Jack Dunham revisited
“In a hierarchy every employee tends to rise to his level of incompetence.”
'The Peter Principle' Laurence J Peter, Canadian educator (1919-1990)
In 'what is leadership?', I shared the notion that as we enter working life, most of our day is spent on routine tasks but, as we pogress, technical knowledge begins to feature and, possibly, an element of supervision.
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At mid-management, we have probably reached the peak of our technical prowess and spend more time managing. By senior management, we are likely to spend even less time on technical matters - as we look to our immediate subordinates for such technical input - and devote our time to managing and leading the enterprise.
This model was shared with me by Jack Dunham and became my 'lodestar' for much of my working life and informed many of my discussions (arguments) with colleagues about the distinction between those who administer, manage or direct. Not always were my views welcome but rarely did anyone challenge their seeming logic.
All that changed when I arrived at Guy's & Tommies and found myself in the company of some seriously talented clinicians who not only provided leadership and direction across the Trust but spent much of their day at the 'coal-face' providing patient care, teaching the next generation of clinicians. Some also undertook research.
Two of their number were the Medical Directors - a surgeon and a physician - who sat with me on the Trust's Main Board. How often I marvelled at the fact that they had just put down their 'knife and needle', removed their scrubs or white coats and now sat alongside me and other directors to discuss a major strategic issue that I had spent all day mulling over.
It was one of them who challenged me as I shared Jack's model with him and a few other clinicians when briefing them about The Shared Agenda, the Trust's new planning and performance process.
He argued, as did his colleagues, that specialists such as them continue to use and hone their technical knowledge and skills throughout their entire careers. Consequently, a more accurate model would be as below (on the right).
I agree but would add a caveat. I believe there are now two distinct models. One for the generalist - among whose number I place myself - and the other for the specialist. Perhaps the thoughts I expressed in 'The Shared Agenda - an introduction' will go some way to justify this fresh view. Some five decades after Jack and I discussed his model, the world of endeavour has changed so much that I think that if he and I were to meet again, he would approve of both variants...do you?
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