Podcast: Transformational vs. transactional approaches to leadership

Hello and welcome to Ascent Dental Radio. A program dedicated to the balance between the clinical aspect of health care and the business of health care. And now here is your host, Dr. Kevin Coughlin.

Kevin: This is Dr. Kevin Coughlin. You’re listening to Ascent Radio -- Ascent Dental Solutions with a focus on knowledge, consultation, development and training.

Today we have an extremely interesting podcast with Ms. Renee Simone. She’s a small business owner of an outstanding private practice in western Massachusetts called Change Happens, Inc. She’s a licensed independent clinical social worker, a licensed alcohol and drug counselor, a licensed RN and she’s in the process of finishing her clinical doctorate in nursing practice.

’ve had the pleasure of meeting Renee several months ago and over several conversations and meetings, I have found her intensely interesting and I have also found a tremendous similarity of medicine and dentistry. I’ve always felt that they are very similar, but in particular, how registered nurses, doctoral nurses and the entire nursing profession and its effect on health care can be so dramatic.

But in particular, Renee’s forte is leadership and how she integrates with other health care practitioners and the qualities that she’s seen dealing with leadership and how health care teams can be better motivated to really ultimately do the most, which is improve health care and outcomes for our patients.

Without any further ado, Renee, thank you for joining me this afternoon. I’m sure our listeners will be incredibly pleased with the information you can provide to help, not just small businesses, but large businesses. Tell me what you found and what you think the direction of health care is going and how leadership is a critical part of that.

Renee: Sure, I’d be happy to talk with you a little bit about that, Kevin. First of all, I just want to say thank you so much. I have so enjoyed meeting you and getting to know you as well and your work and I think that it’s just so important to have these conversations and I hope to be helpful.

My biggest focus and hope is to be able to serve and to fill gaps and to help folks stay ahead of the curve and to really be a leader also in the highest capacity and a high scope of whatever I’m practicing. So I really appreciate you having me here as well.

Kevin: You’re quite welcome.

Renee: As far as what I hope that the nursing profession can bring to changes in health care, this is a very, as other times in history, it’s a very chaotic and active time of change.

There’s a lot of pressure and I’m sure in a lot of other businesses in health care, the pressure is in productivity and cost savings while at the same time not compromising quality. So I think that can be a very challenging space to practice in.

Kevin: Some would say almost impossible.

Renee: Yes. We were listening to a podcast or a talk for one of our classes on nursing leadership and one of the gentlemen talking there said that he feels it’s sort of like the triple threat of management where you have three hats that you’re trying to balance out; quality, time and money.

And whenever you focus on one of those, the other two suffer. So certainly I think that’s to your point where it can seem very challenging and almost impossible.

Kevin: If you were to review those criteria, are they equal? Is there one that you would put more emphasis on another? I know with the corporations getting more involved with medicine and in dentistry in particular, but that pressure for short term profit and perhaps short term gain but long term failure is always there. Can you address that for our listeners?

Renee: Sure. I think that’s the trap, the question. I think we have to look at what we’re really asking. Because that question; which one is more important, I think it just continues to unintentionally get us sucked into the merry-go-round or the trap of trying to choose.

And that sort of to me has been like an undercurrent in health care that people aren’t really aware of and talking about where it kind of pulls you down. I’d liken it to trying to stay alive or survive when you’re being sucked in by an undertone. It doesn’t help to fight.

What really needs to happen in order to survive and make headways is to learn how to step outside of that current. So I really don’t think there is a solution. And I think the longer we try to kind of go round and round on our minds about trying to choose and prioritize, that’s part of the trap.

Kevin: If you were to tell the listeners out of all the criteria with your extensive experience in health care, what are some of the qualities you look for in people who are excellent in management, excellent in leadership, understanding that they’re really two different topics, two different skills and many times, managers try to be leaders, leaders try to be managers.

And sometimes that doesn’t work and I don’t think in our day to day lives in health care we think that there is a difference. Most of the time, the doctor feels that they are the manager and the leader and many times they are the most ill-equipped to do either of those because they lack training. Can you address that?

Renee: Sure. Before I go onto that, I just want to finish up. This will kind of be a segue into talking about that a little bit. I didn’t intend to side-step the question about which one is more important. What I wanted to do is use that to say that that’s where I think exactly service leadership or leadership in a transformational way addresses the wheel of insanity with trying to prioritize.

So to me service leadership is really a way to step outside of that current and really affect change from that position. Because management -- a lot of the literature talks about, in nursing anyways, applying and understanding the differences in types of leadership. So there’s something called Transformational Leadership Style and there’s another style called Transactional Leadership.

Transactional Leadership is really speaking to more of what you’re talking about, that managerial style. That management style. Transactional leaders are really more about developing followers, organizing tasks, making sure the job gets down.

They’re really more task oriented and there’s no place in that with the pressure of productivity and cost effectiveness and instant gain. There really is no place for reflection. We don’t really have time to think, not just in our business world, but in our personal lives often.

So transformational leadership really is more about stepping outside of that current, thinking about what we’re saying, thinking about what we’re doing. And really trying to find ways to be innovative, think outside the box, be willing to take risks, have a vision and helping people follow that in the sense that where people are kind of walking together instead of being directed.

I think of the difference between the image that I’ve seen a lot between a boss and a leader. The world has plenty of bosses and managers. We don’t need any more of those. And it’s not really being effective anyway in terms of progress where health care wants to go. Because bosses tend to be more directive and telling people what to do and managing. And there are some people who like to do that.

Transformation Leadership on the other hand or leadership qualities is more about serving, how can I help you get to where you want to be. And the more that you, I think, empower other people, the more that that power gets recycled back into the relationship and has meaningful change.

Kevin: Do you find that these transformational, is this being taught? Is this being taught in the nursing field, is it being taught in health care as far as you can see or is this something we sort of stumble along and say this works better than that and there’s really been no preparation for it, you just sort of learn by the seat of your pants?

Renee: I think that’s a great question. I’m going to draw on a little bit of what our conversations have been because I think you made an excellent point that there’s really nothing new, necessarily, out there.

A lot of times, we stumble on things because of our own learning curve and our own ignorance and lack of awareness. So from that perspective, actually in my studies, I’ve learned more about what’s out there. Because as a doctorally prepared nurse practitioner, we are more encouraged and trained to accept it when we don’t know the answer to something, but the more important thing is know who to ask or how to find it.

So I’ve been exposed to a lot of incredible information that’s been around for a while on the differences between leaders and managers. I just haven’t looked or known where to look.

And so I think that we’re exposed to it in our training, however, that’s -- actually, I’m glad you asked that because one of my core passions is to find ways to not reinvent the wheel, spend a little bit more time looking and talking to one another about what’s already out there and borrowing from each other what’s working.

So from a transformational leadership perspective, I think clinical social work model since its inception -- clinical social work was born in 1929 in the Chicago settlement houses. And since then, clinical social work has always maintained a commitment to supervision; clinical supervision, skilled clinical supervision, as a way to develop processionals and help new therapies to be the best practitioner they can be.

Kevin: If you were to talk to the audience listening to us now, do you see the value in mentoring, preceptoring, role modeling? I know for myself, there’s been people in my life that they weren’t intending to be a teacher for me, but they sort of acted as a role model. I saw how they interacted at bedside or chairside, I saw how they interacted with team mates, staff, employees and that combination is how, unfortunately, I learned.

There was no class that I went to through my four years of medical dental training to say, “Oh geez, this is how I treat Mr. or Mrs. Smith or their children.” Is that changing in health care? Do you see an improvement in that area? Are there courses that are out there that are focusing on not just the didactics of medicine, which we’re all comfortable with, but that undertone, that patient care, that ability to teach the people around you these leadership skills?

Renee: Excellent question again and that’s what I hope to offer and to bring to health care because there isn’t really anything concrete, formalized, standardized, operationalized around those qualities.

In any profession that I’ve seen, as you mentioned, a lot of times we learn informally. So a lot of the terminology and language that’s similar in dentistry as in nursing, health care, when you talk about mentoring, precepting, guiding, being a support, I think that health care does those things informally and intuitively.

When they’re a good person, they’re a good practitioner, they want to give back, they want to help, they want to teach, they like to teach, like you’ve said, but there really isn’t much structure around that. And I think that that’s exactly the direction that is coming next.

Kevin: At your business, is that where the focus is? If people wanted to reach out and have you help them, are you doing that? Is that something that you offer? Is that something that you’re trying to pursue?

Renee: Absolutely. In fact, that is all about what my quality improvement project I’m working on now for the doctoral program is incorporating and integrating -- because  I have a passion for integration so this is just another extension of that -- integrating the specific principles from a clinical social work model that apply to supervision.

And helping overlay them and incorporate them into other preceptorship programs from nursing to start, but I think they’re applicable to dentistry, I think they’re applicable to other types of health care, I think they’re applicable to other profession.

Because to me, leadership is practicing at the highest good or the highest level that we can be in any profession or in any role.

We get taught that in nursing school. As leaders the rhetoric is you can be a leader regardless of your role, whether you are a floor nurse, whether you are a charge nurse, whether you are a nurse manager, most importantly, when you are trying to manage or lead or oversee things. So I agree that that’s something that can be incorporated into business.

Kevin: I know from just my own personal experience just in the last few weeks, I’m offering a clinical course and it’s on implant surgery and surgical guides and 3D imaging. And within 24 hours, I got 18 people in my company to sign up because they want to know how.

But it’s interesting when I want to get them together to talk about leadership, and I don’t know if you’re aware of it, but I’ve got probably 400 listings on leadership and I researched 12 factors that were important in leadership. And the funny thing is it’s hard to get people to sit down and talk about that.

My summary of leadership, and I can’t say it’s something that I came up on my own, I probably heard it or copied from someone, but leadership to me means the ability to influence people in hopefully the correct direction.

There’s a lot of leaders that can push you in a bad direction, they’re still leaders. But I think good leadership comes by influencing people in the right direction. Would you agree with that or would you want to comment on that?

Renee: I think that’s true for a basis and a start, is the ability to influence. In fact, one of the transformational qualities, one of the four core qualities is idealized influence. So I think that’s very important. I don’t think that comes with pushing, necessarily, because again you can push someone, however, you don’t know which direction they’re going to go in.

If you pull them by effectively leading and modeling and showing, then it’s easier, I think, because then you’re sort of leading and moving together in the same direction. Then people do see you as a trustworthy, dependable, authentic, competent person.

Kevin: Renee, if individuals listening to us today wanted to reach out to hear more about your style and how you can direct and help them in their own personal lives or in their business lives, is there a way for our listeners to reach out and contact you?

Renee: Absolutely. One of the easiest ways is going to be through the website, which is www.changehappensinc.com. You’d be able to reach out through that website to me through email. My personal email is renee.simone50@gmail.com. And then my business contact information the easiest way to text or call that business number is 919-793-6862.

Kevin: So you’d be happy to go to different locations and put on a seminar to help team members improve in their leadership and just the way they integrate with patients, is that correct?

Renee: Absolutely. That’s something that doesn’t feel even like work to me because it’s one of my passions and I really enjoy giving back in that way. And I think I’ve experienced through the results of the growth of my own small practice or business that the return on investment is just incredible.

Kevin: I want to thank you so much for your time. I do want our listeners to know that Renee Simone also has another business and that business focuses on insurances and insurance needs.

And we hope to get her back because quite honestly, although I’ve been in health care for 34 years and still practice every day, I was blown away by this particular area of let’s say life insurance, but life insurance in a different way that I had never really thought about it. And I would consider Renee extremely knowledgeable in this and I’d like to get you back. Would you mind talking to our listeners about that?

Renee: I’d love to. Thanks.

Kevin: I want to thank everybody for today. I hope you enjoyed. I want to personally thank you Renee for your expertise and taking time out of your busy schedule. As always, I want to thank Doug Foresta. Without his ability to put this product together, we would not be here today.

And as always, please feel free to reach out to Doug and his company if you’re interested in podcasting. I can certainly tell you that it has been a big boom to my career and just to my office and my bottom line. It’s an excellent way to communicate.

You’ve been listening to Ascent Radio. My name is Dr. Kevin Coughlin. If you need to get in touch with me or look for additional information, I can be reached at www.ascent-dental-solutions.com.

Thank you very much for listening and Renee, thank you.