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Further thoughts on medical leadership.

Kevin O' Connor's article, "The Best Leaders" in The Physician Executive (Volume 23, Issue #4) is very relevant to medical management. I have noticed that in real life practice, leadership works only with true empowerment. This means that medical managers should take responsibility not only when things go right, but also when they go wrong as a result of empowerment. Pharmaceutical giant and Fortune 500 company Johnson & Johnson has a philosophy of retaining staff who make mistakes and learn from them. (1) Backing empowered staff helps Johnson & Johnson to succeed by building trust with the leaders.

I agree that leaders are servants--many medical managers fail because they stop being clinicians as soon as they put on the administrative hat. The concept of being in the trenches with other clinicians is vital. Yukl (2) proposed two models of leadership styles: (1) master technician, the leader with the highest technical skill, and (2) master conductor, the leader who puts different instruments together and creates music. In medical management, we see both styles at work.

Physicians tend to want to report to a Chief who is the most skilled physician, who may or may not be the best leader. In my experience, a physician leader is easier for a non-physician team to accept, as the respect is already there based on the master technician concept. The ideal leader would be one who orchestrates (master conductor) the whole team, but this takes a lot of skill and patience. The bedside clinical skills have to be translated into human skills.


(1.) O'Reilly, B. J & J is on the Roll. Fortune, 1994, Dec. 26; 178-192.

(2.) Yukl, Leadership in Organizations, 3rd. ed. Englewood Cliffs, NJ: Prentice Hall, 1994.

Robert S. Tan, MD, AGSF

Associate Chief of Staff (EC)

VA Medical Center

Amarillo, Texas
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Title Annotation:Dear Editor
Author:Tan, Robert S.
Publication:Physician Executive
Article Type:Letter to the Editor
Date:May 1, 1997
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