'Power over' versus 'power with'

In the dental office, do you work for someone or with someone? When you need help with a procedure, do you ask for help or do you tell someone to help? When someone tells a joke about himself or herself, do you laugh at her or with her?

The answers to these questions not only give an insight into your work life, but also illuminate how others perceive you. Dental team members can distinguish between hierarchical and competitive models of your behavior, or inclusive and collaborative models of action. Do you exert power over others, or do you invite power with others? There is a big difference, with one form of conduct shutting people down, and the other opening them up.

Power over others

We think of those who exert power over others as the command-and-control boss, the person who uses his or her dominant position to coerce you to work. This is the boss who will tell you to book the patient with severe periodontal disease for 30 minutes, and to get the job done in that time. Or to stay late to offer therapy to one of his parents, not caring that you have children that you need to pick up at daycare. Or this boss tries to pressure you into making an unethical decision about treatment for a patient.

At best, this method of influence disregards others’ agendas, and at worst it uses brute force to accomplish goals. Those who have worked for such a boss feel resentment for having their own views, ideas, or wishes disregarded. Those working in these extreme conditions must think critically to ensure that as a dental hygienist, you are not stepping over the line—both legally and ethically.

This strong-arm style of influence is not limited to hierarchal positions of power, however.1 Teammates may often vie for power over other members of the dental team. The result is a relationship of polarity: you versus them. This desire for power creates a posture of suspicion, if not downright contempt, within the dental team. If the culture of the office is such that it favors a hierarchical top-down model and values certain members of the team more than others, negative effects will filter down among the staff. Dissatisfaction and burnout occur among many talented staff because the underlying modus operandi is power over others versus power with. Unfounded biases grow and the team, in the true sense of the word, does not exist.

Dental team members can distinguish between hierarchical and competitive models of your behavior, or inclusive and collaborative models of action.

One example of a hygienist exerting power over another hygienist can be seen in the delivery of care to someone both hygienists consider a difficult patient. This patient is fearful of dentistry, nervous about her quarterly periodontal therapy appointments, and has a low pain tolerance. Additionally, she is vocal enough in her discomfort that the entire office (including those in the waiting area), hear her lamentations. All clinical hygienists cringe when they see her on their schedules.

When one hygienist refuses to see this challenging patient, whom she calls the “neurotic wimp,” and forces another hygienist to deal with this patient, she exerts power over her colleague. The inflexible hygienist exhibits dominance over her colleague and the scheduling coordinator to achieve this.

Or perhaps subtle power over other team players is exercised in a favored assistant continually not being available for an evening shift, leaving others to pick up the slack. Power over others will undoubtedly create rifts in the dental team.

Power with others

Power with others enlists everyone. It is relational and collective, and creates new possibilities from the very differences that exist within a dental team. Unlike brute force, which needs to be reinforced to sustain itself, power with emerges organically. It can grow, evolve, and manifest into a stronger culture the more it is put to use. Power with is collaboration within an organization and thrives on being cocreative. Everyone on the team counts, and everyone’s voices, ideas, and input are valued. One plus one no longer equals two. The interdependence achieved can equal something far greater than the sum of its parts. Power with has an innate boldness to it, and it believes that acting from self-interest is not the wisest course of action for a team. It is a reciprocal influence, so that others on the team are involved, leading to innovative solutions.

Team members grow stronger and better the more it is used. It is based on the knowledge that one team member cannot know what is best for another without input from the other person. Power with embodies commitment to the team and the understanding that as each person seeks to influence the other, they in turn are also subject to influence.

The early 20th-century business visionary Mary Parker Follett wrote, “throughout history we see that control brings disastrous consequences whenever it outruns integration.”2 Her progressive thinking supported the idea that integration was achieved through relationship, candor, and an ability to see one’s actions as part of a greater whole. Her question of how we could diminish our dependence on power-over relationships led her to the following three insights.

See the possibility of integration—Teams and organizations need to look at polarizing issues with the goal of addressing the key needs and wishes of all parties. Finding common ground and exploring all possibilities will lead to a more cohesive team. Shifting the power of a one-sided influence to one where both sides have influence is more effective for the organization.

Recognize the law of the situation—Trust within the team is gained when there is transparency of operations. Through this transparency, errors can be mitigated before they mushroom. The result of a shared purpose is a collective will that can generate innovation and overcome obstacles.

Become a true leader—True leaders do not manipulate people or use command-and-control tactics. They stimulate what is best in their employees, bringing out their talents and skills. The best leaders unify their team. Parker felt that the person who influences us most is not the person who does great deeds, but the person who makes us feel that we can do great deeds. A great leader can strike a fire in his or her charges and inspire them to take action.

There are many examples of people rising against dominant powers that have exerted power over others throughout history. When people are forced to obey without having say in their living or work conditions, the result is anger. Although fury may go underground, it has been shown time and again to rise, often violently, given the right conditions.

Exercising power with others is more conducive to building cohesive teams. Deep listening, suspension of certainty, challenging assumptions, transparency, and trust are just a few proactive shields against creating a power-over culture. Modelling reciprocal relationships from management will help guard against staff exerting unhealthy behavior toward other staff members. Civility training can educate the entire office on what constitutes professional behavior and offer tools with which to do a reset for an office that has gone awry.

Dorothy Garlough, RDH, MPA, is an innovation architect, facilitating strategy sessions and forums to orchestrate change within dentistry. As an international speaker and writer, Dorothy trains others to broaden their skill-set to include creativity, collaborative innovation, and forward thinking. She recognizes that engagement is the outcome when the mechanisms are put in place to drive new innovations. Connect with her at [email protected] or visit engagingteams.com.

References

1. Power: power over, power with, empowerment. Just Conflict website. http://www.creativeconflictresolution.org/jc/maps-1/power-types.html.

2. Power over vs. power with. The Power of Collective Wisdom website. http://www.thepowerofcollectivewisdom.com/pdfs/power-over.pdf.