Four Stages and the Acupocalypse, Pt 3

Published in on May 18, 2023

Sorry for the delay and welcome back to our discussion of Dalton, Price and Thompson’s Four Stages of Leadership model -- and what it means for acupuncturists.

Here we are at Stage 3: Assuming responsibility for others -- local leadership. Central activities: Interfacing, training, contributing through others. “Mentor”.

As noted earlier, Dalton, Price and Thompson were researching the career development of knowledge workers in big corporations. There’s no indication that they were ever in a position of having to build their own organization or their own small business -- so this is where the context is really, really different from most acupuncturists.

In my mind, there’s a bright red line between Stage 2 and Stage 3, which wasn’t in Dalton, Price and Thompson’s model because they didn’t need to think about it that way. That line reflects the difference between people who contribute to making an organization versus people who just use organizations (if they’re around to use). Back in the day we used to talk about the difference between cooperators and consumers; there are some overlaps here. People in Stage 1 and Stage 2 can participate in organizations, but they don’t put their energy and attention into anything beyond their own role -- especially not organizational infrastructure. They won’t start, maintain, or lead organizations. For that, you need people willing to do Stage 3 and Stage 4 work.

I have a LOT to say about Stage 3, Stage 4, and the bright red line. My shorthand version of the stages so far goes like this:

People in Stage 1 don’t look beyond their own jobs and need to be told what to do by somebody else;
People in Stage 2 don’t look beyond their own jobs and don’t want anybody else to tell them what to do;
People in Stage 3 look around, see what needs to be done, and communicate, interface and develop other people as much as they have to in order to make it happen.

In big corporations, or even in mid-sized businesses, there are sometimes (not always) tangible rewards for progressing through the stages of leadership. And there’s often a perception (if not always the reality) that leadership is rewarded. This isn’t the case in contexts where people have to build organizations from scratch; there are often no personal benefits at all for taking on more responsibility. Sometimes providing more leadership in an organization just means managing more risk, more uncertainty, and more invisible labor, as well as tackling a learning curve of new mindsets, new relationships, and new tasks.

The key characteristic of Stage 3 (which extends into Stage 4) is the idea of getting positive results through other people’s work as opposed to just your own. People in Stage 3 and Stage 4 take care of organizations so that other people have structures to contribute within, as opposed to requiring everybody to create their own structures from scratch (which is possible for Stage 2 people but not for Stage 1 people). People in Stage 3 create opportunities for other people.

As described in The Extraordinary Leader: Turning Good Managers into Great Leaders, by John H Zenger and Joseph Folkman, a person at this level of leadership development: proactively coaches, develops and/or mentors others; is not threatened by the competence of others; clarifies complex data or situations so that others can comprehend, respond and contribute; provides support and encouragement to others when they try to innovate even when they fail; builds commitment in others and holds others accountable; is generous in recognizing the contributions of others; demonstrates confidence and trust in other people’s abilities; knows when to let go of the details in order to help others learn from experience; energizes others to want to change by pointing out the need for change; helps others overcome their resistance to change; clarifies how changes affect everyone’s jobs; coordinates teams to align with strategy; clarifies vision, mission, values and long term goals for others; and consistently communicates “big picture” implications for others.

For the most part, tackling these tasks in the acupuncture profession requires doing it without compensation and/or against resistance of various kinds. As noted earlier, acupuncturists have a weird, tortured, destructive relationship with organizations. This seems to me like a kind of chicken and egg problem. Is the weird, tortured, destructive relationship to organizations a result of most acupuncturists being allergic to the Stage 3 mindset of contributing through other people? Or do acupuncturists not have enough opportunities to learn about and value Stage 3 work because there aren’t enough organizational structures to do it in?

I’ve known a lot of acupuncturists who wanted nothing to do with Stage 3 work because all the interfacing and communicating was just not their cup of tea. Acupuncture for them is all about their personal skillset, which isn’t wrong of course but doesn’t help organizations exist. If being in an organization makes it easier for these acupuncturists to do their own thing (like being hired to work in a clinic that somebody else started as opposed to starting a clinic themselves), then great, they’ll do it. But if you ask them to think about how that opportunity was created for them by someone else, and pay it forward by creating or maintaining opportunities for other people -- nope, hard pass.

I didn’t learn anything about organizations in acupuncture school; the assumption was that I was a consumer, I was there to buy an educational credential and that was that. I didn’t realize that after graduation I would be responsible for creating my own opportunities, including my own employment. Nobody spelled that out for me, especially the risk and uncertainty that comes with entrepreneurship. So I can see how maybe the problem with Stage 3 work in the acupuncture profession, and organizations in general, starts with acupuncture schools.

It took me many more years to understand that organizations, structures for acupuncturists to work in, don’t drop from the sky, somebody has to make them. There have to be individual humans willing to step up to do certain kinds of labor and create certain kinds of relationships in order for opportunities to exist. I’ve learned through painful experience that I can’t allow people to take Stage 3 work for granted, whether I’m doing it or someone else is. The chicken and egg problem of acupuncturists not valuing Stage 3 work and having destructive relationships with organizations, however you arrange the cause and effect, only gets worse when Stage 3 work is invisible and ignored.

You know what’s a great example? The idea that Medicare inclusion will magically save the acupuncture profession -- that’s a perfect demonstration of acupuncturists invalidating Stage 3 work. People seem to seriously believe that jobs for acupuncturists will instantly pop into being as soon as there’s a new potential for cash flow; we don’t have to think about WHO is going to create those jobs and whether they have incentives or support for doing so, let alone all the time and effort required.

Dalton, Price and Thompson’s research helped me recognize that while acupuncturists want professional careers, collectively we just haven’t put in the work to create the underpinnings that professional careers require. We like fighting dry needling much more than we like building organizational infrastructure. Without those underpinnings, more cash via Medicare isn’t going to do much good, it’ll be like a flash flood over dry ground because we can’t absorb it. As other commentators have pointed out, jobs doing acupuncture funded by Medicare will go to other professions that have the infrastructure to create jobs. Acupuncturists can’t even acknowledge that jobs require infrastructure -- and infrastructure requires labor.

If I sound exasperated it’s because I am. Making jobs and opportunities for other acupuncturists is difficult and often thankless work and the only thing that’s worse than it being thankless is when people act like the work itself doesn’t even exist. The new Gainful Employment regulations from the federal government just dropped yesterday -- it remains to be seen whether they’ll get anybody to look more deeply into why there aren’t more jobs for acupuncturists. I believe the acupuncture profession has a massive, culture-level problem that Medicare can't solve: we demand opportunities but we don’t want to create them for each other.

Next up: Stage 4 and the Acupocalypse.