In any business setting, there must be leaders as well as managers. But are these the same people? Not necessarily. There are leaders who arc good managers and there are managers who arc good leaders, but usually neither case is the norm. In health care, this is especially important to recognize because of the need for both. Health care is unique in that it is a service industry that depends on a large number of highly trained personnel as well as trade workers. Whatever the setting, be it a hospital, a long-term care facility, an ambulatory care center, a medical device company, an insurance company, or some other healthcare sector, leaders as well as managers are needed to keep the organization moving in a forward direction and at the same time maintain current operations. This is done by leading and managing its people.
Leaders usually take a focus that is more external, whereas the focus of managers is more internal. Even though they need to be sure their health-care facility is operating properly, leaders tend to spend the majority of their time communicating and aligning with outside groups that can benefit (partners, community, vendors) or influence (government, public agencies, media) their organizations. There is crossover between leaders and managers across the various areas even though a distinction remains for certain duties and responsibilities.
Usually the top person in the organization (e.g., Chief Executive Officer, Administrator, Director) has full and ultimate accountability. There are several managers reporting to this person, all of whom have various functional responsibilities (e.g., Chief Nursing Officer, Physician Director, Information Officer). These managers can certainly be leaders in their own areas but their focus will be more internal within the organizations operations.
Leaders have a particular set of competencies that are more forward thinking than managers. Leaders need to set a direction for the organization. They need to be able to motivate their employees, as well as other stakeholders, so that the business continues to exist and hopefully thrive in periods of change. No industry is as dynamic as health care with rapid change occurring due to the complexity of the system and government regulations. Leaders are needed to keep the entity on course and to maneuver around obstacles that come in its way, like a captain commanding his ship at sea. Managers must tend to the business at hand and make sure the staff is following proper procedures. They need a different set of competencies.
For every leader there must be a follower. Leaders must have someone they can lead in order to accomplish what they set out to do. Not everyone can be a leader nor should be one. Leaders should have certain recognizable traits that will help them take charge, but also followers must have a willingness to be led as well as the ability to do the task requested. True leaders inspire commitment from dedicated people.
Atchison (2003) wrote about this process in his book, Followership. He describes followership as complementary to leadership and recommends that it be recognized as a necessary component for an effective leader. A self-absorbed administrator will not make a good leader. A true leader will recognize the importance of getting respect, not simply compliance, from the people who follow. It is one thing to have people do what you say, but to have someone want to do it is another thing. The leader who understands this is on the way to greatness and will create a much more meaningful work environment. As Atchison says, "An executive title without followers has an illusion of power. These tided executives create a workplace without a soul."