Managers and Leaders

Physicians are trained to be doers or active managers of health.  Most every clinician is considered to be a leader in their own work unit, providing trusted direction as to how care should be provided.  When clinicians step forward and take leadership positions as department chairmen or temporary officers of a hospital medical staff, their primary mode of operation continues to be as doers.  Even though these roles are often thought of as leadership positions, they are actually operating as managers. The difference is important.

What is the difference between managers and leaders?  The best analogy I have heard to date is as follows: managers make the trains run on time, leaders determine where the tracks will be laid.

Organizations need both managers and leaders. When there is too much management and not enough leadership, the status quo is maintained unless external influences cause a deterioration. When there is too much leadership, day to day management is neglected resulting in chaos.

Most clinicians rise to the level of leaders because of their ability to get things done. However the ability to develop vision and inspire others are traits necessary to be a great leader. The more a leader personally does, the less the organization accomplishes.  As clinicians become leaders, the mind set must change from being a doer to becoming an inspirer of others.  Only by working within an organization to develop vision and long range focus can the leader challenge the various managers to direct their work along the correct path.

Consider the situation of a large logjam.  The manager will know that by removing one log at a time, the logjam will be eventually freed. The leader seeks vision and long range focus by climbing to a vantage point and determines where the key log is likely to be. With much less effort, the key log is removed allowing the logs to flow freely to their destination.

I believe most clinicians are good managers, but only a few clinicians are natural good leaders.  The rest of us can learn to be leaders with proper training, guidance and insight.

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