HS850 Unit 5 Clinician to Manager Seminar Reflection Example

It Was Never the Spreadsheets: A Unit 5 Seminar Reflection on Why Clinicians Struggle When They Become Managers

[Student Name]

Purdue University Global

HS850: Advanced Health Leadership

Unit 5 Seminar Reflection

[Instructor Name]

[Date]

The seminar and classmates are composite and described by role; the studies cited are real.

The Position I Brought

My argument rested on my own experience. When I moved from pharmacy practice to managing a department, I could not read a variance report, and budget meetings felt like a foreign language. I assumed others had the same gap. I had also watched two colleagues leave management within a year, and I attributed both departures to the same cause: they had been promoted for clinical excellence and then left to learn the business on their own. The fix seemed obvious and measurable. A course has a syllabus, a start date and a completion record, and I could picture presenting its completion rates to the executive team. Looking back, part of the appeal of my proposal was that it turned a messy problem into a program I could manage. I proposed that the system require a twelve-week finance and operations course before any clinician took a management role.

Moment One: The Chief Nursing Officer

The nurse executive agreed that budgets were hard and said they were the easy part. Within a year she could read a variance report. What took years was being disliked by people who had been her friends on the unit. She described sitting in the break room the week after her promotion and noticing that conversations stopped when she walked in. Her skill gap closed quickly; her identity gap did not.

I later found that her account matches qualitative research. In interviews with doctors and nurses who had become clinical managers in Norway, participants described the transition as a struggle to establish legitimacy with former colleagues and to hold on to a clinical identity while taking on a managerial one, more than as a shortage of management knowledge (Spehar et al., 2012).

What she described was not a missing skill but a lost place: the job had changed who she was to the people she used to work beside.

Moment Two: The Dental Director

The dental director described a different problem. He had kept seeing patients two days a week after becoming director, partly to keep his skills and partly because he did not trust that the managerial role was real work. He spent his management days doing what he called "administrative chores" and felt that his real work happened in the operatory. He said he only became an effective director when he stopped treating management as an interruption of his profession. A business course would not have reached that belief. When I asked what changed his mind, he said a mentor, another dentist who had run a large group practice, told him that every hour he spent fixing the schedule was an hour of care delivered by twelve other people, which was more care than he could deliver himself.

Moment Three: The Administrator Who Hires

The hospital administrator, who has hired and coached clinical managers for fifteen years, said the ones who struggle most are often the best clinicians, because they try to manage the way they practiced: by solving problems themselves. She said new managers need to experiment with how they present themselves and learn from what works, which takes time and safe places to try. I connected this to Ibarra (1999), who found that professionals moving into new roles adapt by trying out provisional selves, observing role models and experimenting with images of the person they might become, and that this experimentation, not formal instruction, is how a new professional identity forms.

My Revised View

I now think my proposal addressed the wrong problem. Business knowledge matters, but it is learned quickly once someone needs it. The harder transition is in identity: from expert to coordinator, from peer to boss and from someone whose value is visible in patient care to someone whose value appears in other people's work. Hill (2003), following new managers through their first year, found that most expected the job to be about authority and control and discovered that it was about building trust and managing relationships.

That changes what I would propose. Instead of a finance course before promotion, I would propose structured peer groups for new clinical managers across disciplines, meeting monthly in their first year, where they can compare provisional selves, talk about the break room silence and get coaching from experienced leaders. The finance content would be offered on demand, when managers face their first budget.

What I Still Question

I am not sure peer groups reach the dental director's problem, the belief that management is not real work. That belief may need a different kind of help, perhaps a mentor from the same profession who made the shift. I plan to look for evidence on profession-specific mentoring for the next unit.

References

Hill, L. A. (2003). Becoming a manager: How new managers master the challenges of leadership (2nd ed.). Harvard Business School Press.

Ibarra, H. (1999). Provisional selves: Experimenting with image and identity in professional adaptation. Administrative Science Quarterly, 44(4), 764-791. https://doi.org/10.2307/2667055

Spehar, I., Frich, J. C., & Kjekshus, L. E. (2012). Clinicians' experiences of becoming a clinical manager: A qualitative study. BMC Health Services Research, 12, 421. https://doi.org/10.1186/1472-6963-12-421