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Table 1 Areas of conflict for middle managers (adapted to [2])

From: Ethical challenges for medical professionals in middle manager positions: a debate article

  Areas of conflict for middle managers (MM)
Strategies • MM are usually not involved in strategic considerations [6].
• A limited freedom of creative leeway can demotivate and paralyze [6].
• Imprecise / unrealistically framed strategies require “silent” adaptations (emergent strategies) [7].
• Achievements are usually awarded to the top management [2].
• Failure of a strategy or failure of implementation of strategy will be attributed to the MM [2].
Role function • MM feel an increasing pressure to succeed with decreasing appreciation of their input [24].
• Compared with the top management, MM try to defend their freedom of action and choice [25].
• Compared to its own employees, MM try to assert their own position [25].
• Various loyalty claims generate stress fields with ambivalence and role dissonance.
• The interface position requires the fulfilment of the “trouble shooter and scapegoat” [26].
• Restructuring/rationalization is carried out to the detriment of the MM (job-, image loss) [27, 28].
Pressure to perform • MM should resolve conflicts and motivate and create trust [25].
• Authenticity, leadership and management responsibilities are expected from MM.
• The diversity of loyalty towards different stakeholders creates ambivalences [29].
• The commitment to loyalty to multiple senior staff members can generate the allegation of a lack of loyalty to one or more.
Qualification • For MM time was too short to prepare themselves for new requirements.
• The advancement from a colleague to a supervisor can be perceived as problematic [30].
• Personnel management measures put high demands on communication and conflict skills.
• Young managers need to develop their own leadership style.
• Unclear instructions have to be transferred into clear measures by the MM.
• An obstacle of delegation can overwhelm the MM, while employees might be under-challenged.
Ethics • The acquisition of ethical values of the company may require the ignorance of own values.
• Exceeding moral limits impose frustrations, uncertainties, and loss of authority.
• A loss of ethical values within a company can demotivate.
• When ethical conflicts become publicized, MM is rapidly becoming a “pawn”. Job losses and the loss of reputation as well as a loss of self-esteem may then assume health-threatening proportions.