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This case uses the context of a teaching hospital, Garden Birch Children’s Hospital Center, to surface the tension that results when a leader exhibits excellent task performance and problematic people performance. The decision-maker, Chief Medical Officer Isla Garamond, is on the hiring committee conducting an international search for a chair of the division of Pediatric General, Thoracic, and Fetal Surgery. She is expected to weigh in today about an application for the position from Dr. David Smith, the director of Pediatric Thoracic Surgery. Without a doubt, Smith is the major reason Garden Birch’s thoracic surgery department has transformed into a leading program internationally. He accomplished everything Garamond had hoped for and more. Garamond is aware that some coworkers fear confronting Smith about his sharp verbal lashings and sometimes demeaning behavior toward other physicians and nursing personnel. In sharp contrast is the feedback from his patients and their parents—they all love Smith. And his residents want to be him. Additionally, a strategic standard causes Garamond to weigh the priority of a less tangible strategic goal against the very tangible choice to keep or lose a talented doctor. Garamond’s opinion holds much sway over the decision.
(1) Explore performance management in a setting involving a technically superior top performer. (2) Understand elements of feedback systems and challenges in interpreting expressions. (3) Recognize and respond to direct versus indirect approaches for engaging in confrontation. (4) Balance the priority of keeping talent and the priority of less tangible strategic goals. (5) Assess complex skills, abilities, and leadership in a high-pressure environment and within the larger organizational goals.