DB'S MEDICAL RANTS

Internal medicine, American health care, and especially medical education

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Politics – Obama vs Clinton – leadership vs. micromanagement

I am going way outside my comfort zone in this rant.  If I make a fool of myself, please tell me.

Like many Americans I am fascinated with the Obama/Clinton competition.  I have temporarily switched from Mike and Mike in the morning to Morning Joe.  In watching this ongoing contest, I have my own theory.  I suspect that my theory is just as accurate as all the talking heads on TV and radio.  Afterall, I have no qualification for understanding politics, which makes my opinion so worthless.

When I see the Barack Obama campaign I see a campaign which primarily focuses on leadership.  He sells himself as an inspirational leader.  He displays charisma, and captivates with oratory.  Many voters want to follow him, because they trust that he will lead them.

When I watch Hillary Clinton I see a technocrat.  She proclaims that she has solutions.  She can fix our problems.  She implies that she knows what is best for us, even if we disagree.

Watch their body language.  He stands tall, and has an easy smile.  He displays passion but always with grace.

Warning – I know that this may read as sexist!

When I watch Hillary (without the sound) she reminds me of a middle school teacher who is trying to intimidate the class into behaving properly.  She points at us.  She shakes her head, suggesting that we really do not understand as much as she does.

The Clinton campaign wants to feature her legislative achievements.  She apparently knows how to get things done.

She and her campaign are missing the point.  I suspect they will never understand, because they are micromanagers.  They want to manage health care, the economy, education, …

Men have a negative reaction to her campaign.  She has a serious gender gap problem, because she stimulates adolescent memories of female teachers (I am really stretching here, but my gut suggests that I am in the right ballpark.)

As I consider academic medicine and especially ward attending rounds, which candidate would likely run better rounds.  We know (from our own research) that residents resent micromanagement.  They want leadership; they value management; but they resent being told what to do.  They work best when the leader helps them find the right path, not when they are made to follow a path.

I do know a lot about attending rounds, and I know little about politics.  My observations have coalesced over the past week.  I find this struggle fascinating, so like most observers I strive to understand.

My experience with learners is that they do not want solutions, they want direction.  They prefer to work towards their solutions.  Maybe this observation fits the primary race.

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