You wanna get rocked?

Stop wasting my precious time..fool..

Well into my leadership career with a few stripes earned, and in a fit of enthusiasm to support my employer I applied for a post as Medical Director.

Medical Director jobs tend to be long term, can be permanent, if you play your cards right, and usually invole attracting a fair amount of derision from colleagues who variously think you are either lazy, morally bankrupt..or more likely both.

Unsurprisingly to me I was shortlisted. They had to because I met all of the shortlisting criteria. No one expected me to get appointed, least of all me, unless someone really badly fucked up. That’s not to say I didn’t give it my all- because I did.

At the time this was a step down the ladder. I was already in a much more senior role outside the organisation. This was something that caused a few select colleagues a degree of irritation. Mostly though, nobody cared or even knew what I did outside. My clinical colleagues appreciated what I could do to help them and conspired with me in their support for organisational culture change.

My direct co-workers, if ever they bothered to consider it, probably imagined my frequent absences comprised messing about in pointless meetings (partially incorrect).

The appointment process, like the employing organisation, was hopelessly bureaucratic, inefficient and misdirected. Nonetheless I had committed so pushed myself through like a lamb to the slaughter, already knowing who the annointed one would be. These things are rarely not a foregone conclusion, having been on the other side of the process a few times, and benefitted at others when I was in favour.

Don’t kid yourself that talent or values have anything to do with it. Fool. In my experience of healthcare jobs, selection processes generally are about de-selection and depending on the intended end point, this can range from weeding out people with the wrong skills, laguards, obvious sociopaths or miscreants or people who by consensus are a ‘bad fit’.

This latter category has sometimes given me a bit of bother, even more so when applying for leadership roles. Generally in my particular clinical specialism organisations are truly desperate and will hire pretty much anyone who can do the basics. But when it comes to leadership if the organisation gets it wrong then they have a problem they could do without. You could start a war, or worse you could threaten the boss’s position.

My natural tendancy has been to let others assume the lead and just fall in, be supportive. But I’m equally happy to lead when needed. My problems usually arise when I fall in, or build consensus, then see that we could do better, more differently. Not wholesale change or revolution, just different direction.

In these circumstances, its never too long until someone, usually the person who can see their job on the line if they don’t adapt, calls time. And then it can get ugly. Lines get drawn, power shifts, priveleges fall away. You either stand and fight or you leave.

I realise this sounds arrogant- it really isn’t. Remember those people who form the consensus? In my experience they usually stay and carry on. Mostly I would back off, and never would I let principle or personal pride get in the way of the greater good.

Clearing the first two rounds of my organisation’s process I pitch for round three. Trial by colleagues. A ten minute pitch followed by Q&A. Easy. Err not so fast..

The person Chairing this session was well known to me. Someone I held in the highest level of contempt. A person who had a reputation for being openly prejudiced and vindictive in a wholly single minded pursuit their objectives. Someone who had been heavily rewarded for openly destroying multiple careers, causing misery and distress.

The Chair’s second in line for this particular session was also someone I had previously got into difficulty with. An apparently benign but mealy mouthed individual who commanded little respect from their peers and who was unequipped for the basics of good leadership. Their survival in this organisation had been artfully sculpted from a long history of reliably delivered incompetence. You want something NOT done? Then this was the person to NOT do it.

This may sound like sour grapes: it isn’t. These individuals are vital to the system. They are the skeletal outline of healthcare systems without which things would lurch around unmanageably and people would get trashed. Respect for that I say.

Their essential presence speaks to the need for managed health systems to be able to keep a lid on things- at almost any cost. Otherwise you risk people trying to fix things which start biting off more than the system could ever deal with. Improvement and innovation must come slowly, be planful and be publicised in a way that keeps everyone reassured.

Otherwise the truth that actually a whole load of things can never be fixed is too awful and then, who knows? People get scared, anxious, angry. The fight emerging could lead to people grabbing at everything to hand and trampling on heads in the rush, blinded by the fear that they might not get what they need. Chaos.

Manage the people, be they patients or employees. Keep them all calm, in line, allow a few to shine brightly and dangle their achievments in front of everyone else so that they can aspire to similar greatness.

Doing this, as I say is artful, requires special people who can be utterly ruthless, amoral and dispassionate- all in the name of the greater good. Neo-conservative control to achieve sustainable utility.

“You have exactly ten minutes- and I WILL be strict” hard stare, “ GO!”

Being experienced in the art of timed pitches was going to be of no help here. I played it safe, answered the exam question, repeated my key message sound bites in case of early lock down and..

“STOP!!”

“I do actually have TEN minutes, and..we are at ..er, well just past seven?”

“Time’s up!” Loser! Hard stare.

“Right..err..Ok So my concluding points are”

“Shut up!!” Or what you fucking toxic monster..?!

In my head Iwas already lunging across the table to reap the kind of grisley retribution many others had only dreamed of..

“Sorry.” I sat down meekly and folded my hands in resignation.

The Chair glared down the table at my colleagues who stared back directly at me, grim faced, pitying. Clearly I was not in the right place, I’d stumbled into the wrong room. I was obviously making trouble, a bad example. A poor candidate. All as per their prior briefing. Let’s get this over with.

“Questions?”

No one spoke. Then, on cue number two executed the killer line. At least I think it was. Words definitely emitted, but, err no- I had no clue what was being asked.

“Sorry, not exactly sure..err was that a question or a comment?” The Chair’s eyes narrowed.

Number two sputtered more noise and I listened intently, still not understanding what the fuck was being said. Hmm, Ok. So I have to say something.

“Right, well, err I would want to come and talk this through with you and colleagues, to err, get a feel for the issues. Try to fathom out what would be the best way of taking as many supporters with us as possible, while converting the dissenters to our view?” Quizzical looks. Utter bullshit. Straight into the bear trap.

Chair: “I think we are done here”. I was ejected.

In all fairness the final stage was much better run. My feedback was excellent and I knew the performance had been of acceptable standard. But the stage three torpedoe had holed me below the water line since which I had been shipping water. I sank without trace.

The ‘right’ appointment for the organisation was made without further discussion. I learned a little more about myself and harboured no regrets. Things did not improve on the shop floor.

Why do this? Its a good question but the answer is simple. I believed, rightly or wrongly I had something useful to offer the organisation and my colleagues were supportive. Genuinely willing to support me in trying to improve their prospects of delivering their jobs for the good of their patients. It was a risk worth taking and I had no regrets.