Feathered leadership: Creating a culture of sublime cooperation

The definition of leadership is the office or position of a leader, an individual who leads. Is this the same meaning readership would ascribe if asked to define it and moreover, how variegated would the translations of leading be based on where one sits in the hierarchy?

This question is particularly relevant as we focus on people in the middle of organizations where there is tremendous potential but little aptitude as a function of that potential remaining (in many instances) in an embryonic state.

Why does this happen? Across any team there are a handful of individuals who don’t realize that potential because they are led by a manager whose scope is limited, whose view is constrained by a lack of relevance or whose approach remains static by the iniquitous stroke of egoism.

Prematurely promoted managers starve many capable individuals on their team because the basic principles of patience, nurturance and encouragement are not correlated to their own success; this is evidenced by the unabating perennial topic of leadership. When there is a preoccupation with operating in a state of high priority/urgency, investing the necessary energy and resources in our middle managers seems untenable and this vision becomes subsumed by competing priorities. Dovetailing HBR’s August 2023 article, “Don’t Eliminate Your Middle Managers,” surfaces a refined imperative to create a paradigm that drives development of leadership competence and adeptness across the swath of mid-level positional titles that intrinsically require leading others.¹ What is proposed here is blueprinting to advance the concept of feathered leadership with the end goal of creating a culture of sublime cooperation.

In the fast-paced world of healthcare, the urgency to address high-priority tasks often overshadows the crucial need to invest in middle managers. As a result, their development is frequently delayed and sidelined by other pressing demands.² In recognizing the importance of nurturing leadership skills among middle managers to effectively lead their teams, the organization needs a strategic plan that prioritizes this feathered leadership development within intention. This involves fostering a culture of collaboration and intentional growth. In doing so, you can create an environment where excellence thrives and sublime cooperation is the norm.

Leadership is often overlooked as the solution to declining organizational performance — the slow degradation of excellence to mediocrity, of schadenfreude and self-preservation. Addressing the recurring issues of internal politics and a shift in focus away from people requires a commitment to develop strong leaders at all levels, especially in the middle, where they can have significant impact.

It’s crucial to counter the recurring issues stemming from poor stewardship, yet it often does not happen. This oversight is especially evident when senior leaders fail to understand what’s happening at different levels within their organizations. Leadership defines how one sees things: How we view challenges, build relationships and prioritize actions. The “so-do-get” model is fundamental in its ability to emphasize the connection between perception, action and results — not just for managers but also everyone else in their professional and personal lives.

When an individual lacking an adaptive consciousness is placed in a leadership role, they have a limited ability to influence and inspire a team to greater heights and can paralyze the organization, leading to a gradual loss of talent, purpose and loyalty.

Even the most competent leaders will fall short if they lack character. True leadership success requires balancing competence with character, creating harmony in body, mind, heart and spirit. In a hierarchical ecosystem, exceptional competence is undermined if leaders cannot build strong partnerships and foster trust-based relationships.

Standards of excellence can’t be watered down, decisions rife with short-sightedness can’t afford to be made and systems can’t be integrated without considering the feedback from the end users who make things happen. Motivating others through character, credibility and poise is achievable if managers commit to continuous learning, rethinking strategies and embracing “confident humility.” 

Harnessing the power of cooperation

Morton Deutsch’s 1949 study highlighted the benefits of cooperation in teams, showing that collaborative efforts lead to increased momentum and success. When people work together toward shared goals and are rewarded for collaboration, it fosters goodwill and mutual purpose, leading to outcomes where everyone benefits.³

Stephen Covey, in his book The 7 Habits of Highly Effective People, emphasizes the importance of an “abundance mentality,” particularly in Habit 4 (“think win-win”). This mindset, which focuses on mutual benefit, is one of the six paradigms of human interaction (see Figure 1):

• Win-Win
• Win-Lose
• Lose-Win
• Lose-Lose
• Win
• Win-Win or No Deal.⁴

Teaching these ideas to middle managers and holding them accountable to adopt these essential leadership principles can address organizational issues such as employee retention and brand reputation. Consider Gallup’s 2024 employee engagement strategies: The research finds that 44% of employees worldwide are stressed, but more engaged employees are less likely to experience stress.⁵

Key Gallup checklist items emphasize the need for managers to develop the skills, confidence and know-how to have crucial conversations in real time. Effective communication is fundamental to maintaining momentum, understanding and perspective. However, only 48% of managers strongly agree they have the skills needed to excel in their roles. The research also revealed that 80% of employees who received meaningful feedback in the past week were fully engaged.⁶ This underscores the importance of continuous, effective communication and timely feedback.

Enhancing team dynamics

Healthcare managers need to focus on relational, interpersonal and hierarchical elements to foster a balanced and effective team. By proactively applying this insight, managers can mitigate the polarizing effects of varying competence levels among staff by reinforcing a culture of learning opportunities and growth. The objective is to ensure the team remains balanced: Unchecked differences in experience can erode interest and infiltrate the team, worsening over time. Managers must understand the principle of potential — the ability to develop and unleash more capabilities — unlocks growth once it is realized. Managers should seize all opportunities to help their team members step up and excel.

When employees feel neglected, their focus shifts to immediate personal impacts, leading to displaced anger and stress. This creates a cycle of negative behavior that can be costly and difficult to reverse. By prioritizing team development and maintaining a culture of growth, managers can prevent this downward spiral and build a more resilient and productive team.

Distinguishing management from leadership

Too often, management and leadership are conflated, leading to employee dissatisfaction from being managed by the wrong people. Promoting from within is ideal for its many benefits (institutional knowledge, established networks); however, when time constraints force quick decisions, the long-term consequences can be severe.

Promoting individuals based on their technical skills, without considering their communication and coaching abilities, can lead to a decline in performance excellence. True leadership involves delegating authority to empower team members, but misuse of this power can undermine operational integrity and financial stability. As such, promotions should only be made after thorough preparation and assessment. The evaluation should balance job skills with behavioral attributes, recognizing that people are multifaceted, involving:

• Discipline (body);
• A need for learning (mind);
• A need for connection (heart); and
• A sense of integrity (spirit).

Preparing new managers involves setting clear expectations about behaviors, actions and decisions that affect team dynamics. Effective leaders create a unified team that delivers on organizational promises and operates smoothly to achieve excellence and sustainable outcomes. Excellence breeds greater excellence, and reducing the gap between leadership actions and their impact helps managers drive success more effectively.

Enhancing leadership training for managers

Leadership courses are conventionally designed to equip new managers with the tools and dexterity to meet the universal needs of employees, such as creativity, freedom, identity, understanding, participation and protection. However, despite these resources, a gap remains between learning and application. Issues such as toxic environments, mismanaged performance, unspoken crucial conversations and disengaged staff undermine the integrity of managers trained in leadership.

When the organization invests in training a new manager, there is an expectation that they will use these skills to benefit the organization by nurturing its human resources. In contrast, leadership programs or institutes, which focus on long-term commitment to driving performance excellence and maintaining a thriving environment, are typically reserved for higher-level roles.

What if this longitudinal approach was available for middle managers? The impact would be significant. Moving away from a “one-and-done” or box-checking improvement drill to an institutionally driven, continuous program would ensure that leadership skills are deeply embedded and consistently demonstrated in the workplace.

Addressing the leadership gap in healthcare management

While there are many excellent managers who possess character and competence and who lead great teams, there are many who are promoted prematurely, lacking in one or both qualities. This imbalance contributes to mediocre outcomes across an organization. This gradual decay in performance and potential can only be reversed when behaviors that rejuvenate stagnation are aligned with performance expectations.

The Peter Principle — introduced by Laurence Peter to suggest that people are promoted to their level of incompetence — is a stark reality in many organizations. The problem persists until there is a shift in how promotional decisions are made, as current practices lead to declining engagement and effectiveness.

The challenge is compounded by competing needs, fierce competition and the fear of losing talent when raising the bar to match increasing responsibilities. However, compromising on these standards before observing demonstrated competence over time is simply not an option. Johann Wolfgang Von Goethe wisely noted that, “the great failing is to see yourself as more than you are and to value yourself at less than your true worth.”⁷

As stewards of our organizations, we must maintain high standards when entrusting someone with a leadership role, ensuring they can inspire those under their direction to consistently bring their best selves forward. Promoting individuals before they have proven their integrity and alignment of intentions with actions not only undermines decision-making but also fails those who will report to them.

We have a responsibility to be truthful, to have crucial conversations quickly and to create mutual purpose. Each person has the capacity to win, but how one wins is what matters and what will determine the trajectory and longevity of their success.

This can be achieved with some foundational precepts that are particularly critical during the seed stages of a skilled employee evolving along the continuum of talent, skill, attitude, knowledge and style.

Provide continuous feedback and adopt a pedagogical approach to attracting and seeking new information, rethinking and problem-solving. Staff are being coached on becoming problem solvers, which means they must be part of the solution. They are expected to simplify common issues into the following three steps and proactively ask insightful questions:

• Define the situation
• Identify the complication of that situation
• Right the situation (problem-solve to find resolution).

As American academic and business professional Clay Christensen notes, teams learn to prioritize and execute effectively while gaining insights into what matters most to the business each time they tackle a problem.⁸

Create exercises that encourage reflection on behavior changes and their impact on outcomes, fostering a sustainable cause and effect understanding. Be truthful about which actions and behaviors have succeeded or failed in achieving desired outcomes, and then discuss the reasons for using these comparisons.

We presented the following to our front desk medical receptionist lead:

As you move forward, include the what and the how with examples to orient yourself to what you started with and where you ended up.  It would also be beneficial to compare ‘old versus new’ by talking through what you used to do with what you are doing now and the associated outcomes. When you granularize to this level, the change effort pops out by showing comparisons.

The medical receptionist lead’s feedback: “This week instead of allowing tasks to overwhelm me and create blind spots, I got ahead of what needed to be done and actively organized around the day in a way that created a shared commitment (my daily process is…). This enabled me to have the mental space to engage the team in a meaningful and purposeful way and diminished opportunities for us to deplete the resources needed to problem solve on the fly and be on our A game.  Before this we had surprises, letdowns, gaps in coordination, and we were unprepared, leaving us without the answers our supervisors needed when asked. Now, we diminished the number of surprises and guesswork because we put ourselves in the know, we have had fewer disruptions, we had improved coordinated efforts and helping hands, and above all, everyone felt positive and uplifted to be part of something great!”

Model the vulnerability you want your new manager to display, demonstrating that mistakes are learning opportunities. Show the value of independent will, agency, relevance and excellence through regular handling of daily challenges, conflicts and exposures which could be structured like this:

In your last wrap-up I (clinical lead) shared with you that the idea of having your administrative counterpart shadow specialty appointments was an excellent idea to widen the scope of her understanding and perspective from an inside-out view. This is putting the concept of seeking first to understand and then to be understood to work.

Optimizing these wrap-ups as the effort needed to hone your leadership skills, please accept this gentle critique with an open mind as we all work together to cultivate more enriching partnerships that generate win-win solutions.

Frustration on the part of healthcare leaders is understandable, as each deviation from a carefully executed solution can feel like reopening old wounds from previous infractions. This new approach encourages addressing the issue from a different perspective, requiring a shift from default punitive measures toward a more effective and ultimately influential strategy and focusing on strengthening your inner circle of influence to shrink the inner circle of concerns. Although this may sound abstract, it can be translated into practical terms as follows:

This week, Sara shadowed an entire specialty appointment, providing valuable insight into their length and the significant scheduling delays they can cause when consecutive appointments are booked. Now that Sara has firsthand experience in the exam room, we will reassess our previous strategy to develop a win-win solution that brings out the best in all of us. Next week, Sara will help me understand the drivers of and demands of scheduling variations to eliminate guesswork and achieve more predictable sessions. Additionally, we will enhance our communication regarding these visits as a preventive measure to encourage continuous progress.

Organizational psychologist William A. Khan revolutionized employee engagement by defining it across three domains: physical, cognitive and emotional.⁹ Empowering managers with coaching, mentoring and a leadership mindset creates a powerful synergy that drives transformative results. Those who strive to do more will rise to the challenge, becoming more curious and bringing out their best selves. Finishing strong is what will “turn their flywheel” and propel them from “good to great” (author James C. Collins).¹⁰

We must use our (own or borrowed) wisdom and tenacity to make tough choices for everyone, avoiding the easy path. By investing time and focusing on root issues, we can make meaningful progress. Starting with accountability around these three pivotal questions, combined with deliberate feedback, is essential. The feedback is important, but what truly matters is how it is used to improve. 

Improved retention, focused purpose and effective information sharing require selfless and self-aware individuals who can consistently integrate these elements to catalyze engagement. As Stephen Covey said in his book The Speed of Trust, “Beginners are many; finishers are few.”¹¹

Notes:

1. Field E. Hancock B, Schaninger B. “Don’t Eliminate Your Middle Managers.” Harvard Business Review. July-August 2023. Available from: https://bit.ly/3BNTlor .
2. Ibid.
3. Deutsch M. “A Theory of Co-operation and Competition.” Human Relations, 2(2), 129-152. https://doi.org/10.1177/001872674900200204 .
4. Covey SR. The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change. 2004. Free Press.
5. Gallup. 2024 Employee Engagement Strategies Checklist. Available from: https://bit.ly/40eo5s8 .
6. Ibid.
7. von Goethe JW. Maxims and Reflections.
8. Christenson C. How Will You Measure Your Life? 2012. Harper Collins.
9. Sinclair S. “Kahn’s 3 Dimensions of Employee Engagement: Still Good to Go in 2021?” Talkfreely. Nov. 2, 2020. Available from: https://bit.ly/3ZUHxJ7 .
10. Collins J. Turning the Flywheel: A Monograph to Accompany Good to Great. 2019. HarperCollins.
11. Covey SR. The Speed of Trust.