Service and Servant Leadership: Part of the PT DNA

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People climbing a mountain

Management as a privilege and a duty

By Mark Anderson, PT

“…when you choose the paradigm of service, looking at life through that paradigm, it turns everything you do from a job into a gift.” — Oprah Winfrey

At the most fundamental level, there are two reasons people want to be leaders: (1) they want to be rewarded and see becoming a leader as a right for years of hard work with all of the status, power, and money it can bring; or (2) they want to serve others and bring about good for those they lead. They see their role as a privilege and a duty.1

In the 1970s, author and management expert, Robert Greenleaf, introduced the term “Servant Leadership.”2 Greenleaf gained notoriety by describing a model of leadership that was paradoxical to other leadership and management styles and philosophies. Interestingly enough, the concept of serving others and, in particular, serving those for whom we are responsible, can be traced back to the Bible. The servant leader focuses on the needs of others before focusing on their own needs. A servant leader acknowledges others’ perspectives and involves them in decision-making when appropriate. This leader prioritizes the well-being and growth of team members, providing ongoing support to help them achieve their goals. Servant leadership builds a sense of community within the team. The overall result is stronger relationships and greater trust between team members and stakeholders.

Robert Greenleaf said:
“The servant-leader is servant first… It begins with the natural feeling that one wants to serve, to serve first. Then conscious choice brings one to aspire to lead. That person is sharply different from one who is leader first, perhaps because of the need to assuage an unusual power drive or to acquire material possessions…The leader-first and the servant-first are two extreme types. Between them there are shadings and blends that are part of the infinite variety of human nature.”2

TRAITS OF SERVANT LEADERS

Servant-leadership is more an attitude toward the responsibilities of leadership than simply a style of leadership. Larry Spears, former president of the Center for Servant Leadership, extracted Greenleaf’s ideas into 10 key servant leadership traits3:

  1. Listening
  2. Empathy
  3. Stewardship
  4. Foresight
  5. Persuasion
  6. Conceptualization
  7. Awareness (including self-awareness)
  8. Healing
  9. Commitment to the growth and development of people
  10. Building community

As you look closely at these characteristics and think about your colleagues and their practices, you will see that many are traits that you find in successful physical therapists and physical therapy businesses. Physical therapists are poised to be servant leaders. Many choose this profession for altruistic reasons: the desire to serve, and the aspiration to help others improve their quality of life. Health care organizations are a natural fit for servant leadership. Institutions such as the Cleveland Clinic have embraced a servant leadership philosophy and have experienced significant improvement in employee and patient satisfaction as measured in their Gallop Q124 and HCAHPS5 surveys.

Despite a proliferation of studies and articles examining servant leadership over the past 20 years, the concept remains a bit elusive. For this reason, and because of the success of organizations that have implemented servant leadership practices (think Starbucks, Southwest Airlines and Ritz-Carlton), inquiry surrounding servant leadership is flourishing. Researchers and leadership experts continue to develop new definitions and tools to measure servant leadership as well as examine the outcomes. Researchers at UIC Business developed the SL-7, a 28-item tool designed to reliably and validly measure servant leadership behaviors and determined that servant leadership is positively related to job performance, commitment to the organization, and participation in community service activities.6,7 Others have demonstrated that servant leadership is positively linked with employee’s perception of work-life balance.8 A 2019 review of 285 articles on servant leadership provided a deep dive into the concepts, 16 existing measures, outcomes, and a future research agenda.9

SERVANT LEADERSHIP IN A PHYSICAL THERAPY PRACTICE

I was raised in a family and community of servant leaders. As a result, service and servant leadership became part of who I am, naturally flowing into my business philosophy and, likewise, embedded in the mission, vision, and core values of our company. We started with one location and four employees in 1984 and are now proudly 42 locations and 450 employees strong, serving patients in three states. It starts at the top. Our company’s leaders are a product of servant leadership. Many of my partners started as students completing affiliations or working as techs in our clinics. We invested in their growth and development and made them part of the Mountain Land community. We have worked hard to create a company philosophy that promotes clinical advancement and a pathway to leadership and ownership. “Caring Company Culture” is one of our core values. Our leaders are responsible to set the example by serving those over whom they have stewardship. The expectation of our managers in all areas is to lead their team members through providing support and foresight in achieving their goals. As an executive management team, we like to think that we work for our Clinic Directors and their staff. My partner, Rick Lybert, likens an employee leaving the company to us getting fired. We ask ourselves, “what could we have done differently to keep that relationship intact?”

At Mountain Land, servant leadership starts with weekly meetings at the clinic level during which the team reviews accomplishments of the past week and sets new commitments for the following week. They focus on how the team can improve processes, create measurable activities or lead measures10 to achieve team goals and, most importantly, support each other through the following week. The clinic director’s role is to listen to team members and make them feel valued, conceptualize what can be accomplished, and strengthen the team bond. The clinic director works closely with individual team members to move them toward achievement of specific measurable goals. Team members are accountable not only to the director, but also to each other.

Clinic directors, in turn, meet weekly with a small group of other directors. Each director reports to the peer group on accomplishments of their team during the past week and presents what they hope to achieve in the coming week. The directors are accountable to their peers, but, more importantly, the peers act as coaches to assist each other in problem solving and support each other in improving their practice.

These days, a servant leadership approach is more important than ever. Our leadership team meets daily to identify ways to support employees as they deal with the stressors of the pandemic. We send PPE to employees’ homes for their families and reach out to individuals to check on their well-being in a deep and meaningful way.

Servant leadership represents only one way physical therapists can serve. When we think about philanthropy, we often think of financial donations. Many therapists don’t have the financial resources to donate money, but can share their knowledge, skills, and time in a meaningful way to help the poor, physically challenged, and underprivileged. Servant leaders demonstrate a conscious effort towards creating value for the community around their organization and encourage employees to be active in the community.6 Our company provides employees an opportunity to serve through several programs and events. Twice a year, we hold an event called Adaptive Water Ski day. Physically challenged individuals use special adaptive water skis to enjoy a sport that they would never have thought possible for them. These events give employees a chance to use their clinical skills outside of their daily routine in a whole new way and environment, which is energizing and fulfilling. This positivity makes its way back to our clinics and the business and every patient benefits!

Mountain Land’s involvement in the LDS Charities wheelchair program provides additional volunteer opportunities. Through their management and training efforts, LDS Charities has provided thousands of wheelchairs throughout the world. For 10 years, our physical therapists have assisted in training technicians to fit wheelchairs for those in need throughout the world, including refugee camps in Iraq, villages in Africa, South America, and the Marshall Islands. Donating our time and using our clinical knowledge to make such a significant difference in the quality of life of others is truly an honor and makes us better people and better clinicians!

Whether you are practicing servant leadership by building strong teams and helping employees feel valued or using your therapy skills providing charitable service to those in need, we can model our efforts in the words of Gandhi: “The best way to find yourself is to lose yourself in the service of others.”

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References:

1Lencioni P. The Motive: A leadership Fable. San Francisco, CA: Jossey-Bass; 2020:130-131.

2Greenleaf RK. Servant Leadership: A Journey into the Nature of Legitimate Power and Greatness. New York, NY: Paulist Press; 1977.

3Spears LC. Character and servant leadership: ten characteristics of effective, caring leaders. The Journal of Virtues and Leadership. 2010;1(1):25-30.

4Patrnchak JM. Implementing servant leadership at Cleveland Clinic: a case study in organizational change. Servant Leadership: Theory & Practice. 2015;2(1):36-48.

5Centers for Medicare and Medicaid Services. The HCAHPS survey: frequently asked questions. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/Downloads/HospitalHCAHPSFactSheet201007.pdf. Accessed January 21, 2019.

6Liden RC, Wayne SJ, Meuser JD, Hu J, Wu J, Liao C. Servant leadership: Validation of a short form of the SL-28. The Leadership Quarterly. 2015;26:254–269.

7Liden RC, Wayne, SJ, Zhao H, Henderson D. Servant leadership: Development of a multidimensional measure and multi-level assessment. Leadership Quarterly. 2008;19:161–177.

8Tang G, Kwan HK, Zhang D, Zhu Z. Work–family effects of servant leadership: The roles of emotional exhaustion and personal learning. J Business Ethics. 2016;137:285–297.

9Eva N, Robin M, Sendjaya S, van Dierendonck D, Linden RC. Servant Leadership: A systematic review and call for future research. Leadership Quarterly. 2019;30:111-132.

10McChesney C, Covey S, Huling J. The 4 Disciplines of Execution. New York, NY: Simon & Schuster; 2016:50-58.


Mark A Anderson

Mark A Anderson, PT,is the 2019 recipient of the PPS Robert G. Dicus Award and is President and founder of Mountain Land Rehabilitation. He can be reached at Mark@MLRehab.com.

*The author has a professional affiliation with this subject.

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

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