The ATTC/NIATx Service Improvement Blog: Myth buster #5, Part 1: There's no right way to make promotion decisions

March 21, 2017

Thomas F. Hilton, Ph.D.

Although this topic might seem to be aimed at clinic directors and their oversight boards, there is also useful information for counselors and other clinic staff members. The more you understand about leadership, the more everybody in the organization can contribute to a better workplace climate and a more therapeutically effective enterprise.

Promoting the wrong person can have dire consequences for both staff members and clients. There is a mountain of research showing that poor leadership leads to staff turnover, lowers morale, and erodes job performance. As each staff member quits in order to escape a negative work climate, the remaining workforce is increasingly drained of experience and corporate knowledge (how we do things around here). Because remaining staff need to orient, train, and supervise new hires, they are distracted from their primary roles as therapists, receptionists, etc. The increased patient load on remaining staff can eventually lead them to burn out and leave the clinic as well. Role overload coupled with a decline in staff experience will eventually impact treatment effectiveness and recovery rates. Unless the downward spiral is reversed, the very survival of the clinic is threatened.

Where do clinics go wrong?

Simply put, leadership is getting things done through people.

In my 40 plus years of research and consulting on organizational change, an imbalance between technical and leadership competencies among supervisory staff always negatively impacts organizational performance. Workforce surveys make it easy to spot problem leaders because respondents score high on such variables as role ambiguity, role conflict, and role overload. They also report low job satisfaction and poor vertical communication with supervisors and other leaders. These are climate factors that directly reflect leader competency.

What is a competency?

A competency is the integration of the learned skills and personal traits that enable a person to perform a role extraordinarily well. The notion of competencies was developed by the late psychologist David McClelland. He used co-worker and supervisor descriptions of ideal performance in various job role situations to identify key attributes for selecting job candidates and/or identifying incumbent weaknesses (areas that could benefit from coaching, training, etc.). Today, most major corporations use some form of competency-based model to guide human resource development, performance appraisals, hiring, and promotions.

What are leadership competencies?

First let’s start by defining leadership. Simply put, leadership is getting things done through people. In most organizations, leadership normally requires technical competencies to optimally manage human and other resources effectively. For example, you would not expect an automobile sales manager to understand how leadership decisions in a treatment clinic might affect client engagement and therapeutic outcomes. Technical knowledge informs task assignments to the best qualified person and enables staff development so they excel in their job roles.

Here is a list of common leadership competencies:

Engaging buy-in for change
Solving problems and making decisions
Managing politics and influencing others
Taking prudent risks to innovate
Setting a vision and strategic thinking
Effectively navigating the organization

Listening & communicating effectively
Developing others
Valuing diversity and differences
Building & maintaining relationships
Nurturing effective teams and work groups
Consistent adherence to ethical principles

Numerous studies have reported that these 12 generic leader competencies describe successful bosses. However, because every leadership job is unique, each requires a mix of unique personal traits, demonstrated abilities, and technical knowledge.

Where do bosses go wrong?

Bad leaders are not bad people; they just lack the competencies needed to get things done through people. In other words, they are more effective technically than they are at getting things done through others. Mistrust in subordinates (and even peers) often leads to micromanaging tasks as well as doing work that subordinates should be doing, because “I am the one who will get in trouble if it is wrong.” Micromanaging eventually creates a climate of disrespect and disempowerment. Staff members often react to disrespect through passive-aggressive withdrawal from tasks. Some will start working-to-rule (doing no more than what is sufficient). Micromanagement further erodes leader effectiveness by lengthening their own workday, skipping meals, and generally increasing physical and psychological stress. All of that infects interactions with the entire staff as things deteriorate.

Why don’t clinics hire better leaders?

Because most clinics are relatively small in size, they have limited time, staff, and budgets to invest in selecting and promoting their staff. This can even extend to hiring clinic directors. Whenever a staff member leaves, the impact on workload is often felt immediately throughout the organization. This often leads to a rush to fill the vacancy. As a result, it is often expedient to promote from within. As talent leaves the organization, seniority and professional credentials are often the primary attributes upon which promotions are justified. Alas, outlasting one’s co-workers in an unpleasant workplace climate is not a leadership competency. Neither is educational level and licensure. Yet, de facto, seniority and credentials are often the main criteria in promotion decisions.

Coming up: Part 2: There's no right way to make promotion decisions

About our guest blogger

Tom Hilton is a retired NIH science officer and NIDA program officer now in private practice. Tom has over 40 years of experience studying and conducting large-scale organizational change initiatives in both general-medical and addiction health services in military, federal, and private sector organizations.