Your Practice / Business

The Business Case for Emotionally Intelligent Leadership

Shelley Simon, RN, DC, MPH, EdD

When you think of great leaders, who comes to mind? Are they individuals in your own field - gifted chiropractic colleagues or perhaps one of your mentors? Are they leaders in business, politics, education, science or religion? What are the common characteristics of great leaders? Intelligence, charisma, integrity, original thinking, the ability to articulate ideas or powers of persuasion? Chiropractors often are ambivalent when asked about their leadership roles or styles. Some don't even consider themselves leaders. "I have a small practice," they'll say. But whether you have two staff members or a dozen, make no mistake about it - you are a leader.

Emotional intelligence (EQ), not IQ or technical competence, is the key to outstanding leadership and building a successful practice. The principal elements of emotional intelligence are (1) the capacity to recognize and understand one's own feelings and the feelings of others; (2) the ability to be self-motivated; and (3) the competency to manage one's emotions. These core competencies and the skills of emotionally intelligent leadership (which we're about to discuss) can be learned and further developed if they are practiced on a regular basis.

Social Competence and Emotionally Intelligent Leadership

Social competence - how you behave with and influence others - is more than simple friendliness and caring. It is friendliness with a purpose and includes the ability to manage conflict, move people and projects in a desired direction, build trust and work collaboratively. Social awareness includes demonstrating empathy, having the ability to read others accurately, putting mutual goals above self-interest and sustaining a service orientation.

The business case for emotionally intelligent leadership is undeniable and essential for managing high-performance teams and building a successful practice, regardless of size or stage. According to author Daniel Goleman, "Managing for financial results begins with the leader managing his inner life so that the right emotional and behavioral chain reactions occur." This single sentence makes it abundantly clear that developing EQ competencies is directly connected to your practice success.

Resonant Leadership

The influence you have on your team and your patients is greater than you might imagine. Your mood as a leader is contagious. It has the greatest impact on performance and outcomes when it is upbeat and in tune with the people around you. According to recent business research, a leader's actions account for up to 70 percent of employees' satisfaction, perception of their workplace, and how they feel about working with you. Successful leaders create a positive emotional environment in which others are inspired and motivated. Artful leadership occurs when head and heart come together - when "leaders execute a vision by motivating, guiding, inspiring, listening and persuading - and, most crucially through creating resonance," according to Goleman.

Emotionally intelligent leaders build resonance by tuning into both their own and other's feelings, needs, and perspectives. They lead people in the right direction by demonstrating authenticity, mental clarity, concentrated energy, an optimistic outlook, a sense of purpose, and the ability to see the big picture. By doing this, a leader is able to inspire, motivate, arouse commitment and sustain momentum. Emotionally intelligent leadership is key to creating an environment in which employees are nurtured and encouraged to give their best. This enthusiasm arouses a similar response in patients, which can lead to better patient compliance and improved outcomes.

Why Pay Attention to Leadership EQ?

To put EQ-based leadership into perspective, consider the following scenarios. These are dramatized to drive home specific points, but you may catch a glimpse of yourself in one or more of them.

Dr. A: The commanding leader whotends toward anger. Dr. A often is an-noyed or frustrated and doesn't mind letting everyone know it. He offers feedback only when someone does something wrong. His modus operandi is: Do what I say because I said so. When anything goes wrong, someone else is to blame. He doesn't like to collaborate or even listen to the opinions of others. His communication skills are marginal and self-serving. On his worst days he slams doors and chastises staff in front of patients. He has little awareness of how his moodiness and anger impact his staff and wonders why turnover is so high.

What would Dr. A gain by building self-awareness and being less demanding and angry? By becoming aware of his own inner signals and triggers, and assessing his strengths and weaknesses accurately, he would more effectively manage himself in the best interests of those he serves (staff and patients). Rather than losing his temper and having little understanding of his impact on others, he would learn to keep himself in check emotionally, ask for and listen to feedback, and begin to build better relationships with staff and patients.

Dr. B: The driven leader. Dr. B, in an effort to grow her practice, has a pacesetting management style. She works to the point of exhaustion and assumes that others want to do the same. She drives her staff too hard and can be coercive and manipulative if she thinks it will get her what she wants. She micromanages and is rarely satisfied with the quality or quantity of others' work. When a staff member or patient doesn't follow her lead, she silently deems them wrong or stupid. Dr. B is self-absorbed and when things don't go her way, she tends toward fight or flight, either attacking or withdrawing.

What would Dr. B gain by controlling her perfectionism and relentless drive for success? By keeping disruptive emotions and impulses under control, and by displaying honesty, integrity and trustworthiness (by speaking and acting congruently), Dr. B would improve her own self-esteem and enhance the likelihood of staying motivated to work on her practice even during challenging times. She would become less demanding, learn to depend on others more, and relate more effectively when difficult situations arose in her practice. She would be more positive, better able to see the upside of things, and experience what it would be like to have others respond to her requests willingly rather than begrudgingly.

Dr. C: The leader lacking in social awareness. Dr. C manages his practice based on vision and purpose, but he takes this approach to the extreme. He becomes overzealous in trying to achieve his vision, and patients wonder whose needs he is looking out for -theirs or his own. He has difficulty reading social cues and doesn't listen to his patients. He thinks he already knows what they are going to say and what they need. He's primarily focused on what he wants patients to do. When patients question his recommended course of treatment or have objections, he dismisses them as non compliant or not smart enough to understand what they need. His style is off-putting and his patient-retention rate is low.

What would Dr. C gain by developing better social awareness? He would develop more resonance with the people around him, most importantly his patients. He would learn to listen and see things from his patients' point of view. By being attuned to how others are feeling, Dr. C would learn to say and do what is most appropriate rather than resorting to a script or reacting in a habitual way. This would allow him to more effectively guide his patients and care for them in accordance with their needs, desires and values.

Different Circumstances Call for Different Styles

An emotionally intelligent leader is one who can move flexibly between different styles in order to effectively manage and respond to any situation. As Goleman says, "resonant leaders know when to be collaborative and when to be visionary, when to listen and when to command." What is your primary leadership style? Can you identify yourself here?

Style Attributes Position General Impact on Others
Commanding Controlling, demanding, domineering, coercive, heroic. Rarely offers praise; commonly finds fault. Makes requests with little or no explanation. Do what I tell you. Negative
Pacesetting Driven, impatient, perfectionist, micro-managing, unreasonably high standards, rarely satisfied. Do what I do, and more. Negative
Affiliative Works to increase harmony, improve morale, communicate well, and manage conflict effectively. Let's do what is best for everyone. Positive
Democratic Builds trust, buy-in and commitment; listens, collaborates, values teamwork. Let's decide what to do together. Positive
Visionary Empathetic, self-confident, builds on the potential of others, is a change agent. Do what will help us reach our goals and your goals. Strongly positive
Coaching Has strong self-awareness, patience; skillful at identifying the potential in others and building on their strengths and goals. How can I help you do it better? Strongly positive
Adapted from Leadership That Gets Results by Daniel Goleman, Harvard Business Review, March/April 2000

Take note of your style during stressful situations or challenging interactions. This "under fire" assessment will yield the most accurate feedback. Ask yourself Situation Needed Style What to Do

Crisis, breakdown, need to revamp or change direction; dealing with a chronically difficult employee. Commanding Take charge with care; communicate in a rational manner; factor in the feelings of others as you do what needs to be done.

Need quick results from a high-functioning team, such as meeting an important deadline. Pacesetting Clarify expectations and offer the rationale behind your requests of others; help others see the big picture vision of what needs to be done - and why.

Working through a stressful time; healing a conflict among team members; need to promote referral behavior. Affiliative Demonstrate that you value people and their contributions; acknowledge conflict; build and nurture relationships over time.

Desiring feedback or input from staff or patients; need to generate new ideas and achieve buy-in or commitment from others. Democratic Create a safe environment; encourage input and really listen; be curious; guard against becoming defensive if you hear something you don't like.

Trying to achieve a clear direction; wanting to retain valuable employees by including them in planning; establishing a competitive advantage through marketing and patient-retention efforts. Visionary Share your vision, purpose and direction with staff; be transparent, congruent and consistent in all your dealings; inquire about how others are feeling and thinking about plans to move forward (don't assume you know).

Developing staff for performance enhancement and growth; establishing rapport and trust with staff or patients; supporting patients in making behavioral changes. Coaching Mentor, train and invest in others; tolerate short-term setbacks on the way to long-term success; establish clear criteria and goals; monitor efforts and results.

how you tend to respond to or relate with staff, patients and colleagues when you are under pressure. If you are only comfortable in one or two of the above styles, you will not have the best outcomes, particularly if you default to the commanding and/or pacesetting styles. While these styles are useful and necessary in certain situations, they create dissonance when relied upon to the exclusion of more positive styles.

Situation Needed Style What to Do
Crisis, breakdown, need to revamp or change direction; dealing with a chronically difficult employee. Commanding Take charge with care; communicate in a rational manner; factor in the feelings of others as you do what needs to be done.
Need quick results from a high-functioning team, such as meeting an important deadline. Pacesetting Clarify expectations and offer the rationale behind your requests of others; help others see the big picture vision of what needs to be done Ð and why.
Working through a stressful time; healing a conflict among team members; need to promote referral behavior. Affiliative Demonstrate that you value people and their contributions; acknowledge conflict; build and nurture relationships over time.
Desiring feedback or input from staff or patients; need to generate new ideas and achieve buy-in or commitment from others. Democratic Create a safe environment; encourage input and really listen; be curious; guard against becoming defensive if you hear something you donÕt like.
Trying to achieve a clear direction; wanting to retain valuable employees by including them in planning; establishing a competitive advantage through marketing and patient-retention efforts. Visionary Share your vision, purpose and direction with staff; be transparent, congruent and consistent in all your dealings; inquire about how others are feeling and thinking about plans to move forward (donÕt assume you know).
Developing staff for performance enhancement and growth; establishing rapport and trust with staff or patients; supporting patients in making behavioral changes. Coaching Mentor, train and invest in others; tolerate short-term setbacks on the way to long-term success; establish clear criteria and goals; monitor efforts and results.

Though we all have natural preferences, we can learn the behavior and skills of other leadership modes or styles. The best leaders maintain flexibility, switching easily between visionary, coaching, affiliative and democratic, and make only rare, strategic use of the less effective pacesetting and commanding styles. To build the skills needed to use each of the six styles, here are some ideas about what to do in specific situations. Experiment with these to develop your style repertoire and flexibility in application.

A primary measure of success is the way your patients and staff perceive you. Attracting and retaining patients requires more than simple patient satisfaction. Building a healthy practice requires leadership that includes the ability to develop and manage relationships effectively. Leaders who have enthusiasm and resilience execute their own visions with skill and confidence and, at the same time, encourage and mentor others toward excellence.

Increasingly, research is showing that effective leadership and business success are the result of IQ, technical competence, and - you guessed it - EQ. The business case for EQ-based leadership is clear and the good news is that, while it does require commitment and effort, the skills can be learned. The even better news is that acquiring these skills is engaging, satisfying and good for the bottom line of any business.

January 2008
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