Leadership in Healthcare
Subtopic:
Leadership Introduction

Leadership isn’t about bossing people around like a manager might. Instead, it’s about guiding others to get things done and inspiring them to want to achieve shared goals. Effective leadership results in a group that performs well and gets results.
Leadership can be described as the art of influencing what people think and how they act, all to reach specific targets.
Essentially, it’s the skill of motivating and earning the cooperation of others to work towards objectives, and this is achieved without using force or coercion.
A leader motivates and inspires people so they are driven to perform their roles well. People willingly follow a leader.
While individuals follow a manager’s instructions because it’s part of their job, following a leader comes from a place of greater personal motivation and willingness.
Therefore, it’s vital for every manager to strive to become a strong leader. A leader prioritizes building positive relationships with each team member, constantly encouraging and pushing them towards better performance. By fostering a supportive and encouraging work atmosphere, a leader significantly boosts employee performance and morale.
A leader is someone who can guide the actions of others because they possess qualities and abilities that their followers might lack.
OR
A leader is an influential figure capable of directing a team or department, even without holding a formally assigned management position.
An Effective Leader is someone who can inspire their team to contribute willingly to achieve group goals in any given situation.
KINDS OF LEADERSHIP
Leadership can be categorized as either Formal or Informal.
Formal Leadership: This type of leader has official authority granted by their organizational role, as defined in their job description. Their power comes from their position.
Informal Leadership: This emerges when a team member, without a designated management role or formal appointment, takes on a leadership role. Their influence arises from their personal qualities and interactions, not their job title.
AN EFFECTIVE AND EFFICIENT LEADER OR MANAGER
Effectiveness is about how well a goal is achieved. For example, if a clinic aims to vaccinate 100 children against measles in a week and successfully vaccinates 95, this can be considered effective management. An effective manager is one who meets or exceeds the set objectives or targets.
Efficiency measures the relationship between the results produced (output) and the resources used (input). It focuses on people and how they work, as well as the time, money, and other resources used to complete a task. Efficiency is about achieving good results with minimal waste and effort. An efficient manager reaches their goals using the planned resources, or even less. The fewer resources (input) needed to achieve maximum results (output), the more efficient the manager.
FACTORS THAT AFFECT EFFICIENT LEADERSHIP
Factors hindering efficient leadership can stem from both internal and external sources.
Lack of Leader Dedication: A leader who isn’t fully committed and dedicated to their role will likely struggle to inspire and motivate their team. Dedication is crucial as it sets a positive example for the team to emulate.
Task-Focused Approach: When leaders only concentrate on task completion and goal attainment, neglecting the needs and expectations of their team members, it can impede efficient leadership. Leaders should emphasize relationship building, understanding individual strengths, and offering support for team success.
Conflicts Between Needs and Expectations: Disagreements can arise when the leader’s needs and expectations don’t align with those of their team. Leaders need to be aware of these conflicts and address them through clear communication, collaboration, and compromise.
Failure to Seek Feedback: Leaders who don’t actively solicit feedback from their team risk missing valuable insights and perspectives. Feedback is essential for growth and improvement, and leaders should foster a culture of open and honest feedback exchange.
Decision-Making Inflexibility: Leaders who are rigid in their decision-making and resist adapting their approach may hinder efficiency. Openness to new ideas, considering diverse viewpoints, and willingness to adjust decisions based on evolving situations are vital.
Resistance to Criticism: Leaders who are unwilling to accept criticism can create a negative work environment and impede efficient leadership. Constructive criticism is valuable for identifying areas for improvement. Leaders should be receptive to feedback and see criticism as a chance to develop.
Ineffective Delegation: Leaders who struggle with delegation often burden themselves with excessive tasks, potentially leading to burnout and reducing their capacity for strategic work. Effective delegation means identifying suitable tasks to assign and providing necessary support and guidance to team members.
Poor Communication: Communication is fundamental for effective leadership. Leaders must establish transparent and open communication channels, actively listen to their team, and address concerns or issues promptly. Without effective communication, shared goals may be missed, and misunderstandings can easily occur.

QUALITIES OF A GOOD LEADER
Authenticity: A strong leader is genuine and true to themselves, displaying their best traits and fostering trust with others through honest actions.
Curiosity: Great leaders possess a curious mindset, always seeking new experiences, different viewpoints, and fresh possibilities to expand their understanding.
Analytical Skills: Leadership requires the ability to dissect complex problems, pinpoint root causes through careful analysis, and make well-informed decisions based on data and expertise.
Adaptability: Good leaders can readily adjust to changing demands and embrace new opportunities and challenges with flexibility and resourcefulness.
Creativity: Leaders cultivate an environment that encourages creativity among team members, valuing diverse perspectives and innovative ideas to foster progress.
Resilience: Successful leaders demonstrate resilience – they can withstand difficulties, recover quickly from setbacks, and seek input from others to maintain direction and momentum.
Empathy: Understanding and connecting with others on an emotional level is a core characteristic of strong leadership, which improves relationships and builds a foundation of trust.
Flexibility: Good leaders are adaptable and open to change, willing to revise their plans and strategies as necessary to respond to evolving circumstances.
Vision: Leaders possess a clear vision of their desired future direction and effectively inspire others to work collaboratively towards achieving that shared vision.
Confidence: A good leader radiates confidence, which inspires trust in their team and provides reassurance, especially during uncertain times.
Competence: Leaders possess the required skills and knowledge to effectively guide and direct their team towards achieving their goals with proficiency.
Credibility: Good leaders are dependable and trustworthy, building a solid track record of fulfilling their commitments and promises.
Action-Oriented: Leaders are proactive and take initiative to drive progress and achieve goals, consistently moving forward with purpose and energy.
Hopeful: Effective leaders instill hope and optimism within their team, particularly during challenging periods, maintaining a positive outlook to foster resilience.
Ability to Lead and Follow: Good leaders know when to take charge and direct, but also understand the importance of listening to and valuing the expertise of others, being willing to follow when appropriate.
Trustworthiness: Leaders are reliable and trustworthy, fostering a work environment characterized by trust, transparency, and open communication.
Optimism: Positive leaders maintain an optimistic perspective, inspiring and motivating their team to persevere and believe in positive outcomes.
Caring: Good leaders genuinely care about the well-being and success of their team members, showing concern and support for their individual and collective progress.
Ability to Develop Potential: Effective leaders can recognize and nurture the strengths of their team members, effectively bringing out their full potential and maximizing their contributions.

POWER AND AUTHORITY IN LEADERSHIP
To lead effectively, it is essential to utilize both power and authority.
Power:
This is the capacity to persuade individuals to follow your directives.
It is the underlying potential to influence people to achieve specific objectives.
Legitimacy:
This refers to the acceptance of the power being used. It is the recognition that the use of power is justified and appropriate.
Authority: = Power + Legitimacy
Essentially: Authority = Power (the inherent ability to get people to accept commands) + Legitimacy (the recognition and acceptance that the exercise of power and the commands given are valid).
Authority is therefore the legitimate entitlement to issue instructions and possess the capacity to ensure compliance. It’s the recognized right to command and the ability to enforce obedience.
TYPES OF POWER / BASES OF POWER
Power sources are broadly classified into two categories: Positional Power and Personal Power. Each category further includes specific types of power.
A Person in a Management Role Typically Holds:
Legitimate Power
Coercive Power
Reward Power
Personal Power Types Encompass:
Expert Power
Referent Power
Legitimate Power. This power stems from the formal position an individual holds within an organization’s hierarchy. It’s based on the understanding that certain roles have the recognized right to exercise control and make decisions that affect others in the organizational context, particularly within healthcare. This authority is conferred by the organization’s structure and official job titles. For instance, in healthcare, your professional role grants you the recognized power to make clinical decisions for patients and manage resources within your designated area. This specific power is inherent to your professional role. It’s often linked to job title and rank in the organizational structure; for example, staff members generally adhere to instructions from a supervisor or in-charge regarding punctuality and duty attendance because they acknowledge that individual’s positional authority.
Coercive Power. Coercive power is a form of influence that relies on employing threats, force, or disciplinary actions to ensure compliance and achieve desired results. In a management context, this means a leader might apply some degree of pressure when necessary to ensure tasks are completed as expected. An example could be ensuring daily facility cleanliness. Another instance arises if a staff member is consistently late; a supervisor might use coercive power to enforce disciplinary measures.
Reward Power. Reward power in healthcare relates to a leader’s capacity to offer incentives or protect team members from negative repercussions. It’s a type of formal power that can be used to motivate and encourage healthcare professionals. You might utilize reward power to recognize and motivate high-performing staff. Examples include providing bonuses, implementing employee recognition schemes, granting time-off or vacation benefits, offering flexible work arrangements, and supporting staff for promotions or further education opportunities.
Expert Power. Expert power in healthcare originates from an individual’s specialized knowledge, skills, and accumulated experience in a specific area. It is a type of power that is derived from deep competence and is generally respected by others. Expert power is a form of personal power that a healthcare professional, like yourself, can possess. For example, a midwife holds specific expert knowledge in managing childbirth. Experienced professionals in healthcare, such as physicians, nurses with specializations, and other specialists, who have developed substantial expertise in their fields, naturally wield expert power.
Referent Power. Referent power in healthcare is the influence a leader or healthcare professional gains through their personal attributes, charisma, and the respect and admiration they inspire in others. It’s rooted in the appeal of a leader’s personality, values, or convictions, rather than their formal position or specialized expertise. Referent power is about the influence a manager exerts over their team. A leader needs to cultivate influence through positive actions and behaviors that encourage team members to remain engaged and committed to the organization.
IMPORTANCE OF POWER / REASONS WHY POWER IS USED
Power is the ability to have an impact on others and accomplish desired outcomes. Common reasons for using power include:
To Secure Competitive Advantage: Power can create a strategic edge in the marketplace, enabling organizations to gain access to resources, expand market presence, and exert influence over market dynamics.
To Access Information: Power can open doors to valuable information that is not readily accessible through normal channels.
To Inspire and Motivate: Power can be a tool for inspiration, motivating individuals and teams to strive towards and achieve shared objectives.
To Enhance Communication Effectiveness: Power can amplify the impact of communication efforts, ensuring messages are not only heard but also properly understood and acted upon.
To Improve Performance and Optimize Processes: Power can be the driving force behind organizational change, promoting improvements in efficiency and streamlining operational processes.
To Obtain Necessary Resources: Power can facilitate the acquisition of critical resources, including funding, talented individuals, and advanced technologies needed for growth and success.
To Protect and Advance Interests: Power is used to safeguard the interests of individuals, teams, or the entire organization.
To Maintain Order and Control: Power is vital for maintaining structure and stability within organizations and across broader social systems.
To Shape Policy and Advocate for Causes: Power is a mechanism to influence public policy decisions and champion specific causes or initiatives.
To Enhance Reputation and Credibility: Power can contribute to building a stronger reputation and greater credibility for both individuals and organizations.
To Achieve Personal or Professional Goals: Power can be utilized to help individuals realize their personal ambitions and professional aspirations.
RULES FOR USING POWER IN ORGANIZATIONS
Employ the Minimum Necessary Power: Strive to use the least amount of power required to be effective in your interactions. Avoid overuse of power and aim to achieve goals while maintaining positive working relationships.
Context-Appropriate Power Usage: Apply power in a way that is suitable for the specific situation. Different scenarios may require different types or levels of power. Evaluate the situation and consider the potential impact of your power on others before applying it.
Discern When to Refrain from Using Power: Recognize situations where using power might not be the most effective or appropriate approach. In collaborative or team-based settings, for instance, influence and persuasion may be more effective than asserting authority.
Focus on the Problem, Not Personalities: When using power, direct it towards resolving the issue or challenge rather than targeting individuals personally.
Make Respectful Requests, Avoid Demands: When exercising power, communicate your needs or expectations in a polite and considerate manner. Demanding approaches can breed resistance and damage relationships, while respectful requests tend to be received more favorably.
Use Coercion as a Last Resort: Coercive power should be employed sparingly and only when other methods have failed. Explore options like persuasion and negotiation first. This helps preserve trust and minimizes negative consequences.
Maintain Expertise to Sustain Expert Power: Expert power is rooted in your knowledge and skills. To effectively utilize this power, it’s vital to stay informed and up-to-date in your field. Continuously develop your expertise to maintain credibility and influence.

TYPES OF AUTHORITY IN ORGANIZATIONS
1. Structural Authority / Bureaucratic Authority / Rational-Legal Authority:
Definition: This authority comes directly from the official position an individual holds within an organizational framework.
Basis: It is rooted in established organizational elements like job roles, clearly defined responsibilities, hierarchical rank, seniority, and the formal organizational chart. Essentially, the position itself grants the authority.
Explanation: Think of it as the power that comes with the job title. A CEO has structural authority because of the CEO role itself, irrespective of their personal traits. It’s authority defined by the organizational structure.
2. Expert Authority:
Definition: This authority is earned through an individual’s demonstrated proficiency, knowledge, and experience in a specific domain.
Basis: It relies on the perception that the person possesses specialized skills and in-depth understanding, making their insights highly valuable and trustworthy.
Explanation: A senior software engineer may have expert authority on technical decisions within a tech company. Their authority isn’t from their rank, but from their recognized deep knowledge of software engineering.
3. Moral Authority:
Definition: Moral authority is gained from an individual’s ethical conduct, personal integrity, and demonstration of respect and ethical principles.
Basis: It is founded on the influence and inspiration generated by a leader’s ethical behavior and strong value system.
Explanation: A respected community leader might have moral authority due to their consistent ethical actions and commitment to the community’s well-being. People follow them because they trust their moral compass.
4. Charismatic Authority:
Definition: This authority is derived from an individual’s engaging personality and inherent leadership qualities.
Basis: It is powered by a leader’s personal magnetism, charm, and ability to inspire and motivate others through their personality.
Explanation: Think of influential figures who inspire movements or strong loyalty. Their authority isn’t from position or expertise, but from their compelling personal appeal and ability to connect with people emotionally.
5. Other Types of Authority:
Physical Authority: Authority that originates from an individual’s physical strength or dominance. (Example: Historically, tribal leaders might have held physical authority).
Parental Authority: Authority considered inherent and divinely ordained within the parent-child relationship. (Example: The authority parents traditionally hold over their children based on societal and religious norms).
Clerical Authority: Authority based on the relationship between religious leaders and their followers. (Example: A priest’s authority in a church stemming from their religious role).
Economic Authority: Authority that comes from the control of financial resources or material assets. (Example: A wealthy landowner historically wielding authority over their tenants).
DIFFERENCE/SIMILARITIES AND RELATIONSHIP BETWEEN MANAGEMENT AND LEADERSHIP
Leadership / Leaders | Management / Managers |
May or may not hold a formal, official role. | Formally appointed to a position with specific responsibilities. |
Authority to influence decisions is dependent on follower willingness. | Authority to enforce decisions comes from their official position. |
Influences others through interpersonal skills and may be formal or informal. | Executes predetermined policies and rules. Uses regulations to achieve goals. |
Embraces risk and explores innovative concepts. | Prefers structure, control, rationality, and fairness. Generally risk-averse. |
Relates to individuals in a personal, empathetic manner. | Relates to people based on their defined roles and job expectations. |
Personal achievements are a source of reward and satisfaction. | Fulfillment of organizational objectives and mission brings reward. |
Success as a leader doesn’t guarantee success as a manager. | Hold managerial roles as long as officially appointed, regardless of leadership qualities. |
Focuses on “why” and “what.” Explores the reasons behind actions and desired outcomes. | Focuses on “how” and “when.” Concerned with implementation and timelines for tasks and results. |
Inspires, motivates, and influences individuals. | Controls and clarifies expectations for team members. |
Service and people-centered. Prioritizes the needs of individuals. | Profit and result-focused. Primary concern is achieving organizational outcomes. |
Strategy-focused. Concerned with long-term, overarching objectives. | Focused on short-term objectives and daily operational tasks. |
Concerned with achieving overall goals and vision. | Concerned with performing activities that contribute to goal achievement. |
Values employee creativity and versatility. | Emphasizes consistency in operations and adherence to established procedures. |
Focuses on aligning organizational actions with policies, standards, and goals. | Emphasizes accountability to leadership for results achieved and adherence to standards. |
Concerned with integrating individuals into organizational culture, policies, and mission. | Responsible for planning and staffing within the organization. |
Primarily people-focused in approach. | More task-focused and oriented towards meeting work targets. |
Initiates and pioneers new directions. | Implements established plans and directions. |
Similarities:
Both leaders and managers share both successes and failures.
Focused work and effective communication are critical for both roles.
Both roles often involve evaluating employee performance.
Both are ultimately accountable for achieving results.
Both may use performance metrics to assess progress.
Both typically work towards a vision and guide their teams in that direction.
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