Hospital Management
Leader vs Manager: What is Leadership?
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Friday, Sep 13
The world can be a disagreeable place but something that we can all agree upon is that good leadership is a necessity for a healthy society. This is just as true in Healthcare as it is in every other facet of society. But what is good leadership? This is just as true in Healthcare as it is in every other facet of society. But what is good leadership?
Dr JH Hacquebord

I recently reviewed an article on this topic for a scientific journal. I was looking forward to reading something of substance about leadership since the majority of what you find on this topic tends to consist mostly of banal platitudes.

The article was a well-written review on 1) what leadership is 2) why leadership in healthcare is important and 3) theories on styles of leadership. I couldn’t agree with the author more that physician leadership in our healthcare setting is of utmost importance. This article is one that most people, even likely business school professors, would find to sufficiently address this topic.

However, this article (and many discussions on leadership) actually address management of people rather than leadership. These two topics may sound very similar but they are very different indeed. One example of the difference between the two is the focus on a goal (leadership) vs focus on a task (manager).

W. Edwards Deming writes in The New Economics (chapter 5): “the job of a leader is to accomplish transformation of his organization…[and] possesses knowledge, personality, and persuasive power”. He goes on that the leader “…has theory…feels compelled to accomplish the transformation as an obligation to himself and to his organization…and has a plan, step by step.” 

In chapter 8 of his book Out of the Crisis, he writes that “the aim of leadership should be to improve the performance of man and machine, to improve quality, to increase output, and simultaneously to bring pride of workmanship to people.” 

From what he writes, an essential component of leadership is that the individual must have knowledge (and sufficiently so) and work to improve the system in which he/she works.  Confounding leadership and management is all too common and unfortunately even done in an article about “leadership”. 

Final Thoughts

In summary, what we require from our leaders is the continued improvement of the system which they lead. Whether the leader is the US President or your surgeon (and everything in between), the leader has to understand what the system is that they lead and have the knowledge, vision, personality, moral integrity, and discipline to continually improve that system.

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