I was witness to an interesting conversation recently between three women, each with over 20 years of experience in health care at the same hospital. All work in occupational therapy and they met to celebrate the retirement of one of the trio. Inevitably the conversation turned to the changes that they had all experienced during this long period of their respective careers.
Some of the themes of this conversation were depressingly familiar. They rued the fact that the standard of patient care had in their opinion declined with an ever greater emphasis being placed on patient throughput and bed utilisation etc. They agreed that when they commenced their careers they were responsible for the evaluation of a patient’s condition and had hands-on experience in rehabilitating them whereas the young OT these days has a wealth of technical knowledge but lacks the opportunity to gain vital practical experience by actually treating the patients.
The net result of these and other trends is that there is an increasing divide between practitioners of the “old” and the “new” and between those who manage the hospital and those that treat the patients. Despite what senior management might say, the emphasis on the provision of patient care is overwhelmed by the necessity to stretch the budget further and further. The net result is greater stress suffered by people at the patient interface who feel that they are not being allowed to do the job that drew them to this vocation in the first place.
My mind recalled the story of the Harvard business professor who asked his students what hospitals did. They replied: “They heal the sick”. His response was: “No, doctors and nurses do that – the role of the hospital is to provide the environment in which the best doctors and nurses want to work”.
One of the trio then made the observation that the situation between the health care practitioners and the hospital administration had deteriorated as the number of women in upper and senior management positions had risen. This statement immediately triggered recollection of a comment by Geraldine Doogue, the Australian TV presenter, journalist, speaker and author when she said that she would believe in equality between the sexes when “there are as many incompetent women in positions of authority as there are incompetent men”.
There appear to be three different scenarios. The first is that the tension between the administration and health practitioners is due solely to environmental factors, namely inadequate funding and the consequences that flow from that. So for this hypothesis the ratio of men to women in management positions is immaterial.
If the number of management positions remains constant and Geraldine Doogue’s tongue-in- cheek comment is true, then logically the number of competent and incompetent managers is not dependent on their sex. However, those who are familiar with my blogs will know that I harbour a strong suspicion that the overall standard of people management has declined. If that is the case, the ratio of incompetent to competent managers will have risen and this will be exacerbated if there is a rise in management numbers. However, as in the first scenario, the sex of the managers is not an issue.
The third scenario is that the sex of managers does have an influence on their ability to manage people and that the inference in the comment by one of the three women is true. Women are inferior people managers to men. Could this be the case? Could it be that only the most ambitious and self-interested women break through the glass ceiling? Could it be that women managers find it more difficult to cooperate with one another than their male counterparts? Could the sex of the managed be a factor in management/employee harmony?
I raised these questions with a female colleague of mine and she immediately pointed out that the health practitioners – the nurses, the physios, the OT’s and the Social Workers etc are predominantly women and then went on to advance the following theory. I’ll paraphrase it as follows.
Men are simple: women are complex. Men say what they think; women don’t. Men are from Mars; women are from Venus. Thus when men manage men – it’s the simple managing the simple. No problem. When men manage women – it’s the simple managing the complex but one offsets the other. It’s a similar offset when women manage men. (You can see where this is heading, can’t you?)
So, when women manage women, it’s the complex managing the complex – there is no offset and neither are any of them from Mars! The problem is that if you subscribe to this theory then in an employment sector where women greatly outnumber men and promotion is largely internal, there will be an increasing number of women in management and administration managing women. Add to the mix the Peter Principle that “in a hierarchy, every employee tends to rise to his or her level of incompetence” and the end result is well – exactly what the three women were talking about.
Has anyone been bold enough to do some research in this area? If so, I’d love to know what the findings were.