Dr. Eleanor Feldman Barbera

I often speak with healthcare groups, giving psychological insights about a variety of issues within long-term care. Sometimes I address a C-suite audience; other times I train direct care staff.

I noticed during the course of these talks that some of the group exercises that generated excitement and intense discussion among direct care staff were met with relative restraint when presented to executives.

After pondering the discrepancy in reactions, I adjusted my talks accordingly and came to this conclusion: Healthcare executives and managers are very different from those they manage.

Understanding and utilizing these differences can facilitate leadership in a variety of ways.

How execs differ from direct care staff

We can consider the discrepancies between the two groups by looking at the traits generally exhibited by each. I’ve borrowed a tool from career counselors, who test their clients’ personality traits to determine what types of jobs best suit them.

One such test is the Myers-Briggs Type Indicator, which examines four different aspects of an individual’s personality as it relates to career choice. The summary below is from an article with a handy chart based on the book, “Do What You Are.”

1. Interaction with the world:

a.  Introverts often like working alone or in small groups, prefer a more deliberate pace, and like to focus on one task at a time.

b.  Extroverts are energized by people, enjoy a variety of tasks, a quick pace and are good at multitasking.

2.  Absorption of information

a.  Sensors are realistic people who like to focus on the facts and details, and apply common sense and past experience to come up with practical solutions to problems.

b.  INtuitives prefer to focus on possibilities and the big picture, easily see patterns, value innovation and seek creative solutions to problems.

3.  Decision-making style

a.  Thinkers tend to make decisions using logical analysis, objectively weigh pros and cons, and value honesty, consistency and fairness.

b.  Feelers tend to be sensitive and cooperative and decide based on their own personal values and how others will be affected by their actions.

4.  Organizational style

a.  Judgers tend to be organized and prepared, like to make and stick to plans and are comfortable following the most rules.

b.  Perceivers prefer to keep their options open, like to be able to act spontaneously and like to be flexible with making plans.

Each person is given a four-letter code – their “type” – and that code is used to determine the best career choices for their personality styles.

Using the Myers-Briggs, healthcare workers (Type ESFJ) are described as gregarious traditionalists motivated to help others, while executives (Type INTJ) tend to be creative perfectionists who prefer to do things their own way.

(Psychologists – INFP – are typed as sensitive idealists motivated by their deeper personal values….Yeah, that sounds about right.)


These personality types, while of course being generalizations, may help you understand and motivate your workers.

What immediately struck me about the type characterizations was the description of direct care staff as “gregarious,” which would explain the variation in the reactions of my audiences. It also suggests that when it comes to rewarding employees, they might enjoy those that are bestowed on the team more than individual rewards. (Think pizza parties more than parking spaces.)

The discrepancy between staff as “Sensors” and managers as “Intuitives” can be seen as boon when workers vet management’s idea before launching. Employees’ common sense feedback and knowledge about what’s worked in the past can give creative solutions the practical dimension they need to succeed. Staff also can offer valuable perspective on how potential changes are likely to affect others on the team.

In addition, vetting ideas through workers will appeal to their preference for cooperative decision-making and can increase acceptance of new initiatives.

Including staff members in the decision-making process might be challenging for INTJ leaders who “prefer to do things their own way.” Overcoming this challenge is worthwhile though, because getting staff input not only leads to better decisions, it makes it more likely that “your way” will become “our way.”

Eleanor Feldman Barbera, PhD, author of The Savvy Resident’s Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is the Gold Medalist in the Blog-How To/Tips/Service category of the American Society of Business Publication Editors Midwest Regional competition. A speaker and consultant with over 20 years of experience as a psychologist in long-term care, she maintains her own award-winning website at MyBetterNursingHome.com.