A key point in Report of the Mid Staffordshire NHS Foundation Trust Public Enquiry from 2012 was a call for ‘the recognition that healthcare management and leadership is, or should be treated as a profession‘.
Earlier this week I enjoyed two excellent days at the Leaders in Healthcare Conference. Over 800 delegates packed the halls and conference rooms listening to speakers from across the world and sharing their thoughts on the topic. There was a recurring theme of the principle that leadership is a behaviour rather than a job role. All doctors have a responsibility to develop and utilise their skills to meet the challenges of the healthcare system, to support colleagues and to deliver excellent patient care. The event was a real demonstration of the drive to promote,enhance and professionalise leadership.
Half way through the second day I made an observation that I shared with some of my fellow delegates. Of the 35 sessions on the schedule more than 20 contained the words ‘leader‘, ‘leading‘ or ‘leadership‘ in the title. Only one contained any reference to ‘manager‘ and one sub-session the word ‘management‘. None mentioned ‘manage’ or ‘managing’.
Some delegates I discussed this with expressed the idea that when talking about leadership they really mean management too. It begs the question:
Is there a difference between leadership and management and does this really matter?
Countless writers and high profile speakers have expressed their opinions and given their personal definitions. Though some say they are one in the same, the majority would generally fall in line with the words of Rear Admiral Grace Murray Hopper who, at the end of her many years of service, as the oldest serving officer in the United States Navy: “You manage things, you lead people.”
The conference was an excellent example of the real focus that is being placed upon the development of leadership. Leadership is being discussed in terms which are ethical, noble and even heroic. Can the same be said of management? That is management with a small ‘m’, as a behaviour and not a role. Many doctors happily attended the Leaders in Healthcare Conference and will be putting next year’s event into their diary. How many of the same delegates would attend a Managers in Healthcare Conference. Again, does it matter?
On our Teach the Teacher courses we often discuss the issue of people concentrating their development upon the things that they want, rather than what they need. The immature student without a study plan will often tend to read what they already know and what they find interesting. They do so at the expense of dedicating effort to the topics which they need to improve performance – the things which are less popular, less attractive, seen as difficult or even dull. Could this be happening to the medical profession with its focus on leadership at the expense of management skills?
Putting a clearer definition to the different terms may help:
- Leadership – getting things done through interactions with other people.
- understanding of how teams develop and function; understanding your leadership style and the alternatives; engagement, motivation and influence; encouraging both innovation and consistency and dealing with under-performance.
- Management – getting things done through organisation and utilisation of people, projects and resources
- establishing proficiency in the tools and process which enable everything from decision making, effective participation in short meetings through to complex projects; conducting effective reviews and research; clearing defining what is required and how even ‘soft’ targets can be measured; robust planning techniques; effective time management and delegation.
A doctor with strong management skills will increase their personal effectiveness and efficiency. A healthcare team with strong management skills will be more effective and efficient. A healthcare system with strong management skills will be more efficient and effective.
The development of medical leadership is gaining real momentum. How do we make the change where developing the skills of practical management for doctors also receives the attention it deserves? That, ironically, is a challenge for medical leadership!