He says though strong management is a complex, ever-changing role, it isn’t hard to isolate the characteristics that separate good managers from bad ones. On the simplest level, he says managers can be compared to characters in Disney movies, a staple for anyone with young children.
Mr. Zasa has three young children, so he’s familiar with the archetypes that appear again and again in Disney movies. The lines drawn in Disney movies are distinct; the good princess is selfless, fair, loving and loved, while the evil queen is manipulative, selfish and narcissistic. In the movies, of course, it’s fairly obvious to tell which characters are good and which are evil. In the ASC world, he says it may not be so simple.
“The personality type of the ‘evil queen’ is particularly insidious because they seem very competent and are able to lead others,” Mr. Zasa says. “[The problem is that] they achieve results through manipulation and force, which creates deep-rooted problems for your surgery centers.”
Here, he shares four questions to ask to distinguish “evil queen” managers from “good princess” leaders:
1. How does the manager react to praise? Mr. Zasa says you can tell a lot about a manager from the way they react to success within the center. “When your organization has achieved success, ask your manager what happened and why the success occurred,” Mr. Zasa says. “If the person sits there and uses the first person — ‘I, I, I’ — and takes credit for it, that’s a red flag.”
He cites Pat Summitt, former head coach of the Tennessee women’s basketball team, who recently accepted the Arthur Ashe Courage Award at the 2012 ESPY Awards Show. Ms. Summitt, the coach who has racked up the most team wins in college basketball history, could easily accept all the credit for her success. Instead, she accepted the Arthur Ashe award with a nod to her supporters, saying, “I’ve always said you win in life with people, and I have been so blessed to have great people in my life.”
“She talked about the success of people around her,” Mr. Zasa says. “It’s not about you. It’s about the organization and the people who get you there.” When promoting staff members to management positions, he recommends looking for team members who encourage collaboration and give credit to their peers. Those will be the managers that inspire people to work hard and reward staff members fairly for their success.
2. How much turnover does the facility have? High turnover can indicate problems with facility management, Mr. Zasa says. If you want to know whether your employees enjoy working for you, compare your rate of terminations and departures with your peers. Ideally, your surgery center should include a cadre of staff members who have been with the facility for several years; the great managers speak of nurses who have stayed for 15 years, despite salary and benefit competition from the local hospital.
“I can’t get rid of any of my people,” Mr. Zasa jokes. “One of my nurses is 79 years old, and she’s finally going to retire. We have huge longevity at ASD, which makes me happy because we must be doing something right.” He believes management issues are at the heart of many high turnover rates in ASCs. In 2011, the Society for Human Resource Management conducted its annual survey to determine levels of employee satisfaction in the United States. The survey found that “relationship with immediate supervisor” was ranked third among the top factors affecting satisfaction. The only two higher factors were job security and the opportunity to use skills; compensation fell lower, and benefits lower still.
This means that if you have a high turnover rate, you should hesitate before blaming the problem on salary or benefits. Look at your management team and analyze the relationships between your managers and their subordinates. “How does the staff react to you? Do you and your managers act like the selfless princess, or the manipulative queen?” Mr. Zasa says.
3. How does the manager respond to interpersonal issues among staff members? Good managers don’t engage in drama, Mr. Zasa says. In a small facility, it can be easy to get caught up in the day-to-day problems of your employees. A nurse might come to the administrator and explain that the scrub tech said something hurtful to her, for example. Mr. Zasa says while employees should be treated with respect and kindness, there simply isn’t time for an ASC administrator to listen to every gripe and take sides in petty arguments. “You cannot sit there and let people eat up your time with all their personal drama,” he says. “At the end of the day, the job is taking care of patients and making sure physicians are happy.”
He says bad managers often get caught up in center drama because they enjoy playing favorites with their employees. This mirrors the archetype of the evil queen, who manipulates her subordinates with ever-changing levels of praise and disdain. “A good manager will rise above it,” Mr. Zasa says. He says he has a joke with one of his administrators: Whenever a staff member comes to her with an interpersonal problem, she should ask herself, “What would Joe do?” The answer is usually to listen for a few minutes, ask the employee for a solution to the problem, and move on. The good queen rises above the drama and sets an example of fairness and equity for all, promoting self esteem and a feeling of positivity among the staff and the physicians. “Be the good queen,” says Mr. Zasa.
4. How are decisions implemented at the center? Bad leadership can take on the guise of good leadership if employees are motivated by fear, which can make it hard to identify “evil queen” managers, Mr. Zasa says. Employees motivated by fear will work hard and produce results, but for the wrong reasons — because they fear the manager’s retaliation. “Look at how a manager makes decisions in the surgery center,” Mr. Zasa says. “How was the decision implemented? Was it ‘you have to do this,’ or was it a discussion amongst the team?”
He says good managers communicate the reasons for big decisions in the surgery center and sit down with employees to explain the process. They also ask for feedback because they know management doesn’t always understand the “ground level” needs of staff members. Bad managers implement changes unilaterally. They don’t ask for feedback because they don’t want to be told they’re wrong. “You can manage through fear, intimidation and people’s need for income, or you can manage through motivation,” Mr. Zasa says. “Motivation is more effective.”
While the Disney characters draw bright lines for children between good and bad, their message is uniform. Strive to selflessly lead and infuse positivity among the staff and physicians. Encourage your people and lead with an even hand. “Remember a pinch of pixie dust changes everything,” Mr. Zasa says.
Learn more about ASD Management.
Related Articles on ASC Turnarounds:
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5 Common Mistakes Made in Ambulatory Surgery Centers
