Throughout our careers—indeed even in our personal lives—we struggle to achieve a proper balance between being a giver, sharer, taker or matcher.
Adam Grant, a professor specializing in organizational psychology in the Wharton School at the University of Pennsylvania, Philadelphia, in his bestseller book, “Give and Take,” separates people by their reciprocity style into givers, takers and matchers. Givers, as the word implies, give more than they take as they are more attentive to others’ needs than their own. Sharing knowledge is also a mark of a giver. In contrast, takers are self- focused and take more than they give because their own needs are more important in a competitive environment where they need to succeed and be one step ahead of others. Finally, matchers balance giving and taking in some imprecise proportion, preferring to view each action as a transaction and may even keep score. Whether in our personal or academic life, we may switch between these roles, trying to achieve an equilibrium.
So let’s now take a look at a few examples where there may be a clash between our expected role as givers versus what may be best for us as individuals.
As students or residents, we are usually—but not always—takers. In academic or teaching roles, we are expected to be givers of information. Our role may be to help junior faculty or residents succeed in academic activities such as presenting a paper or achieving prime author roles. On the other hand, this requires giving up the limelight that otherwise could have been ours.
As faculty, we are perhaps gearing up for promotion. Most of the work on a major paper may be done by a junior individual who actually deserves to be named as the first author. What will our choice be?
Elsewhere, we may become an expert in the latest technical procedure, a scenario in which few others are our equal. So do we share these skills with our colleagues and thereby grow the competition? Or do we plow on for as long as we can in order to seek sole credit?
We could also be the go-to person on matters related to the business side of medicine. The head of a national surgical organization may favor a particular person as the subject expert, and this individual is then invited to discuss these issues nationwide. Meanwhile, a younger person with solid qualifications might then approach the organization, asking to participate alongside the senior individual. In the final analysis, the organization proceeds to slow walk the request, not wanting to upset the senior surgeon or possibly even at his direction. The message is clear: There will be no sharing of the limelight. What would you have done as the expert in this situation?
Then there are times when you are in matching mode. In this scenario, you have been a giver to someone whom you have repeatedly helped to progress in their career. Now, with roles reversed, you want a position in an organization and ask this individual—the hitherto taker—for a favor to help you. The taker in this case must think about whether they wish to reciprocate for the first time or otherwise avoid the issue until they are able to grab the role as their own. Therefore, as a taker, do we now change our role to one of a giver?
Setting up boundaries
In his book, Grant, the organizational psychology professor, also points out that one must distinguish the act of giving from attributes such as timidity, availability and empathy, and do so to a fault. Takers are best positioned to take advantage of givers when the givers are not assertive, making themselves available at a moment’s notice often as a show of empathy to support the taker. Time and knowledge are valuable currency. Spending both freely—often at a personal loss—benefits only one side.
For most of us, it is often hard to set boundaries: Delay helping a constant taker and you could risk being called rude, selfish or even an ogre! As an example, we receive calls or emails from distant relatives around the world asking for advice on matters related to themselves or their neighbors in specialties we know little about. Obtaining expert advice from colleagues and then answering these queries takes up valuable time. We are not thinking about being in a matching mode and simply assist any way we can.
So when do we give up some of the limelight to others? After our own personal goals have been achieved? Or do we believe Grant when he asserts that eventually givers come out ahead? Essentially, as a giver, you are offering your shoulders for others to stand on and rise. Advancing in academic medicine requires senior colleagues/mentors to give in order to help us reach our career goals.
In my case, as I was trying to carve out an academic presence at the same time as operating in private practice, I did not have people blocking for me.
Those who did have these types of sponsors moved ahead. Later on as a member of senior faculty myself, having missed out on someone advocating on my behalf, I have felt an obligation to give and share with my junior colleagues as much as possible. In turn, this has been rewarded with respect and appreciation for the efforts I have made to advance their careers. In retrospect, it is also possible that in some instances I may have overdone it and hurt my own progress. Indeed, I often wonder if a time had come when I wanted a match, could I have expected reciprocation?
Now, I often try to assign a percentage to each of the modes of giver, taker and matcher if I am not in a teaching or mentoring role. It is a useful exercise. If I feel someone is repeatedly taking advantage of my giving, my default may be to match and then judge the reaction, which discourages the constant taker.
‘Paying it forward’
Another way to be a giver is to simply share information or knowledge in which we may have become an expert. Knowledge is said to be power. There are two non-exclusive ways of power-sharing: closed-network sharing (or person-to-person sharing) and open-network sharing (or sharing through a central open repository, or in the academic environment at meetings).
My concern is focused on the lack of person-to-person sharing in our divisions, departments and medical centers. My observation is that a lot of people, depending on the unique institutional culture, keep knowledge close to the chest. Even sharing information that may be useful to others is kept private. Senior physicians should share knowledge and be blockers to thwart obstacles for their younger colleagues. The cycle of “paying it forward” may inspire them to do the same when their time comes.
From an organizational perspective, cultivating giving behavior should be rewarded, and not just through means of personal achievement or company metrics. The correlation between employee-giving and business outcomes is solid. However, career advancements—be they titles or bonuses—are based on individual achievements and tend to encourage a race to the top between colleagues. Studies looking at links between productivity and givers have shown mixed outcomes. Therefore, academic organizations and professional bodies such as the Society for Vascular Surgery must include giving and sharing as part of the mix when evaluating individuals for promotions, responsibilities and appointments to prestigious committees or leadership roles. Or am I being too naïve?
- Grant, A. “Give and Take.” Penguin Books. 2014. ISBN: 0143124986, 9780143124986
- Grant, A. In the company of givers and takers. Harvard Business Review. April 2013. https://hbr.org/2013/04/in- the-company-of-givers-and-takers
Bhagwan Satiani, MD, is professor of clinical surgery in the division of vascular diseases and surgery, the department of surgery, in the Ohio State College of Medicine at The Ohio State University in Columbus. He is an associate medical editor of Vascular Specialist.