345Techniques: Translating Materials in Classroom Pedagogy with Group Work and
Active Learning Techniques; and (6) Key Learning Points and Conclusions.^11 Next
we will distinguish leadership from management, and define what leaders do—that
is, define how leaders build a group of professionals into willing followers.
Leadership Versus Management: Some Definitions
Imagine we were talking about strategic issues in medical practice 5–10 years ago.
Would we be talking about the same things we are talking about today? If we came
back 5 years from now, again would we be talking about things that have evolved
very differently from what we expected 5 years before?
This runs to the heart of what effective leaders must do. They must understand
the evolving situation, all the important variables, and how they are related.^12 As
Mary Parker Follett once said, it takes insight to master the current situation and to
“...see possible new paths, the courage to try them, the judgment to measure
results...” ([ 23 ], p. 170). If leaders are effective, they are creating a future situation
while dealing with the current situation.
Clinical leaders should not be predicting or forecasting but rather anticipating
and responding to change—in the surgical sciences, the regulatory environment,
the dynamic and highly competitive marketplace, rapidly changing technology,
and so on. More than coping with change, clinical leadership is about shaping the
upcoming situation.
There is a difference between managers and leaders. To manage an organization
literally means to handle many complex activities. Managers plan, recruit people,
design and align the organization, establish budgets, coordinate, and report on per-
formance. Managers also decide when people and budgets have to be cut, labs have
to be outsourced, service lines have to be “rationalized,” and medical suppliers have
to be consolidated. As the former CEO of Nissan and Renault, Carols Ghosn once
said to a business school audience, “management is about telling people to do things
they otherwise don’t want to do.”
Without willing followers, managers lose control of the situation. Managers have
a choice. They can rely on authority, rewards, coercion, fear of punishment, or other
negative incentives; or use positive leadership strategies to guide and motivate peo-
ple. Now we can see the challenge of leadership and what leadership means.
The best definition comes from Kouzes and Posner [ 34 ]:
Leadership is the art of mobilizing people to want to struggle for shared aspirations.(^11) There is an appendix on teaching physicians and mention of several case studies that can be
obtained for the author.
(^12) The great management prophet, Mary Parker Follett, argued that leadership was all about diag-
nosing situations. This can be found in a lecture she gave in 1949 entitled “Freedom and
Coordination” reprinted in a book published in 2003.
20 Teaching Surgeons How to Lead