What Rahm has shown us: Leadership and 'rubbing people the wrong way'

Leaders are constantly faced with tough decisions, and must consistently negotiate between the need to be an effective leader and a likeable one. But exactly how much does likeability influence efficacy?

Democrat Rahm Emanuel's brash leadership style has helped him drive through the ranks in his career, according to the Wall Street Journal. He has risen from senior White House aide to a congressional leader to chief of staff for President Barack Obama, but now he is fighting for reelection as Chicago's mayor.

Mr. Emanuel's failure to capture the 50 percent plus one vote to win a second term as Chicago's mayor, leading him to an April 7 runoff against Cook County Commissioner Jesus "Chuy" Garcia, may suggest leaders do need to be likeable to be effective — or at least elected.

The mayor's fight for reelection is proving difficult — Mr. Emanuel received 45 percent of the vote, and Mr. Garcia finished the race in second place, garnering 34 percent of the votes, according to the WSJ.

Mr. Emanuel's demeanor is one of his defining characteristics and has become a magnet for media attention. The tale of the politician, in his younger days, sending a dead fish in a box to a pollster who was late delivering results is infamous. He earned the name "Rahmbo" and "Rahmfather." He has a penchant for cussing. He sliced off part of his right middle finger while working at Arby's in his early days. President Obama would later joke the accident "rendered him practically mute."

In the realm of healthcare, too, the manner in which a leader forms and sustains relationships, works with other groups and wages influence are crucial elements that can open doors to new opportunities, or severely damage a leader's potential to get things done.

Mr. Emanuel's tough leadership style has been a point of criticism against him by voters and local politicians, especially those who opposed his decision to close underutilized mental health clinics and schools in a consolidation move, according to the report. Positioned against "nice guy" Mr. Garcia, Mr. Emanuel's brusque leadership style has arrived at the forefront as a potential deciding factor in his reelection bid.

In a recently aired campaign commercial, Mr. Emanuel acknowledges that his style rubs some people the wrong way, but stresses his toughness comes from a love of the city and a genuine desire to make decisive, positive changes.

"They say your greatest strength is also your greatest weakness. I'm living proof of that," said Mr. Emanuel. "I can rub people the wrong way, or talk when I should listen. I know that. But I'm driven to make a difference… I'm not always going to get it right, but when it comes to fighting for Chicago and Chicago's future, no one's going to fight harder."

Scott Becker, JD, CPA, publisher of Becker's Hospital Review and chairman of the healthcare department at McGuireWoods, says Mr. Emanuel's leadership style "issue" is a difficult and complex one.

"I believe Rahm Emanuel's team and employees have huge regard for him," says Mr. Becker. "That stated, his actions don't always align with or pander to traditional Democratic interests. Teachers' unions and others expect Mr. Emanuel to fully align with them, so where Mr. Emanuel puts budget concerns above political alignment, he is viewed as gruff or tough."

However, as Mr. Emanuel says in his commercial, these tough decisions are motivated by his commitment to really get things done to improve the city.

Hospital and health system leaders also face the challenge of balancing their sense of likeability with their ability to crank down and make tough decisions. The fact is, it is impossible to satisfy everyone's interests all the time, but it is in their best interest to foster strong relationships with those they work with and for, including the senior leadership team, board, clinical staff, patients and community.

"Certainly more and more we expect our leaders to both provide clear direction and make sure core goals are met. Over the long run, leaders must be — if not likeable — at minimum, clear and respected. Clarity and respect are generally put above likeability," says Mr. Becker.  

The idea of toughness in leadership is most effective when maintained in a balanced way, Mr. Becker says. Hard-line leadership may yield effective short-term results, but this style could also eventually wear out the leadership team. In healthcare, this could lead to a trickle-down effect among clinical workers that could be a detriment to patient care.

While hospitals and health systems can greatly benefit from a strong, decisive leader, the leader does not run the organization alone. If a leader fails to align his or her objectives with those of the rest of the organization and community, he or she cannot possibly be effective. Being pleasant or likeable doesn't necessarily make or break leaders' ability to be get things done, but if they cannot maintain the respect and cooperation of the people they work with, it will be difficult to accomplish anything.

"The best leaders in organizations, in my experience, manage down really well, while the worst managers are tough on those below them and pander to those above them," says Mr. Becker. "I think Rahm is a great example of one willing not to pander to a portion of his constituents and should be highly respected for it."

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