Recently a friend sent me a new book entitled The Leaders We Need: And What Makes Us Follow by Michael Maccoby, a psychoanalyst, anthropologist and consultant. For anybody concerned about the lack of quality leadership in healthcare today, Maccoby comes at the subject with a slightly different twist than most authors of management books.
Out in front
Author says healthcare desperately needs leadership
He gives us a very simple description of what constitutes a leader. There is only one irrefutable definition of a leader, and that is someone people follow. This may seem too simple a definition for many academics, but once accepted it opens the door for plenty of hard thinking. Once we agree that anyone with followersliberator or oppressor, transformational visionary or transactional solveris a leader, then we have to answer two difficult, essential questions about leadership. Those questions are: Why do people follow the person? And how do people follow the leader?
He makes it clear that any leadership theory has to include understanding and engaging different kinds of personalities. He also talks about Sigmund Freud, who gave us some explanations of how a followers unconscious motivations work. He describes how Freud practiced psychoanalysis for many years and was puzzled why so many of his patients, both male and female, would fall in love with him. What he finally decided was that: People were relating to him as if he were some important person from their pastusually a parent. In undergoing therapyor falling in love, for that matterpeople were transferring experiences and emotions from past relationships onto the present. Freud thought the phenomenon was universal and he wrote, There is no love that does not reproduce infantile stereotypes, which, for him, explained why so many of us choose spouses like our parents.
Maccobys book is filled with all sorts of succinct insights into character and personality and, therefore, as he winds his way through his discussion of leadership he often stops us in our tracks with insights into peoples behavior characteristics. Later in the book, he talks about healthcare and his opinions are not very complimentary. He describes the industry in these terms, Its a knowledge industry and should provide solutions rather than just products and services, but its mode of production and the social character of many of its key professionals lag behind the times. Healthcare is an industry desperately in need of visionary leaders who partner with operational and network leaders to transform organizations and even influence the social character of physicians.
Another one of his observations about healthcare is well worth repeating. We found that leadership is essential to improve the quality of patient care and cut unnecessary costs. In some of the more prestigious healthcare organizations, we found an angry clash between doctors practicing an obsolete craft-based mode of production, and hospitals, organized like industrial bureaucracies, whose administrators were attempting to force the physicians into the iron cage. He feels unless we rise to the overwhelming challenge of transforming the industry into a more productive and efficient system we may be running out of time and literally turn it into a system dedicated to mediocrity.
He says that one type of leader cant transform business bureaucracies and health organizations into efficient organizations. He believes a system of leaders is needed. And he describes them as visionary strategists who are generally productive narcissists, obsessive systematic operational leaders and interactive network leaders. In short, they get things done by understanding that leaders can only lead if others follow.
Charles S. Lauer is the former vice president- publishing and editorial director of Modern Healthcare. He now is a consultant to the healthcare industry and also serves on the boards of healthcare companies.
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