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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.