Leadership: The Seven Deadly Sins of Management

I love to return to the roots of a topic to see how and where different thought processes started. This is certainly true with the concepts of management. I have found after 20 years of successful senior leadership and entrepreneurial experience in health care that this can help to hone your skills and keep you ever ready. Dr. W. Edwards Deming’s seven deadly diseases of management will be discussed in narrative fashion below as an example.

I was chatting with Cecelia again. She is my director of pathology. Over the past few weeks she had established a team to tackle the challenges that she had coordinating the order and return results of testing with the lab. Initially, she had trouble getting enough members for her team but that problem had been resolved. Cecelia was my most emotional leader and I was not satisfied that all was well yet.

“You have all the members of your team, Cecelia,” I said. “But you still seem troubled to me. Is there anything on your mind?”

“I don’t hide things very well, do I?” she asked.

“No, your usually a stone,” I said. “It is just my keen sense of observation.”

She laughed a little, but pressed on, “I know I am a worrier, but I have not been able to get all these changes in health care out of my mind.”

I looked at her and waited.

“It’s just that I know it is a tough time for hospitals right now, and I am worried that we won’t make it. Can you put me at ease?”

No one-sentence answer was going to satiate the growing anxiety that was Cecelia, so I took a different approach. “Have you ever heard of Dr. W. Edwards Deming?” I asked.

“No,” she answered.

“Well,” I said. “He is one of the fathers of management. He died in the early 90’s, but I use him as example, because I want you to see that the more things change the more they stay the same.”

Cecelia nodded.

“He had this thing called the seven deadly diseases of management,” I said. “If you do these things, you are sure to fail. I am going to list them and we’ll see which ones relate to us. If they all do, then worry. Heck, I will worry. But if they don’t, then lets agree, right here to not worry. Okay?”

“Okay,” she answered. “It sounds good to me.”

“His first disease was a lack of consistency of purpose,” I said. “How do you think we are doing, as an organization on that one?”

“Well, we say that we will provide a quality service, in a safe and cost effective manner, that will delight our customers,” She said. “And since we have great quality scores, high customer satisfaction scores, and good safety rounding, I know those are good. In regards to cost effective, you and I are always reviewing my salary and supply costs against the budget, so I know those are good, too. So relative to consistency of purpose, I would give us a passing mark.”

“Good answer,” I said, impressed with her full understanding of the issue. I shut my jaw and continued,” the second deadly disease related to paying too much attention to short-term profits. How do we fair on that one?”

“I assume,” Cecelia said, “That focusing on short-term profits is bad, because you sacrifice quality and your reputation. I have never heard anyone of our senior leaders say that we should ignore quality or cut corners to make a quick buck, so I would say we are clear on that one, too.”

“Two-for-two,” I said. “The third one related to doing regular performance appraisals.” I let my voice die off at the end.

“You know how much I hate those. It seems like I am doing one on a staff member all the time.” she said.

“Now that you know are existence depends on it, I bet you don’t complain as much,” I joked.

Cecelia did not laugh, “No, but at least I will keep doing them, so we are clear on that one.”

“The forth deadly disease was about management. It discussed how quickly management responded to concerns or issues that needed attention,” I said.

“Oh, brother. You are in hear if someone whispers we are having a problem, so I would say we are not suffering from that disease.”

I nodded. “Deadly disease of management number six is being transparent about your figures and accounting. No hidden expenses, profits, that sort of thing.”

“Negative on that one, too,” Cecelia said. “We all get to look at the numbers with the CFO every month. What is number six?”

“Excessive medical costs,” I answered. “That would include worker’s compensation and the health insurance we help provide.”

“I don’t even know anyone out on worker’s comp,” She said, “It seems that this hospital is pretty fair with what it pays for our insurance, but our rates have gone up. I guess I could take solace in the hospital not suffering from deadly disease number six, but it still hurts me.”

There was no denying that, so I didn’t. “The seventh disease related to excessive costs of fixing mistakes. Those mistakes would be both medical errors on our part, or falls in the parking lot, that sort of thing.”

“Now I see why you guys are always crawling all over the place ensuring safety, safety, safety.”

“Is that a negative then?” I asked.

She paused. “I know that when I say yes that you are going to say that I can now stop being anxious…”

I smiled. “Any further questions?

“Nope,” she answered.

I sat looking at her.

“Okay, negative on all seven deadly diseases of management. We are consistent in purpose, do not put an emphasis on short-term profits, do evals, have a mobile management team, are transparent, do not have excessive medical costs, and do not have lots of costs tied to fixing our mistakes. I won’t be anxious anymore,” she finished.

“See ya,” I said and I was gone.

Thanks for reading.

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