Leading Up
It is true that it can be lonely at the top. Believing that leaders are truly born and not made, many find themselves in their natural environment, but without the stamina to continue the leadership role. And for those who happen into leadership created from circumstance and necessity, with support barely more than lip service, how long would this appointment be tenable for?
When personal and professional support to the leader dries up, what happens next?
Currently we are seeing a crisis in leadership in Australia, as the pandemic continues and followers demand direction to cling onto hope and certainty. But we are also witnessing our leaders, those we cling onto are fatiguing and faltering under the sustained pressure of meeting unrealistic expectations and relentless pressure.True leaders do step up in times of crisis, but how do they sustain themselves?
This opens the question. Do the followers have a role here, and is there opportunity to ‘lead up?’
A good example of this in action is occurring in many general practices across Australia. The pressures and uncertainty demand more stable leadership than ever, but it would be inevitable that despite steadfast resolve, very few clinics could keep up with change with no notice, announced at pressers at media grabs ahead of any communication. Strong practice partners and practice managers continue to lead in the interests of their staff and ultimately their patients and reputation. The balance is fine and notwithstanding any skill or ability, sooner or later the cracks will appear.
Followers demand or at least expect leadership and tenacity at times of such unprecedented change, with just so much at stake. And of course they should. In an imperfect world followers could scatter, and a spectrum leading to anarchy could ensue. This could hold ethical, medicolegal, and practical consequences that would ordinarily be curtailed by strong, consistent, effective leadership.
Calls for support of general practices, their clinicians and staff, are merely just that, calls. There is no relieving workforce, no administration workforce or any other practical strategy that can be rolled out post haste. To be eighteen months into the worst pandemic in recent history and have precious little in the way of tangible support does not bode well for any relief on the horizon.
So where do the solutions lie? And we do need solutions before our entire general practice workforce falls over. These general practitioners have had little if no leave, while constantly stepping up to address the increasing mental health burden, the demand for evidence and guided decision making that is an essential part of the vaccine rollout and doing very much more with so much less across Telehealth platforms and modalities.
The answer must come from within the walls of the buildings that house these exhausted but steadfast clinicians and staff. Waiting for more from without is short sighted and breeds disappointment and resignation that simply, nobody cares. The system that lies within made up of GP registrars, the GPs, the administration staff must develop an awareness and a conviction to care for and support their leaders. This could appear as gestures of compassion, a simple hello and checking in while in the tea room or in the carpark. A coffee run to ensure the leaders are caffeinated before a long session. An offer to share the load so the leaders can take a break for some sport, leisure time or even rest. Practice managers should be supported by their reception and administration staff to be given time and space to keep up with all the changes occurring, often on a daily basis.
The strongest general practices will be tested by now, and those that have teams that nurture each other with reality based compassion and practical acts of kindness will reap the benefits. They will withstand those weeks when the demand is extreme. Lack of leadership leads to one pitting against each other, a loss of direction and focus and an inevitability that this too will never pass.
Doctors are mandated to do no harm. Harm can manifest in many ways. Poor culture and comradery will show up as impacting on standard of care. Teamwork, nurturing and compassion will fuel the bottomless pit, protecting leadership, and ensuring best practice reigns supreme when so many external forces threaten this every day.
