May 26, 2021

Your Leadership and Effective Authority

Clinician Leadership | Leadership Development | Team Development

Reading Time: 6 minutes

In today’s necessarily complex organizations, the organization chart rarely provides complete clarity around the issue of authority. Within a hospital, work is done across departments and functional lines, knitting together their capabilities in initiatives designed to improve a process or implement a program. In multi-entity systems, local hospital leaders depend on the performance of functions centralized at the system level to meet their budget targets and performance goals.

In this context it is quite common for my coaching clients who bear responsibility to lead such initiatives to express frustration that others, upon whom they are dependent for success, lie outside of their direct authority. “If only those people reported to me I would be much better positioned to meet my performance goals,” they lament.

At the surface, that argument seems to make sense. If everyone upon whom I depend for success reports to me, I theoretically have the positional authority to align priorities, resolve differences of opinion, and dictate the actions to be taken to execute in accordance with my expectations.

However, in our experience, that argument doesn’t hold up. In fact, it is often a red flag for a leader whose “effective authority” is in need of focused development. In this article, we want to explore the nature of authority, its limitations, and when positional authority is a necessary and helpful tool.

The Fiction of Positional or Formal Authority

In this discussion we define the term “legitimate authority” as the ability to drive a decision to an outcome in a manner which achieves shared ownership and sustained commitment. Using that definition, the use of positional or formal authority as a blunt instrument to direct others’ actions has the potential to fall far short of legitimacy.

In any organization or system where the pursuit of a shared goal depends on the integration of multiple functions, decisions made in a manner that ignores the appropriate needs (not preferences) of those functions will only stand as long as those whose needs are not being met lack other options to correct the situation.

What are those other options? The most obvious is to opt out by leaving the organization or situation. Worse than that, however, is to stay and actively work to undermine the decision. There are numerous ways for that to happen, including:

  • Indifferent, technical compliance without commitment, doing the least amount required rather than investing the best one has to offer.
  • Seeking leverage by speaking out to customers or other key stakeholders, voicing dissatisfaction with the situation as an explanation for gaps in the customer experience.
  • Developing alliances with others, inside and outside the organization, who can equalize the power gradient through their positional or coercive power.

Let’s use an example. Leaders in Health System A decide to make a change in its nursing care model for med-surg units across the network, based on the recommendation of a consultant who predicts significant savings with no adverse impact on quality or patient safety. While promising in theory, the model is dependent upon important building blocks and adaptation to nuances in the physical layout and operating systems of different nursing units (e.g., training, supply management, information systems flow, physical reorganization).

In its zeal to capture the savings from the proposed change, leaders in the organization interpret feedback around these issues as nothing more than defiant resistance to change. The response from senior management is increased pressure for “compliance,” using their positional authority to direct nursing leaders and their staffs to support the change.

What would you predict are possible responses to positional authority in this scenario? As the predictable problems occur upon implementation as a result of flaws in the design and deployment, conscientious nurses defend themselves to patients and referring physicians, explaining that they are only doing as they have been directed. Physicians, unhappy with the impact on the care of their patients, voice those concerns to senior leadership and, in some instances, express their dissatisfaction by choosing to admit their patients at a neighboring facility. Talented leaders and staff members who take pride in their profession and have numerous options to work elsewhere choose to do so, unable to live with the fallout from the change. Nurses, feeling powerless in the face of this troubling decision, reach to a third party, a union, to equalize the power and give them a voice.

The theoretical power of positional or formal authority is just that, theoretical, if wielded in a way that ignores or neglects the legitimate concerns of those upon whom success is dependent. And that power only lasts until those affected find other options to correct the situation.

Exercising Legitimate Authority

Legitimate authority is rooted in trust established between people on the basis of confidence in the character and competence of one another.  Trust in another’s character involves more than affirming their personal integrity. It requires a sense of shared purpose, that the people involved are equally committed to the same goal and believe it is best, or only, achieved together.

The process of exercising legitimate authority involves making decisions to advance the shared goal in a manner which seeks to address the needs of those upon whom a successful, sustainable, outcome is dependent. A key word in that sentence is needs (or requirements), not preferences, as the needs of any one function/stakeholder must be addressed in a manner compatible with the needs of the others.

Exerting such authority comes not from the organization chart but from an approach which engages stakeholders in a creative process to identify and address, together, the needs of one another in the pursuit of their shared goal.

Based on my work with clients who successfully accumulate, expand, and effectively exercise legitimate authority, here are a few simple tips on how you can do the same:

  1. Invest in building trust.
    Spend time to establish relationships with key collaborators outside of the context of addressing a particular issue or decision. The more people get to know one another at a level which gets beneath stereotypes or assumptions, the greater the chance they can retain trust and work collaboratively through differences in ideas.
  2. Identify, affirm, and stay centered on the shared goal and the benefit of collaboration.
    Recognition that achievement of the shared goal is best or only possible through the interdependent efforts of multiple parties is key to giving each of those parties a platform for effective authority. It encourages the parties to do more than advocate for their individual interest as they recognize that over time and overall their self-interest is best served by addressing the needs of those upon whom they are interdependent. Keeping that shared goal and collaborative benefit at the forefront helps to bring people “back to center” when their differing perspective threaten to drive people into a defensive, self-protective posture.
  3. Listen and communicate deeply.
    In order to create opportunity for dovetailing solutions, it is important for each party to share more than their proposed alternative. By communicating more deeply, the parties can gain an understanding of the aspirations, fears, and assumptions behind those alternatives, opening up a pathway to create an option which will address each other’s needs compatibly. For those in the “sender” mode, take time to share the data, assumptions, experiences and rationale which lies beneath your position. For those in the receiver mode, probe deeply to understand those same things about others, and avoid making up your own story to explain their perspective.
When Positional Authority is Needed

The process to build legitimate authority works well when those engaged are able to find a solution which meets the intent of that process. But what if finding that dovetailing solution is not possible?  What if the parties have legitimate differences of opinion about critical factors which lead them, in good faith, to divergent, mutually exclusive conclusions?

The best solution, of course, is to find to close the gap between their opinions or assumptions around those key factors. Additional research, use of a third-party expert, building a prototype or doing a small-scale pilot – all of those tools can be helpful in building alignment and finding common ground. But there are times when, despite everyone’s best effort differences of opinion around key assumptions.

The worst case for teams at impasse is to remain stuck there, creating a situation in which team members become adversaries in a power struggle. Rather than seeing their impasse as a difference in ideas around how to achieve their common goal, team members begin to assume there are different agendas. Trust among team members quickly begins to break down.

This is where positional authority plays an important role. If leadership has identified the person who has final formal authority over a project or program, whether those on the team formally report to that person or not, part of their role is to make the call when dovetailing agreement cannot be achieved. In doing so, though, it is critical that exercise of positional authority come after all legitimate interests and points of view have been heard. It is also important to follow the decision with a commitment to monitor what transpires after that decision is implemented so that, if the non-prevailing point of view proves to be correct, adjustments can be made as appropriate.

The goal when a team finds itself at impasse is not to walk away with everyone “happy” but to have everyone walk away feeling heard and with trust in the good faith of their colleagues.


While the notion of formal, positional authority is alluring, the reality is that its effectiveness is limited and reliance on it as a primary tool for leadership can have serious negative consequences.

For those who lack positional authority over a process or initiative important to their performance, resist the temptation to assume you are powerless to influence change. Work to build effective authority by forming trusted relationships grounded in shared purpose and mutual respect.

Those relationships can be the key to galvanizing the attention and support of those outside your formal authority to collaborate in the pursuit of solutions which address your needs and advance the team’s shared goal.

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About the author

Robert "Bob" Porter, JD, MBA, PCC

Robert "Bob" Porter, JD, MBA, PCC is an accomplished organizational leader with over 30 years’ experience in health system leadership. Bob has extensive experience in working with senior leadership executives in complex organizational settings, with a proven track record for engaging diverse stakeholders in the redesign of organizational systems and processes to achieve breakthrough improvement in performance.

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