All people will experience leadership or being led at times during their life. Whether this be in the school yard or in a board room, we have all had leaders in our groups and teams. Many of us have been the designated leader. Given that leadership is so ubiquitous, seemingly we’d all have a clear understanding of what makes a good leader. However, like many of the most important elements in organisations and society, leadership is poorly understood.

Leadership is felt at the unconscious and emotional level rather than evaluated cognitively. We ‘know’ when we are being led well or badly. Good leadership needs to include technical competence and proficiency with the prevalent systems but must also encompass factors that are only experienced intuitively.

The emotional measures of leadership, such as how much trust the group places in the leader, have become neglected and undervalued. Perhaps these elements are diminished because they are less visible and harder to evaluate and comprehend. However, the emotional aspects of leadership are some of the most critical. These factors must come to the fore and be examined and developed if our systems are to change for the better.

What is Leadership?                                           

When I was first starting to be appointed to leadership positions within medical teams and hospital departments, I felt some anxiety. Who was I to direct and control these groups of educated and high-performing individuals? I started to research leadership theories and practices to improve my capabilities and alleviate my anxieties.

From the multiple shelves of books on leadership in any bookstore, it became apparent to me that leadership is a highly valued but poorly understood topic. I also found that there were many different approaches and answers to the question about what leadership consists of. Many of these bookstore texts, often written by an individual who had followed an unconventional path to success (which often also included becoming outrageously wealthy), asserted that their method was the only recipe to achieve your goals. However, none of them seemed to hold the secret to my leadership challenges. While all of the books contained insights and interesting anecdotes, it appeared that each organisational or group context would be different and require its own approach.

As well as edicts from billionaires, many of these leadership books were written by military leaders, detailing actions in battles and wars that were then somehow extrapolated to peacetime business situations, or leadership in other fields. This felt disingenuous when thinking of organisational leadership. A business or hospital is not at war with its competitors. Most of the messages didn’t seem to apply. I wasn’t at war, beginning a start-up, or concentrating on amassing a fortune. Despite the multitude of conflicting ideas, I didn’t really apply any of the lessons learned from the leadership texts.

Oddly, I found that some of the best outcomes that I had with my team would be when I used techniques or styles of behaviour that were similar to those used when playing or coaching sports. The groups responded to being cared for in similar ways. It wasn’t so much control or detailed direction that was required, more so care and respect.

The medical teams needed to connect with each other just as much as a group of teenage athletes playing a sport did. The kids played better when they were treated with affection and allowed to have a sense of fun. The doctors performed for higher stakes, but also worked more effectively when they had a caring and enjoyable environment. It wasn’t about controlling them – it was about relationships and guidance.

The realisation (which perhaps should have been obvious) was that there isn’t a secret way to lead specific teams. All teams are the same, in many ways. The first factor to create a great team and culture is as simple as being nice to people and treating them fairly and respectfully with clear communication. The doctors didn’t want me to tell them how to do their job, they just needed a supportive framework around them where they could develop trust and feel part of a team in which there was regard for all members.

 The Desire For Leadership

It is obvious that leadership roles are desired and prized by many in our society. People gain power with leadership roles in any setting and associate such roles with enhanced status and often increased remuneration. As humans, we have an unconscious mental shortcut that assigns other abilities to those in powerful positions, frequently assuming that due to their high status in one field, their opinions about unrelated topics also somehow have extra authority. Therefore, there are many reasons and attractions to leadership. People with certain personality characteristics – including narcissism – will be drawn strongly to leadership roles, even when they are poorly suited.

Each of us has an image or construct of the ‘ideal’ leader, ranging from an authoritarian figure who can bravely lead us forward through solo action and decision making, determination, and self-will, to the democratic leader who involves and consults many people before making each decision.

Leadership is a complex concept that encompasses many facets. It may sometimes be easier to consider what it is that leadership is not than to define what leadership actually is. Leadership is not just the job title, the position, a particular set of attributes, or an ability to organise and manage. Some of the areas encompassed by leadership include: setting cultural expectations, communicating, motivating, collaborating, directing, delegating, taking ownership of difficult situations, taking responsibility for poor outcomes, inspiring others, dispensing consequences, recognising noteworthy efforts, giving directions, making sense of uncertainty, strategising, collaborating, expressing gratitude, forgiving, counselling, and supporting.

Further, leadership is about directing focus onto areas that need or deserve attention. These may be organisational goals, improvements, corrections, or modifications required, as well as areas that warrant praise due to unusual or unprecedented success, exemplary effort, and behaviours valued by the organisation. The leader must have the requisite skills for the position within the appropriate industry and must have clearly held personal values which are congruent with the desired culture of the organisation. The leader must also have an ability to create and share goals with other members.

When I think of the consultants, directors, or heads of units who influenced me most during my training, I must wrack my brain to discern who gave the best advice on surgical technique, or who I obtained certain theoretical knowledge from. However, I have immediate recall of how I felt with each of my ‘bosses’, and what emotions they stirred in me. Some of the lessons I learned were from those I didn’t want to emulate. The best learning was from those whose behaviour I admired. These people were kind, not only to patients but to juniors, nurses, and all staff. I felt great affection for these leaders, and I worked harder for them as I was determined not to let them down. When around good people, we behave more virtuously, with the opposite also applying. The best leaders – those I wanted to be like – were honest, kind, and fair.

As leadership research increases, it is more frequently recognised that emotional intelligence correlates with leadership effectiveness. This does not just imply nicety, but also kindness, empathy, an ability to register the emotional states and needs of other people, and a willingness to try to assist. These qualities are part of the rich mix that constitutes wisdom. Wisdom implies a level of intelligence, both cognitive and emotional. It also requires self-regulation of emotions, which allows the use of different and appropriate styles of interaction according to circumstances and the people involved.

Wisdom has long been recognised as an important virtue in a leader, with both ancient Greek and Chinese philosophers having similar sayings along the lines of, ‘With power must come wisdom’.

The current challenges to hospitals are causing many organisations to consider their culture and try to increase organisational pride, foster staff well-being, and produce a flourishing environment. This is more than merely trying to continue with a current strategy, or business as usual, which only requires technical management or transactional leadership. These hospitals are also examining their leadership structures.

Evolving into a thriving organisation requires a more inspired transformational leadership style that engages the emotions and imagination of staff. This is where curious, appreciative leadership prioritises development of people over development of building or organisational processes. In this environment egos can be controlled in order to collaboratively create the desired vision. With this style, the leader does not need to control everything. They are more responsible for helping to unify, envision, and facilitate. The leader does not have, or need to have, all the answers. The leader encourages a vision and invites others to collaborate with the detail. In this structure, a leader will be content helping to trace an outline and stepping back to allow others to add the colour.

The Secret to Becoming a Leader

When many of us rise in seniority and start to assume leadership roles, we follow the same path. We read leadership guides and manuals, we watch TED Talks, we explore the importance of performing a daily ‘twenty-mile march’,[i] try to become more effective by establishing ‘seven habits’,[ii] and suppress hunger while we are ensuring that we ‘eat last’.[iii] We try to begin with understanding our ‘why’[iv] and attempt to ‘lean in’.[v]

These are all inspiring messages with outstanding lessons. But reading a book or having a position title does not make one a true leader. We may consider ourselves the leader, but can someone really be described as a leader if they don’t have committed followers? Without followers, or at least colleagues who are collaborated with and consulted, perhaps the real position description is organiser or manager. Staff do not choose to be led or become followers because of which books someone has read. They listen to and line up with those they trust and feel affection and respect for.

Perhaps we don’t need the books. It may be better to just reflect on how our own memorable and treasured leaders have treated us in the past. In some ways, we already instinctively know what is required, if we are brave enough to admit it. Deep down, we all know how to look after others, build mutual positive regard, and help create happy and functional teams.

The mentors and very best leaders that each of us has been associated with created a feeling of nurturing, and a sense of being understood. There were, of course, non-negotiable areas relating to performance standards and behavioural guidelines, but even these were learnt in an overarching framework of kindness. To give these gifts to others will be to get them back. The leader in title, who treats others with affection and care, will become the leader with devoted followers.

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Excerpt of From Hurting to Healing – Delivering Love to Medicine and Healthcare

Author: Simon Craig; Hambone Press, 2023.