingly polarized over a multitude of issues. As individuals, we may feel compelled to take positions on social and political issues; however, as organizational leaders, we have a responsibility to manage ourselves in the best interest of the mission we serve.
A recent survey by Indeed.com indicated that 36% of employees might leave their jobs if the CEO expressed views with which they disagreed.(1) The way in which we approach contentious issues matters and can be a determinant of our success and the arc of our careers.
Leadership today needs not only strategic thinking and visioning, but also skillful execution. This is where the concept of centrist leadership emerges. Centrist leadership is not about seeking an ideological center; it is about developing and leveraging an important set of skills for bringing populations toward a common goal. Centrist leaders can motivate large and complex organizations through inclusivity and thoughtfulness while minimizing the paralysis often brought on by polarizing perspectives.
Centrist leadership begins with a clear understanding of the populations that influence organizational decision-making, strategies, and operations. This population will likely include providers, staff, board members, and external stakeholders, such as politicians, community leaders, and area business leaders. Each population has its own dynamics that must be understood and taken into consideration (see Figure 1).
Successful centrist leadership starts with self-awareness and an ability to manage personal beliefs. Over your career, you are likely to advocate for political, social, and even medical issues that seem reasonable to you but not to others.
As a healthcare leader, you are obligated to the organizational mission, not to your personal opinions. You need to be authentic, but always focused on your purpose and goals. You must be a more centered version of yourself. You need to be politically savvy without being political, knowing when it is best to let others carry the torch. You can support an issue that is important to you without being the spokesperson or attending a rally.
While coaching executives over the years, I have found that this is not always an easy concept to grasp, much less to put into practice.
Bringing people together in support of a common mission and vision requires that you understand them as a collective. In its simplest form, think about a bell-shaped curve. Figure 2 depicts a normal population distribution. Within all large organizations there usually exists a few people who will always “love” or “hate” the leaders and their direction. While there is no exact number in these categories, consider them in this example to be over two standard deviations from the mean on either side.
Neither group should be your primary concern. The oppositional group can distract you, take up your time, but be unmovable. The “love you” group can lead you to a false sense of broad organizational support.
Focus on the group that is one standard deviation from the mean. These are the individuals who are most open-minded, who listen, who provide thoughtful commentary, and who decide on their positions issue-by-issue. If you earn their buy-in, you will likely earn followership from those who initially donate trust (until proven otherwise) and some of those who are initially negative and doubtful.
In this model, if you earn the buy-in of those within one standard deviation of the mean (68%), you will likely have earned those that started with a favorable position, and you have achieved 84% buy-in. Of course, this is a conceptual model; the real world is not quite that simple.
It would be much easier if every population we led followed a normal bell-shaped curve distribution, but that is not reality. The people who comprise our organizations and our external stakeholder groups fall into various populations and subcultures, each with its own set of expectations and perceptions.
The distribution can be narrow for smaller or like-minded groups; the distribution can also be skewed or bimodal, based on intrinsic belief systems, ideology, or politics. In large organizations, all these distributions can exist within one organization (see Figure 3). While this is our reality, it does not change the effectiveness of centrist leadership.
Early in your career, such as in a medical director role, you may lead more homogenous populations. As you progress into roles with broader responsibility, such as a CMO or other executive positions, you’ll see those bell curves widen and diversify. Where you once oversaw the work of other like-minded physicians and direct-care personnel, now you’re dealing with finance teams, facilities, partnerships, local governments, and maybe even a board of directors. Centrist leadership skills will help you lead through that increasing complexity.
THE MIDST PRINCIPLES
Being a centrist leader is not about taking a neutral or non-controversial position on all issues, but instead, having the skills to approach these issues in a manner that engages others rather than alienates them. While nothing replaces experience, the MIDST principles provide a good baseline from which to develop your skills (see Figure 4).
Measured
Being a measured leader requires gauging your reactions appropriately to convey a balanced mindset. Quick and strongly opinionated reactions can be viewed as unreasonable or emotional, particularly if you are perceived as blaming or “killing” the messenger. On the other side, if you are perceived as too laissez-faire when confronted with challenges, you run the risk of being perceived as dismissive, inattentive, or disinterested (see Figure 5).
Early in my career, I was subject to the latter. As an emergency medicine physician, I would reflexively become calm in chaotic situations to bring the care team into focus. The CEO for whom I worked was more reactionary; the calmer I became, the more reaction she would display. She was trying to convey to me that this was a serious matter, and I was trying to calm the room. We were misinterpreting each other, and I had to learn to show more reaction to the matter at hand. Sometimes it was as simple as verbally acknowledging the seriousness of the issue and confirming that I would investigate and address the matter.
When in the presence of a group of people with different viewpoints, a person who is not being measured can create a difficult-to-change perception of bias. Perhaps the easiest way to keep yourself in check is to constantly remember to “first seek to understand” before reacting or passing judgment.
Information-Driven
Being information-driven means taking in all the relevant factors and contexts to make the best decisions and engaging others in the process. Divisive issues are often complicated by conscious and unconscious bias and can engender emotional reactions. The overly data-driven leader runs the risk of ignoring human factors that affect the way people think and running afoul of important social or cultural contexts. Although it can give the perception of being tone-deaf or uncaring, on the flip side, ignoring the data increases the risk of making big mistakes.
Even as practicing clinicians, we start with the science, history, physical exam, and diagnostic tests to reach treatment decisions; however, when we present the options to our patients, they might choose to deviate from our “best” evidence-based approach because of personal preferences, religious beliefs, or other factors.
A balanced approach brings the head and the heart into the work and, if conversations are well-crafted, can turn a potentially difficult situation into a reasonable conversation. Exercising this skill is especially important to a leader dealing with a polarizing issue where emotions may run hot.
My organization’s board members are designated as either ex-officio or state government-appointed. There are high-profile Republicans and Democrats on our board in an era where there is no shortage of polarizing issues, yet, we have a high-functioning board with very dedicated members.
Being both measured and information-driven in leading through difficult discussions minimizes unhelpful positioning and keeps everyone focused on our mission and vision.
Directional
Being directional means being steady in pursuing organizational vision, strategies, and operational goals. If you’re constantly shifting priorities or chasing shiny objects, you will lose credibility with those who hear shifting messages or don’t see actions aligning with previously stated intent (see Figure 7).
Organizations and people cannot shift direction as quickly as you change your mind. Being directional takes personal discipline, especially if you are creative and excited by new ideas. Conversely, if you enforce adherence to a strategic plan despite changing market trends or intra-organizational changes, you will be viewed as unreasonably rigid, and you will lose support or influence with key stakeholders.
I have worked for individuals who were on either side of this spectrum; both were difficult in their own way. Directional leaders adhere to the plan and shift direction thoughtfully and rationally, making decisions based on changing conditions and conversations with key stakeholders. Seldom does any change in the external environment truly require a rapid organization-wide change of direction, especially if there is a well-crafted strategic plan. Be careful not to react reflexively to loud voices that may be “demanding” a change. If you please one group reactively, you will likely alienate another.
Solution Seeker
There will always be problems that require your personal attention. A solution-seeker owns the problem and works constructively with everyone involved to find a path forward.
At one end of the spectrum are leaders who are scrappers; they are quick to jump into the fight, and in doing so often waste time, organizational resources, and personal capital. On the other end of the spectrum, there are conflict-avoiders who mistake “not rocking the boat” for leadership. Navigating populations begins with understanding opposing views, areas of commonality, and the differences that keep them apart (see Figure 8).
I am a strong believer that good strategy eats culture for lunch. A decade ago, I became embroiled in a long-standing feud between an academic medical center and a local community hospital located two miles apart. The cultural divide was wide. Patients, the community, and even the respective organizations were negatively impacted.
A small group of newcomers into the situation visualized a better future. Instead of taking a side or avoiding this very uncomfortable conflict, the newcomers made a diligent effort to understand both sides, build trust, and craft a new vision. It was a time-consuming effort and required significant discipline to not be drawn into the “fight.”
Ultimately, we were able to pursue a new vision and enter into a fully economically integrated joint operating agreement that has benefitted all stakeholders, resolved our differences, and changed our respective cultures. This agreement remains in place today with strong bonds between the organizations.
Thoughtful Questioner
There are leaders who tend to jump quickly on new ideas, concepts, or trends without adequate deliberation. Conversely, there are those who say “no” before people with new ideas are fully heard. Both behaviors can be harmful, but in the extreme, the tendency to say “no” and argue just about everything is especially troubling.
Oppositional leaders come across as being opinionated, demanding to always be right, and displaying an uncontrolled ego. They shut down good ideas, portray negativity, and create an aura of unapproachability.
A good leader must be a good listener and provide balanced responses (see Figure 9). Train yourself to ask thoughtful questions, to “first seek to understand.” Additionally, avoid beginning your responses with “no” or “yes, but.” Thoughtful questions coupled with more positive language like “yes, and” often lead to better group dynamics and, subsequently wise decisions.
BEING A CENTRIST LEADER
It is helpful to reflect on where you fall on the MIDST scale (see Figure 10). Give some thought to leaders you have worked with or observed, and where you would rate them on this scale. Think about their effectiveness in navigating difficult situations, building strong teams, and executing strategy. Think about how you felt working for them.
Determine which behaviors you want to emulate and which you do not. Be honest with yourself and do not be discouraged if you or others perceive you in the extreme of one or more areas. My observation is that, initially, most people are outside the effective range on most, if not all, the centrist leadership behaviors. All these leadership skills can be developed once you have insight into your baseline and your goal.
Being a centrist leader requires understanding people collectively and engaging them inclusively in the journey. Centrist leadership is about opening space in the room for constructive conversation and effective problem-solving. In today’s increasingly divisive and polarized environment these skills are more important than ever.
Reference
Indeed Editorial Team. Navigating Politics in the Workplace During a Divisive Election Year. Indeed online platform, March 12, 2024. (indeed.com)