LMX Theory: Investing in Dyadic Relationships

Leader Member Exchange Theory (LMX) is a unique theory that expands upon some of the tenants of other theories. Other theories, such as trait, behavioral, contingency, and implicit theories tend to focus more on the perceptions of leader characteristics and how they make leaders more or less effective in different situations. However, these theories risk neglecting follower characteristics and the relationship between followers and leaders. LMX Theory looks at the way leaders form individualized relationships with followers and highlights how that relationship can be a two way relationship where both members benefit.The theory holds that leaders are more effective when they take time to foster unique, individual relationship with unique members. The theory holds that leaders should evaluate relationship quality, taking note of which followers are members of the in-group and which are members of the out-group, and move out group members into the in-group accordingly. The theory holds that strong relations between leaders and followers cultivated within groups have the ability to confer benefits on both leaders and followers.
For example, leaders will experience increased communication, lower employee turnover, better employee attitudes, more positive performance evaluations, and higher degrees of mutual trust, respect, and obligation. Meanwhile, followers can expect to receive better assignment, more attention and support, higher energy and job satisfaction, and increased responsibility and opportunities. In my Theories and Models class, we looked at LMX theory particularly through the lens of a professional setting with the leader being a manager, boss, CEO, etc. and the follower being a subservient employee. However, personally, with regards to my site, I have seen in particular how healthcare providers serve as leaders and interact with their patients as followers. When doctors meet with patients, evaluate them, and establish treatment procedures for the patient to follow, this creates a definite leader-follower dynamic. I have seen the way in which providers seize the opportunity to use the dyadic relationship between themselves and the patient to enact change over time. This is an intensive and challenging process. However, I have witnessed firsthand the way providers strive to form individualized relationships with followers to create a two-way relationship where both benefit. This requires providers to take an extended portions of time meeting with their patients, getting to know them, and following up with them. Throughout my weeks at the clinic, I have realized how integral the follow-up procedure is to patient case. I cannot count the number of times I have heard the word “no show” used in the clinic. Before working in the clinic, I never would have guessed how many patients simply fail to show up for their appointment. Moreover, before, I would probably have guessed that in the event of a missed appointment, the provider would simply let it go and leave it up to the patient to reschedule. I would have thought it would be less effective and unrealistic for the providers to invest time and energy following up with their patients. However, this has been the opposite of the case.
Just yesterday, as one of the nurses walked her patient out of the exam room following an appointment, hug her, and remind her to book her follow up appointment. Jokingly, the nurse prodded, “If I don’t see you back in two weeks, I’m going to walk across the street and knock on your door to get you!” I was extremely impressed by the way providers seem to recognize and respond to the fact that many of their patients require long-term investment and follow-up. Providers establish an “us” mentality, letting their patients know they are on the same team and on the road to treatment together. In a community where many individual health issues are often compounded with behavioral, monetary, and familial issues, providers step up and are willing to do whatever steps to give patients the care they cannot give themselves. This is something that requires additional follow-up appointments, longer examination times, referrals to mental health professionals and counselors, and giving patients additional resources. However, because providers are aware of the needs of the community, they are prepared to go the extra mile and invest in the needs of their patients. This cultivation of leader-follower relationship results in better patient care and a better overall working environment in accordance with LMX theory.