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Developing Command Presence

August 11, 2011
by Pete Rivera
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Being poised and in control is really a symptom of organizational leadership or the lack thereof

One thing that is never taught in an MBA courses, is how to appear poised and in control. In the military we would call this having “Command Presence.” It’s a natural impressive appearance and attitude that commands respect. The flip side of this is someone that appears “rudder-less.” The wind takes them wherever it is blowing and they just go along with the organizational flow.

I had a very low tolerance for leaders that could not make a decision, until I realized that sometimes inactivity or indecisiveness was a way that some people use to stay employed. If you are not sticking your neck out, you don’t have to worry about having it chopped off. Large medical centers are notorious for this type of behavior. Managers can hide in the shadows and let others take risks. Smaller organizations can’t afford to have “redundancy” within the management team.

Regardless of why someone lacks Command Presence it is really a symptom of organizational leadership or the lack thereof. Just because you are a senior manager does not mean that you stop being mentored. The assumption is that you should have all the tools that you need to make you effective. But the truth is that you never stop learning. CIOs should provide opportunities to observe how their direct reports handle challenges and work with those that don’t have a natural ability to lead.

In the Healthcare IT world we have many homegrown leaders that have the technical knowledge, but lack the people skills. It is one of the primary challenges in developing technology teams. It's hard to have command presence if you are a geek at heart. Sometimes you have to accept that your first choice to lead a team may not have the proper skill sets yet. If you force it by pushing them outside their comfort zone with management responsibilities, you may just lose a valuable technical expert.

One manager I had grew within the organization from a two year RN to a Clinical Applications Manager. Other than the technical training for the various applications, she was never developed to lead a team. This is where the organization failed her. On the other hand, she did not go back to school to either finish her BSN or get a Master’s degree. This is where she failed herself. Eventually the lack of education became a stigma for her and probably led to her hesitation and indecisiveness when dealing with strong personalities and higher education. The lack of leadership training contributed to her inability to respond appropriately to personnel issues. Watching her lead a team meeting was extremely painful.

There are many ways to help your staff develop command presence. Balance technical training with opportunities for leadership training. Make leadership time part of your staff meetings and use real life leadership challenges to ask, “What would you do.” Never forget that we are not just managing technology.



Great post and an important topic. Although great physicians exude a presence, it emanates from a combination of 3 distinct places, and only after an important pre-condition is met. This is similar to the scenarios you outlined and have one important distinction.

The distinction is that "physicians are trained to have a healthy skepticism for unproven methods." As a result, in order for physician leaders to exude command presence, they need either proof, or a process they believe and trust as an alternative. That's a high bar, especially with program and project management, and true CEO sponsorship. That turns out to be rare. And leadership discontinuities are common, in the world in general and provider organizations are no exception.

For physicians, like all other professionals, the three places where command presence comes from are 1) native talent (not trainable in general the way I'm using the word talent, i.e. the Gallop way), 2) skills, and 3) experience.

We are having a lot of success by fostering a physician advisory board. Physicians get clarity on where to have confidence that they're doing the right thing, or a reasonable thing. We're also finding a lot of value for physicians in joining AMDIS, and explicitly using change management techniques for communication and education. That clearly fosters the development of command presence in physicians leading their dimension of HCIT projects.

This was a very interesting post Pete- I never really thought about how leadership can be both a personal and an organizational attribute- I love your advice to balance opportunities for leadership training with personal educational pursuits.

Joe, it sounds like AMDIS is providing a really good forum for physicians to get more active leadership roles within IT. This is really needed in areas of EMR and HIE's. I think many physicians realize that the "implied respect" that they enjoyed in the clinical setting does not always translate in IT. You really have to roll up your sleeves and earn the respect of the technology folks.
This comes naturally to the really good ones.