Interview with a Director Every organization has several types of managers. A college setting, for instance, could contain a president, his deputy, school deans, associate deans, departmental chairs, and other administrators. A medical facility (privately-owned), on the other hand, could contain first-line supervisors, plant managers, standard compliance managers, marketing managers, financial controllers, and top executives such as the president, deputies, or a chief executive officer. For purposes of convenience, this text distinguishes three types of managers on the basis of their functional title, position, and organizational level, as shown in table

Table 1.1 Types of Managers

Organizational level

Position

Functional Title

Top managers

(have managers as subordinates)

Executives

President

Vice-President, production

Vice-President, sales

Vice-President, HR

Chief financial officer

Middle managers

(have managers as subordinates and report to top managers)

Managers or directors

Sales manager

Production manager

HR manager

Finance manager

First-line managers

(have non-managers as subordinates; report to middle managers)

Supervisors

Production supervisor

Regional sales manager

Assistant HR manager

Chief bookkeeper

(Source: Pearson Learning Solutions, n.d.)

What comes out quite clearly is that each manager "spends his or her time very differently depending on the specific type of manager he or she is," but interacts, and works hand in hand with other managers towards the attainment of the greater organization's goals (Pearson Learning Solutions, n.d.). To this end, the author set out to determine the kind of interaction between the middle and top managers in a hospital setting; specifically between the HR manager, and the Vice-President - HR, and thereafter, establish the role played by each one in the attainment of the facility's goals. A set of well-thought out questions (drafted in fig.1) was used to collect information from two separate interviews with the vice-president - HR, and the HR manager at the local health facility.

Fig 1: List of questions for the Interviews with Managers

1. How long have you had this position and what is your title?

2. What factors influence your decision-making?

3. Can your unit allocate and reallocate budgets, and to what extent?

4. What is you unit's role in the publication of market-oriented care-provision calendars?

5. Would you deliver media information or press releases?

6. How would you rate your unit in terms of independent decision-making?

7. To what extent does your unit interact with employees and other managers?

8. How is your unit affected by the current trend of changing management structures?

What stood out from the interviews is that managers at different levels of management carry out different functions and are tasked with different responsibilities, but they all "plan, organize, lead and control the people and the work of that particular organization in such a way that their organization achieves its goals" (Pearson Learning Solutions, n.d.). Particularly important is that all managers, regardless of their levels, spend a larger "part of their day with people -- talking, influencing, listening, motivating and attending one-on-one conferences or committee meetings" (Pearson Learning Solutions, n.d.). Moreover, it can rightly be expressed that structural hierarchies in the health sector are highly dynamic today, thanks to the structural changes brought about by outsourcing, organization flattening, and increased use of working teams (Simmering, 2014).

Management Levels and the Four Functions of Healthcare Management

Managers at different levels of the hierarchical structure spend their time differently with regard to the most common healthcare management functions of "planning, organizing, leading, and controlling" (Simmering, 2014). Planning, in basic terms, has got to do with setting goals and targets, and formulating strategies that could aid in their achievement (Simmering, 2014). Organizing entails putting up structures that facilitate the coordination of tasks, and ensuring that people can work together in a coordinated manner towards the achievement of the organization's goals (Simmering, 2014). Leading is about motivating employees and increasing their desire to contribute to the achievement of the goals of the organization (Simmering, 2014). Finally, controlling has to do with assessing performance and comparing actual results to the pre-determined targets and goals (Simmering, 2014).

The highest level of management spends a bulk of its time in goal-setting and planning. The actual implementation of the plans formulated by top managers is, however, left to the middle level managers (Simmering, 2014; Pearson Learning Solution, n.d.). Top level managers could, for instance, set a target of expanding their facility's product range to include dental services. Middle managers would then take this goal, translate it into such specific projects as 'hire two dentists and make the public aware,' and then hand the same over to their subordinates for execution (Dessler, 2001). Top managers would only come in to assess...

The middle manager, on the other hand, plays a significant role in communicating with subordinates and motivating them to work towards the goal's realization. This implies that "the amount of planning, organizing and controlling decreases down the hierarchy of management," as leading increases (Simmering, 2014).
Management Levels and the Three Roles of Management

Managers at the different levels of management carry out different managerial roles, which can generally be categorized into informational, interpersonal, and decisional roles (Simmering, 2014).

Decisional Roles: these have to do with resource utilization and strategy formulation (Simmering, 2014). The four roles in this category are; the entrepreneur role, the disturbance handler, the resource allocator, and the negotiator (Simmering, 2014).

The entrepreneur role, which is mainly held by top managers, is captured in the planning function and "requires the manager to assign resources to develop innovative goods and services, or to expand" an organization (Simmering, 2014).

The disturbance handler role is about correcting unanticipated problems arising from the external as well as internal environments, and is usually open to all levels of management; minor problems such as store robberies could be addressed by middle management, whereas more serious concerns such as the recall of a defective product are dealt with by top managers (Simmering, 2014).

Under the resource allocation role, decisions involving large budgetary allocations are addressed by top managers as middle managers deal with the more specific allocations (Simmering, 2014).

The negotiator role is about working with others, including labor unions, distributors, and suppliers to reach crucial decisions (Simmering, 2014). First-level managers hold negotiations with regard to salary issues, overtime rates, to name but a few; whereas middle managers "are likely to work to secure preferred prices from suppliers and distributors" (Simmering, 2014). Top managers, on the other hand, "negotiate on larger issues such as labor contracts, or even on mergers and acquisitions of other companies" (Simmering, 2014).

Interpersonal Roles: these call upon managers to not only supervise but also direct employees, and are mainly held by middle managers (Simmering, 2014). The manager communicates the organization's future plans to employees, sets a positive example, gives guidelines to subordinates, mobilizes the support of employees, and makes decisions (Simmering, 2014). The liaison role requires a manager to share resources effectively, establish alliances and coordinate the efforts of different units, and is "particularly crucial for middle managers who must often compete with other managers for important resources, yet must maintain successful working relationships with them for long periods of time" (Simmering, 2014).

Informational Roles: these have to do with the acquisition and the subsequent transmission of information down the chain of command (Simmering, 2014). The monitoring role has to do with evaluating performance and taking corrective action in case of unfavorable deviations, as well as watching out for, and responding to any changes that could impact negatively on organizational performance (Simmering, 2014). Although monitoring is critical for the various management levels, managers at the very top are more likely to watch out for external threats than middle managers.

The disseminator role requires managers to inform employees of the organization's purpose and mission, as well as of any looming environmental changes that could affect their performance (Simmering, 2014). Finally, the role of spokesman requires managers to communicate with the external environment, through advertisements, or by communicating the organization's direction to the community. Announcements regarded major, such as strategic adjustments, are more likely than not to be communicated by a top manager, whereas the communication of more routine information could be left to middle or first-level managers. For instance, "a middle manager may give a press release to a local newspaper, or a supervisor manager may give a presentation at a community meeting" (Simmering, 2014).

The Changing Structures of Management

One of the managers expressed that they are becoming uncomfortable with the title 'manager'; because the job and roles of management are changing so fast that the word is beginning to imply subordinates. The author found this quite reasonable, and set out to establish the possible causes. Increased team use, outsourcing, and organizational structure flattening were found to be the major contributors to this trend.

Organizational structure flattening: traditionally, organizations had tall organizational structures, with numerous middle management levels; such that each manager supervised only a very small number of subordinates (Simmering, 2014). Today, most organizations have flatter structures and individual managers have broader spans of control. Flat structures have a number of advantages, including reduced bureaucracy and less centralization, and increased flexibility to respond to the competitive marketplace and dynamic customer needs (Simmering, 2014). Flatter structures imply a diminishing need for middle-level management ranks, which translates to fewer promotion opportunities for first-level managers and a…