Aug 31, 2022 4 min read

After completing a keynote speech on risk management in Seattle, a young man introduced himself to me and said, “I just wanted you to know that I decided to go into health-care administration after reading your blog post about that fish.” Of course, I was intrigued, flattered, but also somewhat amazed at how far-reaching the influence can be from the written word. Here’s a version of that story.

While walking down the hallway, my cell phone rang, and I leaned against the wall near one of our fish tanks. Before long, my eyes were pulled toward the activity in that tank. That’s when I saw it. It was clearly the alpha fish. It swam incessantly through the tank – chasing, harassing, biting and terrorizing the other fish. It was, much like one of my previous health system bosses, a bully.

As the alpha fish equivalent in what was then my own smaller fish tank, my days were filled with problem-solving tasks. It often felt like a whack-a-mole exercise. Each day my associates presented their problems and looked to me for solutions.

Having been in health-care management for a decade before this, it became obvious that the problem-solving techniques established by many of my superiors were primarily directed toward CYA triage within the bureaucracy.

That exercise went something like this: Listen in what appears to be an engaging manner which includes head-nodding. Take whatever completely guarded, small step that might appear to contribute toward the resolution of the problem. Then encourage the presenter to continue to seek other ways to resolve the issue by triaging within the organization.

This exercise reminded me of an original painting I once purchased of a group of extremely well-dressed professionals pointing at each other in a blame-like manner across a large conference room table. It was titled, “Not Me!”

Sometimes because of impatience or frustration, I came up with solutions on my own: immediate, timely and definitive solutions. Because this type of decision making occurs in a personal vacuum, I became that bully fish.

Typically, when a unilateral decision emanated directly from me, the response was predictable and immediate. It started with a smile and a nod of agreement from the participating party. Then, there was a commitment to move forward, and finally there was a faux thank-you for dealing with the issue so decisively.

Fairly soon after this exchange, the push-back would begin. This type of bully decision-making most often lacked any authentic endorsement from those involved, and the outward resistance intensified in a usually passive-aggressive manner ensuring at the very least, some level of failure.

On the other hand, when the problem was worked on as a team, in a constructive manner that offered support but not a complete solution, the results were most often very positive. Recognizing the talent in the room, working with them on their ideas, endorsing their abilities, and most importantly, giving them credit for their work makes all the difference. This combination of empowerment and encouragement helped the associates reach positive solutions as stakeholders in the effort.

The amazing thing about even this method is that, if applied very purely, we may also fail because we are working with moving targets enveloped in emotions, politics, unpredictable outcomes, and other yet-to-be-defined obstacles, but at least you won’t have your car keyed.

Leadership, not just management, is the point. This requires a perceptive commitment and sensitivity toward understanding the people with whom you are engaged. Bottom line? It is obvious that there is not one definitive answer, no single authoritative solution, no particular optimal choice, and bullying is definitely not the answer. Utilizing a team approach is better than forcing your solutions down everyone’s throat.

That same day, I called the fish tank maintenance professionals, had that fish removed and taken to a tank filled with other bullies somewhere in Washington, D.C.

Nick Jacobs of Windber is a health-care consultant and author of two books.