Power and political astuteness




Power

An agent’s ability to influence the target



Relationships of power exist where there is a perceived dependency between two or more people in an organisation. For example, a manager may appear to control vital information or resources that are needed by others in the organisation. This need for information or resources creates a dependency on the manager, which in turn leads to the manager having power over the others.


Authority


Power is not the same as authority. Pfeffer (1978) argues that authority is a unique manifestation of power. He suggests that authority stems from an individual’s place in the hierarchy; therefore, authority is attached to a position in the hierarchy, rather than to an individual. So position-holders within an organisation can use the authority vested in their position to make decisions and shape outcomes.






Authority

A unique manifestation of power attached to a position in the hierarchy rather than to an individual (Pfeffer, 1978)



There are a few important points to note about authority. Firstly, subordinates typically comply with the instructions of their supervisors or managers because they recognise that the authority they hold is legitimate. Secondly, authority is reflected in the organisational hierarchy and is devolved down the chain of command of an organisation, with more authority being vested in positions at the top of the hierarchy. Power is not confined to positions of authority. For example, a nurse may exercise power over their supervisor: there may be a relationship of dependence between the two that results in the nurse being able to shape the behaviour of her supervisor. Thus, power can be exercised in any direction in the hierarchy – up, down or horizontally – that is, between units in the organisation.


Sources of power


French and Raven (1959) identify two main sources of individual power: power that is derived from the position an individual holds in the organisational hierarchy, or position power (which includes legitimate, reward and coercive power); and power that stems from an individual’s characteristics, or their personal power (which includes expert and referent power).


Legitimate power

Legitimate power is derived from the authority vested in an individual by virtue of the position they hold within the organisation. The source of this power is based on the idea of legitimate authority, which is conferred on an individual who occupies a particular position. For example, a charge nurse will typically have legitimate power over subordinates, as part of their job description will require them to direct and monitor the behaviour of the nursing staff they supervise.






Legitimate power

Power derived from the authority vested in an individual by virtue of the position they hold within the organisation



However, the effective exercise of this power relies upon the willingness of the subordinates to accept someone’s authority over them (Giddens, 1997; Hardy & Clegg, 1996). For example, the power of a nurse manager to make a nurse change their working hours to suit a roster depends on the willingness of the nurse to agree to such an arrangement.


There are a few other interesting points to note about legitimate power. Firstly, an individual will surrender this source of power when they vacate the position. Secondly, legitimate power is limited in its scope, as it applies to work-related situations. For example, a chief executive officer would not have legitimate power over how an employee spent their leisure time or how they might spend their discretionary income.


Reward power

Reward power concerns the capacity to reward employees (or to withhold rewards or privileges). It is held by an individual who has the ability to confer promotions, financial rewards, leave or praise to employees. For example, the dean of a faculty of medicine holds reward power: they have the ability to allot bonuses to high-performing staff, award citations for high-quality teaching and research, and promote and provide opportunities to deserving staff.






Reward power

The capacity to reward employees





In some respects, reward power is similar to legitimate power, in that the ability to reward individuals is tied to a position in the hierarchy; for example, a chief executive officer or general manager can offer rewards, but a co-worker cannot.


The use of reward power is an important element in understanding how to motivate employees. If the reward being offered is highly valued by employees, reward power will be strong. Conversely, reward power will be weakened when the rewards offered have little appeal for employees.


Coercive power

Coercive power results from the ability to rebuke employees for inappropriate behaviours and actions. Exercising this power can result in chastising, demoting or terminating the employment of subordinates. In certain circumstances it may be necessary to use coercive power to stem inappropriate, unethical or illegal behaviour of employees. For example, if an employee repeatedly refuses to follow health and safety protocols, which endangers not only themselves but patients and other co-workers, it may be appropriate for a supervisor to exert their coercive power to quash such behaviours.






Coercive power

Power resulting from the ability to rebuke employees for inappropriate behaviours and actions



Expert power

Expert power stems from a person’s high level of knowledge and skill in a given area. When an individual demonstrates their expertise, their thoughts and recommendations will be given more credibility, and they are more likely to be trusted and respected by others. People may be persuaded to follow suggestions and instructions because they defer to a higher level of understanding.






Expert power

Power stemming from a person’s high level of knowledge and skill in a given area



Marie Curie, who discovered the chemical elements radium and polonium and pioneered research into the treatment of tumours using radiation, had expert power. Her contributions to chemistry and medical research were recognised by the award of a Nobel Prize in both chemistry and physics. Prior to her death in 1934, Curie was able to use her expert power to attract funding and other resources to continue her important work, and she also changed the way other researchers conducted their studies (Marie Curie – Biographical, 2015).


Referent power

Referent power stems from a person’s charisma, likeableness or appeal and the resultant influence this has on others. A prime example of referent power is the influence that celebrity endorsements have on our purchasing behaviour. For example, consider the recent growth in celebrity-branded fragrances, including perfumes by Beyoncé, David Beckham, Kim Kardashian, Britney Spears and Kylie Minogue. Consumers may strongly identify with these celebrities and be persuaded to purchase the perfumes they endorse.






Referent power

Power stemming from a person’s charisma, likeableness or appeal



In the work environment, an employee with charisma or appeal may find they have considerable influence over others who respect or wish to please them. The obvious danger of referent power is that someone who is affable or charismatic may acquire significant power in the organisation without having the requisite authority or knowledge to use this power effectively.


Use of power


While an individual may possess power, it does not necessarily mean that they will be able to influence the behaviour of others. Hickson, Hinings, Lee, Schneck and Pennings (1971) argue that the effective exercise of power is influenced by external factors, or contingencies, which can advance or impede the use of power by an individual or a department. Hickson and his colleagues identify uncertainty, substitutability and centrality as the main contingencies of power.


Uncertainty

Uncertainty refers to a lack of information about events that may impact on an organisation in the future. This may include scarcity of information about the availability of resources, changes to government regulations or laws, actions of competitors or viability of existing markets. Where there is uncertainty in the business environment, organisational planning becomes more difficult, as contingency plans must be made to address all possible eventualities. Pfeffer (1981) argues that the most valued skill within an organisation is the ability to protect organisational members from uncertainty.






Uncertainty

Limited or no understanding of knowledge or information regarding a given state or situation



Hickson et al. (1971) suggest, however, that it is the ability to cope with sources of uncertainty that generates power, rather than uncertainty itself. Pfeffer and Salancik (1978) build on this idea by explaining the link between an organisation’s environment and its political processes. They argue that the environment poses uncertainty for an organisation in terms of constraints, contingencies and resources. This in turn produces a need for someone to cope with this uncertainty on behalf of the organisation. The ability to cope is translated into power within the organisation.


Therefore, Pfeffer and Salancik (1978) argue, there is a direct relationship between the distribution of environmental uncertainty and the distribution of power within an organisation. Those individuals or departments who can cope with such uncertainty garner power and influence within the organisation. The ability to manage uncertainty in turn creates certainty for others and creates power through the dependencies created.




Shifting power bases in modern healthcare

There is little doubt that many government-funded healthcare providers are under increasing pressure from government and other stakeholders to operate with maximum efficiency and accountability. This shift has had a significant impact on who manages hospitals, with a rise in non-clinical administrators assuming senior management positions and controlling much of the decision-making, policy development and budget allocations within hospitals.


However, a study by Amanda Goodall (2011) published in Social Science & Medicine suggests that hospitals perform better when doctors are in positions of leadership. Julian Le Grant (as cited in Brindle, 2011, July 20, para. 11), professor of social policy at the London School of Economics, attributes these findings to the fact that clinical managers ‘command the respect of their colleagues, which is a fundamental problem where chief executives come in from outside’. This suggests that the expert power of clinicians is an important factor in influencing the behaviour of hospital staff.

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Feb 6, 2017 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Power and political astuteness

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