Referent Power is Critical in Healthcare Leadership

I recently retired from a Chief Medical Officer position in a large integrated health system and have been able to focus more on executive coaching.  In coaching, we have to build trust and rapport quickly so we may better advise and guide executives and other clinical leaders through their high-performing leadership journey.  I find myself reflecting on the role of power and influence in healthcare leadership based on various discussions and my own experiences.

All of us in the healthcare industry are facing irresistible and strong forces for change calling for leaders capable of leading change throughout their organizations in order to survive and flourish in days to come.  I’ve learned a lot throughout the years from other executive and physician leaders and from collaborating with my coaching colleagues. Here are some of those learnings:

There are a number of different sources of power and influence that leaders can use.  Among them are:

  • Position power: comes from position or title.
  • Reward power: comes from the ability to provide a reward or some sort of payment or recognition.
  • Punishment or coercion power: comes from the ability to provide a negative consequence for non-compliance.
  • Knowledge power: comes with having a high level of knowledge about the particular subject matter.
  • Expertise power: comes from having successfully done whatever the task is repeatedly in the past.
  • Referent power: comes from relationships of trust and respect.

In times like these, it is easy as a leader to utilize position power as the method to make change happen.  Position power is that which comes from a person’s title or position in an organization.  Things happen because the leader dictates that they will.  Often in this scenario we will hear comments like, “If people don’t like it, they’ll have to live with it or find somewhere else to work.”  Little or no attention is paid to the relationship between the leader and subordinate.  The changes take place, but at a price.  Often a very high price. 

If the leader uses referent power in tandem with position power, the change happens more easily and with much better engagement from the majority of people on the team.  Referent power comes from relationships, and it takes time to develop.  The leader needs to be open with team members, admit mistakes, explain his/her own weaknesses, emote humility, and take the time necessary for others to truly know him/her and to know and understand them.  It comes from being meticulously honest and following through on commitments.  In short, it comes when others truly trust the leader.

We gain referent power when others trust what we do and respect us for how we handle situations.  Learning how to harness and gain more referent power is key for leaders even those not in senior or executive roles.

There is increasing pressure to drive performance in this challenging and turbulent healthcare environment.  New partnerships and relationships within the organizations and other strategic alliances are necessary.  Executives and leaders often outperform in physician and employee engagement when they are able to use their personal and referent power and influence.  Physicians also tend to become more engaged and devoted to the organization when they feel they can trust the administrative leaders.

Time spent developing referent power is time well spent. Healthcare leaders don’t need to push their own agenda or “bully” to see results.  High-performing leaders and teams know how to influence people and partners by utilizing their trusted relationships in an honest and transparent manner.  Referent power can become one of the best tools in their toolbox and it pays dividends over and over through results.

Photo of Brent E. Wallace, MD

written by:

Brent E. Wallace, MD

Senior Vice President & Executive Coach