Learning to Ride the Elephant

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By: Wiley W. Souba, MD, ScD, MBA, dean, Geisel School of Medicine at Dartmouth. Dr. Souba is recognized for his innovative approaches to developing leaders and leadership. He lectures regularly, conducts workshops, and has published more than 40 articles on topics such as personal and organizational transformation, leading oneself, and the language of leadership.

“Drive out fear” quality guru W. Edwards Deming emphasized over and over. He was alluding to the kind of fear that discourages employees from speaking up, whether it be constructively disagreeing with a supervisor or pointing out a process or practice that could be improved. In their recently published Academic Medicine perspective, Dankoski et al stress the importance of developing faculty who are adept at broaching difficult conversations with those in power, to counteract organizational silence. When people are afraid of contradicting their bosses or afraid of being labeled a rabble-rouser if they say what’s on their mind, organizational performance suffers. When organizational silence is rampant, the best that can be hoped for is resentful submission. Creativity and risk-taking are invariably quashed and morale suffers. Sadly, this is the landscape at many of our academic health centers.

I have worked in universities where the “boss” discouraged, even suppressed, dissent. Years ago, one very senior university leader told me that he did not like conflict because he thought it created too much unrest and disruption, which distracted people from their work. But, more importantly, I suspect that he believed that dissent made him look as if he wasn’t in control. Curiously, leaders who encourage straight talk are more respected because it demonstrates that they know they don’t have all the answers. When the untalkable becomes talkable, it strengthens the bonds (commitment, trust) that hold people together in the midst of the pressure, heat, and explosiveness that can arise in tough conversations. At the same time, the requisite variety of responses for dealing with a changing external environment increase.

To attack organizational silence, senior leaders must pave the way. If they are serious about designing learning organizations, they must realize that the dominant tendency is for employees to regard speaking up as risky. If the example isn’t set at the top, the rank and file won’t follow. Top leaders must publicly recognize and support individuals who ask penetrating, uncomfortable questions rather than viewing these individuals as non-team players. Leadership is always born out of high-powered human connections that are the outcome of vigorous, healthy debate. This is a telltale sign of organizational health. Unfortunately, it is all too uncommon.

Conversations in every organization are guided by a set of (mostly) implicit rules, which circumscribe what may be discussed and what may not. Interestingly, most of the time the capacity needed to thoughtfully discuss the undiscussable already exists in the organization. But with no formal venue to get the issues out in the open, the default venue becomes the restroom and the water cooler.

Elephants are brutally difficult to take on; old habits die hard. Building a culture where individuals are willing to speak up about organizational issues cannot be learned from a lecture or from reading a memo. When someone explains to you how to discuss the undiscussable, their account gives you no direct access to the skill. You may be able to recite all the books on organizational silence, but until you experience firsthand what it is to discuss an undiscussable and what it is to confront your fears and inadequacies in dealing with it, you will never master elephants.

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