Loneliness at the Top: Ten Ways Medical Practice Administrators Can Manage the Isolation of Leadership

Is it really as lonely at the top as people say that it is? Often, yes it is. Leadership can be isolating, making leaders feel that they’re out on a limb all by themselves. As Edmonson(1) says, “Leadership is naturally lonely. Every leader I know struggles with it at some level.” Blom(2) agrees, suggesting that loneliness ramps up with increased levels of leadership. According to Blom, “With every step in leadership we make comes the inevitable increase in loneliness. The higher we climb in leadership, the more responsibilities we get, the lonelier we become.” Is it any wonder, then, that you may find that your job as a medical practice manager is a lonely one, at least some of the time? The good news is that you’re probably not as alone as you think. Managers in other medical practices no doubt feel the same as you.

Why is managing a medical practice sometimes such a lonely business? There are two basic reasons. First, medical practice managers must sometimes distance themselves from their employees simply to do their jobs well. As the practice manager, you can’t always share what you know or how you feel with the members of your team without betraying confidences or undermining your authority. For instance, you may not be able to share with your staff the problems you’re facing with one of your physicians or employees. You may not be able to vent your frustrations to your staff, or to complain to them about how difficult your job is. According to Thinking Partners, Inc.,(3) “Exceptional leaders . . . exhibit self-control. Leaders with emotional intelligence find ways to manage disturbing emotions and impulses.” Unfortunately, the self-control required of your leadership can be isolating, separating you from everyone else.

Second, medical practice team members may behave in ways that exclude you simply because you’re their manager. For instance, they may leave you out of their inside jokes. They may not invite you to lunch or to their outside-of-work social events. They may even treat you more formally and carefully than they do their coworkers. That’s because they may fear you, although that fear may have nothing to do with you personally or with anything you’ve ever said or done to them. Or if you were promoted from within their ranks, they may resent you for being above them now in the practice hierarchy. Or as Levine(4) suggests, they may look up to you so much that they treat you as though you are “on a pedestal.” In any case, your employees may keep you in the margins of their social structure simply because you’re their boss. They will be unlikely to forget that you have hiring, performance and salary review, assignment, and firing authority over them. That can make many employees feel uncomfortable when they’re around you. It’s no wonder, then, that they may be keeping you at arm’s length.

Even if you accept that loneliness is commonplace among leaders, you may be tempted to downplay the significance of your feelings. However, chronic feelings of loneliness can lead to serious problems. Let’s explore some of these and the reasons that practice managers must take action to prevent and mitigate their loneliness.

Do It for You; Do It for Your Team

A medical practice manager’s loneliness can have health repercussions. An article in Psychology Today(5) warns that lonely individuals report higher levels of perceived stress even when exposed to the same stressors as non-lonely people, and even when they are relaxing. As well, loneliness in adults is a major precipitant of depression, illness, and alcoholism. Psychology Today warns that loneliness “increasingly appears to be the cause of a range of medical problems, some of which take decades to show up.” Weintraub(6) adds further evidence that being lonely can make you sick. According to Weintraub, “A lonely person’s blood pressure tends to be higher and change more as they [sic] age; and they are more likely to have high levels of inflammation, which leads to even more health problems.” Clearly, sustained periods of loneliness at work can affect you adversely, and the problems associated with your loneliness can spill into your well-being and personal life.

However, a leader’s loneliness can also be a problem for those he or she leads and serves. As Hedges(7) points out, “Any leader’s isolation has negative ramifications on others. And it’s not just CEOs who experience this kind of loneliness. . . . In fact, anyone who finds themselves [sic] peerless can feel isolated. This isn’t good for decision-making, culture, or performance.” Hedges warns further that because a leader’s actions “reverberate,” his or her isolation and loneliness can become a larger problem when they lead to poor decision-making, negativity, fatigue, and frustration. She adds, “And who wants to work for an unhappy person?”

Although the problems associated with leadership loneliness can be serious for both a practice manager and everyone else in the medical practice, they can be managed. As Hedges suggests, “The key is to deal with this loneliness in a healthy way.” Following are 10 effective and healthy strategies to help you manage the isolation and loneliness that often accompany leadership in a medical practice.

Ten Effective and Healthy Ways to Manage Leadership Loneliness

Unfortunately, chronic loneliness can lead to self-destructive behaviors such as over- or undereating, overspending, self-pity, drug and alcohol abuse, physical neglect, and sabotaging relationships.(8) However, there are healthy and effective ways to manage the loneliness that often accompanies leadership, including these 10:

1. Accept your loneliness. Although most people feel lonely at times, loneliness often seems to carry a stigma. According to Hall,(9) lonely people fear being judged as “unlikeable, a loser, or weird” so they don’t discuss their sense of loneliness, alienation, or exclusion. Blaming yourself, calling yourself names, and berating yourself because you are feeling lonely is not effective and not accurate, Hall says. In fact, feeling lonely in the absence of meaningful connections is normal. Therefore, a good first step in managing the loneliness that often accompanies leadership will be your own understanding and acceptance, without judgment. See the sidebar “Feeling Lonely? Acceptance is the First Step” for more ideas on this subject.

2. Focus more on the needs and feelings of others. You can spend your days in your medical practice dwelling on your loneliness. Or you can be grateful for the diversity of people you work with every day, silently wishing them good health and good fortune, and smiling at each person you encounter. The latter approach is not only more productive and fun, but also more likely to help you lessen the feelings of loneliness. Offer kindness and generosity of spirit to all you come into contact with for their sake, as well as for your own.

3. Strengthen existing relationships. Your role as a medical practice manager is only one aspect of your life. You may already have friends and acquaintances that you could get to know better, or connections with family members that could be deepened. If so, why not call your friends and family more often, go out with them more, and find other ways to enjoy your existing relationships and strengthen bonds?

4. Become more socially active outside of work. Taking a class is a great way to meet people who share at least one of your interests. It can also provide a sense of belonging that comes with being part of a group, and help you stave off feelings of loneliness. So, too, can volunteering for an organization or cause you believe in, joining a gym, and getting involved in a hobby or sport in which you interact with others.

5. Organize social functions with your team. Don’t wait for an invitation that never comes to lunch, happy hour, or an after-work outing. Organize your own staff social events. Once the members of your medical practice team have had opportunities to interact with you outside of your medical practice, they may be more inclined invite you to their own gatherings. Even if not, the staff social events you organize may make you feel less isolated, especially if you make a point of connecting with each person.

6. Develop a professional support group. Developing a strong professional support network can help leaders to become happier, more productive, and better prepared to face the world. According to George,(10) “Authentic leaders build close relationships with people who will counsel them in times of uncertainty, be there in times of difficulty, and celebrate with them in times of success.” Your support group can also help you to develop much-needed feelings of belonging. As Brown(11) suggests, “A deep sense of love and belonging is an irreducible need of all people. We are biologically, cognitively, physically, and spiritually wired to love, to be loved, and to belong. When those needs are not met, we don’t function as we were meant to.” Developing a consistent group of peers with whom you can be vulnerable, who will support you, and who will not turn away from you is extremely helpful in leadership, George says.

7. Work with a coach or mentor. Medical practice managers who experience loneliness may feel less alone when they work on their personal development outside of the practice. They may be able to share their frustrations and challenges with a mentor or coach, who will provide needed support and help them develop concrete solutions. Having someone reliable in your corner can make a huge difference when you’re feeling isolated and lonely. As well, loneliness often provides a distorted picture of reality. Lonely individuals paint on a canvas of self-pity and depression, tinting everything gray and black, bleak and hopeless, sad and morose. A mentor or coach can bring you back to reality, and encourage you to think more accurately and positively.

8. Join or become more involved in professional organizations. One of the greatest benefits of joining and becoming active in a professional association is that you will have opportunities to get to know other medical practice managers. That will help you battle feelings of isolation and loneliness, knowing that they face similar challenges. Spending time with other medical practice managers at conferences and other face-to-face meetings is ideal. But ongoing electronic communication with other practice managers can also be very helpful as you face the day-to-day challenges in your medical practice.

9. Represent your medical practice in your community. Chambers of Commerce and other local organizations have frequent events where you can mingle and meet business and professional practice owners and managers from your community. From luncheons to golf tournaments to mixers to casino nights, your Chamber of Commerce will be all about widening your network and providing opportunities to develop friendships, while promoting your medical practice.

10. Become a mentor. Mentoring a new medical practice manager will allow you to view your own growth, and your practice, from a completely different perspective. It will also help you feel more connected to your profession, and less lonely.

References

1. Edmonson R. Seven pitfalls of leadership. RE. January 10, 2013. http://www.ronedmondson.com/2013/01/7-pitfalls-of-leadership.html . Accessed November 23, 2015.

2. Blom R. Nine healthy ways to deal with leadership loneliness. ChurchLeaders. www.churchleaders.com/youth/youth-leaders-articles/158376-9-healthy-ways-to-deal-with-leadership-loneliness.html . Accessed November 24, 2015.

3. Exceptional leaders . . . exhibit self control. Thinking Partners, Inc. www.leadershipmasterymap.com/ExhibitSelfControl_000.htm. Accessed November 23, 2015.

4. Levine IS. Guest post: there’s a reason it’s lonely at the top. Psychology Today. March 4, 2011; www.psychologytoday.com/blog/the-friendship-doctor/201103/guest-post-there-s-reason-it-s-lonely-the-top . Accessed November 22, 2015.

5. The dangers of loneliness. Psychology Today. July 1, 2003; www.psychologytoday.com/articles/200307/the-dangers-loneliness . Accessed November 23, 2015.

6. Weintraub K. Dangers of loneliness. Boston Globe. April 24, 2015; www.bostonglobe.com/lifestyle/2015/04/24/loneliness/WMyewgKBU5cBjVnbkH9bVK/story.html . Accessed November 24, 2015.

7. Hedges K. Do you feel lonely as a leader? Study says you’re not alone. Forbes. February 23, 2012; www.forbes.com/sites/work-in-progress/2012/02/23/if-mark-zuckerberg-is-lonely-heres-my-solution/ . Accessed November 23, 2015.

8. Luna A. 17 habits of the self-destructive person. LonerWolf. http://lonerwolf.com/self-destructive-person/ . Accessed December 1, 2015.

9. Hall K. Accepting loneliness. Psychology Today. January 13, 2013; www.psychologytoday.com/blog/pieces-mind/201301/accepting-loneliness . Accessed November 27, 2015.

10. George B. Psychology today: overcoming the loneliness of leadership. October 30, 2015; www.billgeorge.org/page/psychology-today-overcoming-the-loneliness-of-leadership . Accessed November 28, 2015.

11. Brown B. The power of vulnerability. TED. June 2010; www.ted.com/talks/brene_brown_on_vulnerability?language=en#t-745230 . Accessed November 28, 2015.

Feeling Lonely? Acceptance Is the First Step

Feeling lonely has little to do with how many people you interact with. Some people who feel lonely interact with lots of people all the time. They may be constantly surrounded by people but not feel connected to them. In fact, chances are that as a busy medical practice manager, you interact with people all day long. So if you’re lonely, that has to do with the way you feel inside, not necessarily the way you are spending your work time. Filling your time with more of the same kinds of interactions won’t necessarily make you feel any better.

Unfortunately, once you begin to feel lonely, you may come to believe that something is wrong with you. As Hall(1) suggests, “Many lonely people believe they are unique in their situation and that it’s not normal to feel as lonely as they do.” Yet most everyone experiences loneliness at times, especially those in isolated leadership positions.

Feeling socially different from the rest of your medical practice team and unable to talk with them about your loneliness can add to the problem and lead to harsh self-judgments. But judging yourself for feeling lonely will compound your problem. You’ll feel bad because you’re lonely, and then you’ll feel even worse for judging yourself for not taking action to solve the problem. This cycle of loneliness and harsh self-judgment can make it even more difficult for you to change things. And, unfortunately, loneliness left unchecked may be expressed in anger or resentment, which often results in others pulling away, making the problem even bigger, Hall warns.

Accepting that loneliness is a part of the human condition can help to keep things in perspective. So, too, will recognizing that loneliness is often part and parcel with medical practice leadership. Hall suggests that you can lessen the impact of leadership loneliness if you:

1. Accept your feelings.

2. Do not judge yourself or others who are lonely.

3. Seek healthy ways to make yourself feel better.

Hall adds, “There is no one idea or one path to move from loneliness to contentment, but there are general ideas that seem to work. A first step seems to be acceptance without judgment.”

Reference

1. Hall K. Accepting loneliness. Psychology Today. January 13, 2013; www.psychologytoday.com/blog/pieces-mind/201301/accepting-loneliness . Accessed November 27, 2015.

Helping a Lonely Member of Your Team

Loneliness is not the exclusive domain of medical practice managers. Any employee can feel lonely too. As Korkki(1) suggests, “It doesn’t matter where a person is in the office hierarchy—employees at all levels become lonely, even when other workers are all around them.” As a medical practice manager, there are a number of things you can do to help prevent and lessen employee loneliness, such as:

• Facilitate team building activities that require employees to interact. Even simple icebreakers at the start of meetings can make everyone feel included and help the members of your team learn more about one another. Longer retreats and workshops geared toward team building also may help lonely employees to form bonds with their coworkers.

• Assign a “buddy” to a new staff member. The early period in any new job can be a lonely one. Having a friend to have lunch with and who takes an interest in them can help new employees feel included from the start, even if that friend is assigned.

• Pair or group employees to tackle projects. Form committees and work groups that will give lonely employees opportunities to collaborate with their coworkers.

• Create a culture of inclusion. Explicitly teach your employees the benefits and powers of including everyone in team events. Model inclusive behaviors, and reinforce them whenever you see them. Teach your staff that purposefully isolating or shunning a teammate is a silent form of bullying, and that the behavior won’t be tolerated in your medical practice.

Reference

1. Korkki P. Building a bridge to a lonely colleague. The New York Times. January 28, 2012; www.nytimes.com/2012/01/29/jobs/building-a-bridge-to-a-lonely-colleague-work
   station.html . Accessed December 1, 2015.

Lonely? Leave Your Office

Having an office or workspace that’s separate from all or most of your staff can be helpful when you need to have sensitive conversations or uninterrupted time for your work. But it can also be physically isolating.

Kearns(1) warns that too much time in a workspace apart from your staff can increase the chances that you will feel lonely. According to Kearns, “It can be easy to justify staying in your office to complete all of your important tasks. After all, you have timelines to meet and goals to accomplish.” However, a negative side effect of all that focus and drive can be what Kearns describes as a “sudden feeling of doubt.” You may wonder if anyone cares about your efforts or whether your team even needs you, he says.

Before the doubt gives way to loneliness, Kearns suggests that you get out of your office and interact with your team. Get up and walk around. His advice: “Be interested in what they are doing. Thank them for being a part of your team. Make a connection.” You can take as little as a few minutes walking around your medical practice. The key is to get out of your chair and interact with your staff regularly. If you do, Kearns says that you will gain a clarity that keeps you focused on what is important to you and your team. You’ll also feel more connected to your employees, and less isolated and lonely.

Reference

1. Kearns K. Top 7 ways to combat being lonely at the top. Christopher M. Knight’s Top 7 Business. November 23, 2005; http://top7business.com/?Top-7-Ways-to-Combat-Being-Lonely-at-The-Top&id=1199. Accessed December 1, 2015.

Confidants and Leadership Loneliness

Leaders in any organization need to address their personal lives, emotions, intimate fears and concerns, struggles, and failures. Rokach(1) suggests that a spouse or life partner can be a natural confidant for many leaders. According to Rokach, “A good marriage, a caring partner, and open communication provide the type of setting a leader needs to unload, to share, and to hear from a supportive friend.”

There are things that we discuss only with people who are very close to us, Rokach explains. These important topics may vary with the situation or the person; we may ask for help, probe for information, or just use the person as a sounding board for important decisions. Confidants influence the actions of others in a constructive and meaningful way, she adds, suggesting, “Leaders need such individuals in order to function both personally and professionally at their optimal level.”

The medical practice manager must be very careful in choosing his or her confidant. According to Lomenick,(2) your confidant:

• Should not be a member of your team who reports to you as a subordinate or peer;

• Should not be your boss;

• Should be someone with honesty and integrity (You must be 100% sure that this individual will not talk with anyone else about what you’re sharing, Lomenick warns.);

• Should be someone you can rely on, share with, lean into for tough decisions, gripe to, and receive counsel from;

• Should advise you but not make decisions for you;

• Should have nothing to gain (According to Lomenick, “Make sure your confidant is not motivated one way or the other by the outcome of your decisions.”); and

• Should do more listening than talking. As Lomenick suggests, “Advice and counsel many times can be best given through a sounding board than a clanging gong.”

References

1. Rokach A. Leadership and loneliness. International Journal of Leadership and Change. 2014;2(1): Article 6:46-58; http://digitalcommons.wku.edu cgi/viewcontent.cgi?article=
   1014&context=ijlc . Accessed November 30, 2015.

2. Lomenick B. 10 reasons leaders need a confidant. Ministry Today. November 20, 2013. http://ministrytodaymag.com/leadership/pastoral-care/20510-10-reasons-why-leaders-need-a-confidant . Accessed November 30, 2015.