HCS/325 Week 1: Manager Versus Leader, sample paper

Manager Versus Leader in a Twelve-Provider Family Medicine Practice: Mintzberg's Roles, Kotter's Distinction, and One Practice Manager's Monday

[Student Name]

University of Phoenix

HCS/325: Health Care Management

Week 1 Assignment

[Instructor Name]

[Date]

The practice, manager and staff are a composite written for a model paper.

Health care management textbooks often open with the difference between managing and leading, and the distinction can seem academic until one watches a manager work. A composite practice manager runs a family medicine group with twelve physicians and advanced practice providers, forty support staff and about 38,000 patient visits a year. She reports to a physician managing partner and is responsible for operations, staffing, billing oversight, facilities and compliance. Her Monday offers a useful laboratory. By noon she had solved nine problems, and by five o'clock she realized that none of them would matter if the practice could not keep its medical assistants past their first year. This paper analyzes her day through two classic frameworks and argues that health care managers need both management and leadership, deliberately chosen.

Two Classic Frameworks

Mintzberg (1973) studied what managers actually do by observing chief executives through their working days. He found that managerial work is fragmented, fast-paced and driven by interruptions rather than calm planning, and he organized it into ten roles in three groups. Interpersonal roles include figurehead, leader and liaison. Informational roles include monitor, disseminator and spokesperson. Decisional roles include entrepreneur, disturbance handler, resource allocator and negotiator. In Mintzberg's scheme, "leader" is only one of ten roles, focused on motivating and directing subordinates.

Kotter (1990) drew a sharper line. He argued that management and leadership are distinct and complementary systems of action. Management copes with complexity by planning and budgeting, organizing and staffing, and controlling and problem-solving; it produces order and predictability. Leadership deals with change: it points the organization somewhere new, gets people lined up behind that aim and keeps them energized when the going is hard; it produces movement. Organizations need both, and most, Kotter argued, are overmanaged and underled.

Health care management texts adopt both views, describing managers as responsible for planning, organizing, staffing, controlling and directing, while emphasizing that leading people through constant change in health care requires skills beyond administration (Buchbinder et al., 2021).

Monday Through Mintzberg's Roles

At 7:30 a.m., two medical assistants called in sick. The manager moved a float medical assistant and asked a nurse to room patients for one physician, the disturbance handler and resource allocator roles. At 8:15, she reviewed the weekend's patient portal messages and the prior week's no-show report, the monitor role, and noticed that no-shows had risen for new-patient appointments. At 9:00, she met with a representative from the electronic health record vendor about a costly upgrade and negotiated a delay in the fee schedule, the negotiator role. At 10:30, she welcomed a visiting group of nursing students and explained the practice's team model, the figurehead and spokesperson roles. At 11:00, she forwarded a new payer policy on prior authorization to the providers with a short summary, the disseminator role. At 1:00, she called the hospital's care management department to set up a shared process for patients discharged on weekends, the liaison role. At 2:30, she met with a medical assistant who had been late four times, the leader role in Mintzberg's sense of directing a subordinate.

Mintzberg's map shows how much of her day went to monitoring and reacting. Almost every role she played was triggered by something that happened to her rather than something she initiated. That pattern matches his observation that managerial work is shaped by interruption.

Monday Through Kotter's Distinction

Kotter's distinction sorts the same day differently. Covering the sick calls, negotiating the vendor fee, forwarding the payer policy and reviewing the no-show report were management: they kept the practice running predictably. Even the conversation with the late medical assistant, as it happened, was management, because it enforced a standard.

Only two moments came close to leadership. The call to the hospital about weekend discharges began to set a new direction for how the practice handles transitions. And at 4:30, reviewing the staffing report, the manager saw that the practice had hired eleven medical assistants in the past year and lost seven, most within their first year. Every sick call, every rooming delay and every patient complaint about waiting traced back to that turnover. Solving it was not a management task of filling shifts; it was a leadership task of changing why people stayed or left.

Why the Distinction Matters in Health Care

In health care, the pressure to manage is intense. Patients arrive every fifteen minutes, regulations change, payers require documentation and staffing gaps must be filled today. A manager can spend every hour on these demands and be praised for it. Kotter's warning is that such an organization can be well managed and still decline, because the problems that threaten it, turnover, burnout and changing patient expectations, require direction and commitment that management tools do not produce. For this practice, medical assistant turnover was driving overtime costs, slowing patient flow and adding to physician frustration. No amount of skillful scheduling would fix it.

What Leading Would Look Like

Leadership in this case would mean setting a direction, such as making the practice a place medical assistants want to build a career; aligning people, by involving physicians and the current medical assistants in understanding why colleagues left; and motivating, by creating visible paths such as a lead medical assistant role and tuition support for those who want to become nurses. The manager scheduled exit interviews with former staff, met with the managing partner to propose a career ladder and planned a listening session with the remaining medical assistants for the following week. These actions did not replace management; they added a second kind of work to her week.

Conclusion

One Monday in a family medicine practice showed a manager fully occupied by Mintzberg's roles, most of them reactive, and almost entirely engaged in what Kotter would call management. The discovery that the practice was losing most of its new medical assistants revealed a problem that only leadership could address. Health care managers need to manage well to keep patients safe and operations predictable, but they also need to recognize when a problem calls for direction, alignment and motivation. The difference between a manager and a leader is not the title; it is the kind of work chosen when the day's demands leave time for only one more thing.

References

Buchbinder, S. B., Shanks, N. H., & Kite, B. J. (Eds.). (2021). Introduction to health care management (4th ed.). Jones & Bartlett Learning.

Kotter, J. P. (1990). What leaders really do. Harvard Business Review, 68(3), 103-111.

Mintzberg, H. (1973). The nature of managerial work. Harper & Row.