My friends and regular readers of this blog know that I rarely shy away from confrontation. If I see something that I believe is a problem, I point it out. When I was a rehab manager, I depended on my employees taking this approach with me as well. I had worked for a large company and it would have been impossible to see all the potential problems that could plague the department down the road. It also helped keep my own thought processes in check... as well as my ego. I think questioning things is healthy.
One of the reasons I'm no longer happy in the position I'm leaving behind is a culture that's the polar opposite. Questioning is frowned on and upper management seems to only want to hear support for their own agendas and opinions. It's ironic that they've just begun to implement a shared governance program. As I'm winding down here, I simply say "yes" with a smile. My investment is over and my potential to have a positive impact on anything is nil.
Why does upper management behave like the emperor with the new clothes? Are egos really so much more fragile at that level? Having someone who is unafraid to say, "Excuse me, but you're heading for the edge of a cliff!" would seem like an asset to me. Being a team player doesn't mean always saying "yes." It means working for the best outcomes for everyone, especially the patients.