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Section 6.3Managing With Power
Political Games Henry Mintzberg (1983, 1985) developed an elaborate model of organizational behavior as a series of political games and players (“influencers”) that represent different external and internal interest groups seeking to control the organization’s decisions and actions. Table 6.1 describes how these games might be played by professionals in health organizations.
Table 6.1: Mintzberg’s power game
Game Health organization example
Insurgency: Individuals or groups of follow- ers resisting authority
Nurses leak information to the press about planned staff reductions that they say will endanger patient safety.
Counterinsurgency: Leaders fighting back to defend against insurgency
The CEO prohibits anyone other than the designated organizational spokesperson from speaking to the media.
Sponsorship: Junior staff seeking patronage from powerful leaders
The financial analyst asks the chief financial officer to serve as her mentor.
Alliance building: Leaders building power through peer networks
Hospital department heads form coalitions and establish norms for mutual support and cooperation.
Empire building: Leaders accumulating resources to build their power bases
When the head of an HMO coding unit resigns, the claims department manager sug- gests incorporating the coding unit into his department.
Budgeting: Managers’ striving to increase their unit’s budget
The hospital compliance manager inflates estimates of staff hours and consultant time needed for Joint Committee accreditation review.
Expertise: Expert employing his or her power for personal benefit
The doctors in a community clinic refuse to allow nurse practitioners to prescribe medi- cines.
Lording: Flaunting authority The hospital chief of medical staff repeatedly tells the chief nursing officer that medical treatment decisions are made by physicians.
Line versus staff: Conflicts between manag- ers with and without line authority
The chief information officer refuses to enforce the company dress code for the infor- mation technology staff and ignores requests by the vice president of human resources to meet and confer.
Rival camps: Organizational factions blam- ing and disparaging each other
Two health plans merge, and employees from each organization compete for power by insisting that their company’s business process is better.
(continued)
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Section 6.3Managing With Power
Game Health organization example
Strategic candidates: Individuals or groups advocating for selection of a specific indi- vidual for a key position or office
When the CEO of a large community health center system announces his plans to retire, trustees and executives promote various internal successors and oppose the use of an executive search firm.
Whistle-blowing: Reporting damaging information about an individual or the organization
The hospital controller reports to the CMS that the CEO authorized payments to the hospital’s contracted travel agency for luxury vacation packages for physicians admitting a certain number of patients.
Young Turks: Employees or junior leaders attempting to buy the company or take over its leadership
Hospital nursing unit managers demand replacement of the long-tenured and dictato- rial director of nursing.
Sources: Mintzberg, H. (1983). Power in and around organizations. Englewood Cliffs, NJ: Prentice Hall; Mintzberg, H. (1985). The organization as a political arena. Journal of Management Studies, 22, 133–154.
Health professionals in organizations where these games are played have several courses of action. They can ignore the games, in effect leaving the playing field to the gamers, and dedicate their energies to performing well. They can get out of the game entirely by seeking a job in another organization. Or they can play to win; some of the games can be useful strategies for success. The key task is to analyze what is going on in order to make these choices.
Transforming Power Into Influence
Having the knowledge and skills necessary to succeed within a company does not auto- matically translate into a promotion, pay raise, or acquisition of more responsibility. The challenge is garnering knowledge from prior education, research, and experience, and then performing when the moment is opportune. Management does not always explicitly acknowledge who is influencing the company or which associates’ work products are rec- ognized as outstanding. The definition of power in organizations is shifting from having authority and control over others to the ability to get things done (Whetten & Cameron, 2011). To get things done and to be recognized and rewarded for this ability, health pro- fessionals need to develop strategies for gaining organizational power throughout their careers, and using that power wisely and constructively.
Power Signals One way to gauge whether management is receptive to use of knowledge and influence is through nonverbal communication. Wall Street Journal columnist Sue Shellenbarger (2013) reported on a study demonstrating that eye contact is significant in any type of in-person communication exchange. The more time a superior maintains eye contact with
Table 6.1: Mintzberg’s power game (continued)
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