Growing leaders in your practice: What is a leader?

16 min read

Who are the leaders in your practice?

While facilitating a leadership workshop, I asked “Who are the leaders in your practice?”. This question stimulated some robust discussion. While some groups discussed the positions in their organizational leadership chart, one thoughtful response was “Everyone is a leader in my practice”. I asked this practice manager to describe to the group what leadership looked like in her hospital. She explained that every employee was invested in the success of the practice. Rather than defined leaders, the management team in the hospital believed every team member was a stakeholder and had an equal voice in the crafting of policies and procedures.

She went on to explain that there was a culture of trust within the practice that encouraged constructive conflict. Because every individual participated, the discussions incorporated many different perspectives, allowing for better decisions to be made. This attitude helped to drive a culture of accountability within her practice. These factors helped to shape a healthy and happy work environment with low employee turnover, less burnout, better teamwork and high workplace satisfaction.

How did the management team in this hospital create the environment described above?

Qualities of a leader

The qualities of effective leaders have been described in many ways. Simply defined, a leader is “a person who motivates a group of people toward achieving a common goal.”1 I believe that this definition is incomplete and that effective leadership requires agility. We live in a rapidly evolving world, with an uncertain and complex business climate. Our workforces are shaped by the events occurring in the world as our employees reached maturity. As such, we have a very diverse generational workforce with differing ideas about what effective leadership is.

Today’s successful leaders possess the following six characteristics:

1. Emotional Intelligence

Identified in 1995 by Daniel Goleman, he applied this term to business in 1998, when studies indicated highly developed emotional intelligence was more than twice as important than IQ or experience in predicting success in truly effective leaders 2,3. Emotional Intelligence, or EQ, is defined as the “ability to identify and manage your own emotions and the emotions of others”4.

According to Goleman’s research5, Emotional Intelligence is comprised of five separate skill sets.  The first three represent self-management skills: self-awareness, self-regulation and motivation. The final two are relationship management skills: empathy and social skills. While there is a genetic as well as a nurture component to Emotional Intelligence, it is widely recognized that EQ increases with maturity. Furthermore, Emotional Intelligence can be learned. It requires that individuals break old habits and form new ones, focusing on the five EQ skills.

2. Vulnerability

In the not-so-recent past, leaders shied away from showing any sign of weakness. Admitting to being vulnerable would have been a career-limiting action. While often viewed as synonymous with weakness, vulnerability is a paradox in that it takes great courage to allow oneself to be vulnerable. Brene’ Brown, a social scientist who has performed extensive research on Wholehearted Living and Vulnerability, defines vulnerability as “uncertainty, risk and emotional exposure”6.  She states that “vulnerability is the catalyst for courage, compassion and connection”. Great leaders understand that when they allow themselves to be vulnerable, they invite others to be vulnerable as well. These actions require humility, transparency and trust; they serve as the basis of relational interactions and as an inspiration for loyalty.

3. Communication

Effective leaders are great communicators. They have learned the value in listening with the intent to understand what the speaker is trying to convey. They ask curious questions that “promote discovery and insight”7.  Leaders who build organizations like the one described in the opening paragraph understand the value of encouraging a culture of feedback between team members. They don’t avoid critical conversations, knowing that unresolved crucial conversations become conflicts. They have learned the value of understanding others’ perspectives.

Successful leaders utilize good communication tools such as open-ended questions, reflective listening and allowing others to complete their thoughts without interrupting. They are aware that 93% of communication is non-verbal; they seek to understand non-verbal messages and are willing to explore those messages verbally.  Exceptional leaders understand the value in being fully present in the moment. As described by James Autry in The Servant Leader8, being present means “having your whole self available at all times-available to yourself as you try to bring your values to bear on the work at hand, and available to others as you respond to the problems and issues and challenges of team members…”

These leaders know that it is impossible to multi-task and be fully present. They make a conscious decision to apply laser-like focus toward the situation, be it an employee’s needs, a patient’s care or a client’s wants.

4. Authenticity

Remarkable leaders know who they are and what they believe in. They uphold their personal core beliefs and align their actions with their core values, regardless of how tempting it might be to compromise themselves for personal, professional or financial gain. They are true to themselves. In doing so, they set the standard within their organizations for others to live and honor their own values.

5. Seek Change

The world around us is constantly evolving. Many leaders may embrace this change in their personal lives, but are reluctant to challenge the status quo within their own hospitals. Outstanding leaders understand the value of being forward-focused. While they are managing the present, they are actively planning for the future.

These leaders understand the importance of maintaining a broad professional network, so that they may gain information and clarity around changes that are likely to impact their businesses. They are curious, seeking new ways of doing things. By challenging the status quo, they help to build a culture of innovation and possibility in their hospitals. Finally, these leaders are not afraid of failure. They establish a culture where employees are encouraged to try new ideas. When these ideas fail, the processes are dissected so that the failure becomes a valuable learning experience. They ask “what went well?” and “what could be better yet?”. Team members are encouraged to apply these lessons and try again.

6. Followership

As our understanding of leadership has evolved, so has an awareness of followers. Historically, leaders have used influence to persuade followers to achieve pre-determined goals. What role do followers play in the leadership process? This question has formed the basis for a new field of research, Followership.

This area of study has accelerated in the past 9 years, when it became apparent that “leadership cannot be fully understood without considering the role of the follower in the leadership process”9. It is important to recognize that leadership is impacted not by the role of follower, but as result of ‘following behaviors’. Without this, leadership does not occur. As discussed by Mary Uhl-Bien9, “it is probably easier to recognize leadership in following behaviors than it is in leadership behaviors, as individuals attempting to be leaders are only legitimized in the responses and reception of those willing to follow them”.

Millennials in the Workplace

An understanding of the followership concept is important in developing awareness around evolving leadership models. The significance of this concept becomes even more critical with the presence of the millennial generation in our hospitals. Millennials, as a group, share some unique characteristics that will impact their preferences for leadership style. They are the most diverse generation, socially and racially. Due to their acceptance of variety, this generation views problems broadly, applying concepts that work in one area to problems that arise in others. They have also been raised with an ‘elevated status’, where their opinions have been solicited and considered in decision-making paradigms. Therefore, hierarchal boundaries are less clear. They will seek to collaborate with whomever can help in the attainment of their goals.

A commonly used model of leadership in many hospitals is transactional leadership, when followers behave in ways defined by their leaders. This leadership style is incompatible with the needs of the millennial generation. To succeed, leaders will be required to flex and adapt, adopting leadership styles that are more transformational in nature. Transformational leadership is described as leadership that occurs “when one or more persons engage with others in such a way that leaders and followers raise one another to higher levels of motivation and morality”9. Culturally, hospitals will need to adapt in ways that support the core values defined by this generation, such as collaboration, teamwork, transparency and relational interactions.

What changes can you make?

Through carefully selecting and cultivating their hospital leaders, the organization described in the first paragraph nurtured a culture where followers and leaders worked hand in hand, where all team members were empowered and felt valued. This leadership approach is attractive to millennials, encouraging them to bring added value and innovation to the workplace. What changes can you make to emulate their success?


1. Ward, S. Leadership, About Money
2. Golemen, Daniel. Boyatzis, Richard., McKee, Annie. “Primal Leadership: Learning to Lead with Emotional Intelligence”. Harvard   Business School Press, Boston, MA 2002
3. Fernandez-Araoz, C. “Great People Decisions”. Wiley 2007
6. Brown, B. Daring Greatly, 2012
8. Autry, J. The Servant Leader 2001
9. Balda, J., & Mora, F. (2011). Adapting leadership theory and practice for the networked, millennial generation. Journal of Leadership Studies, 5(3), 13-24.



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