Leadership in Healthcare Management Mohammed Khalil Al-Haddad, FRC Psych* The merit and influence of good leadership has become far more acknowledged and widespread in healthcare management. First-class leadership is vital because the complexity of the healthcare system requires the qualities of a good leader who can link the world of management to the world of medical/clinical practice, while understanding people's needs and accommodating and developing the broad array of health services needed by them. Leadership is acknowledged as being both a process and property. Process leadership is the use of non-coercive influence to shape a group or organization's goals, motivate behavior towards achievement of these goals, and to help define group or organizational culture. Property leadership is the set of characteristics attributed to individuals who are perceived to be leaders1 . These two functions should be continuously balanced against a solid comprehension of healthcare system. The most effective leader is the one who can accomplish the group purpose while carrying out the main tasks of leadership critical for success. In order to attain such level of leadership and success, several important issues come into play. The most essential and commonly known are: motivation, shared vision, good communication, good time management, and a situational approach to leadership. Appreciating these points and knowing how to enforce them within the relevant context of healthcare management makes all the difference in the success of a leader. To motivate people, a leader needs to understand their needs. "Anything that humans expend effort for can be source of motivation"2 . People expend effort on behalf of their physiological needs, family, group loyalty, money, security and deeply held beliefs like religion. Though, the tasks of a leader with respect to motivation are many, he/she should recognize the needs of followers and help them see how those needs could be achieved. Sometimes leaders help remove constraints or inhibitions that impede the full play of motivation. Knowing how to treat people has a direct effect on the amount of effort these people will be prepared to exert in getting things done. The leader may even get them to try extra hard, purely by motivating them. Once the leader feels people are motivated, the challenge lies in maintaining their momentum, by watching for any signs of poor morale, showing interest in them, and manifesting appreciation for good work. -------------------------------------------------- * Chairman Department of Psychiatry College of Medicine & Medical Sciences Arabian Gulf University & Consultant Psychiatric Hospital Ministry of Health Kingdom of Bahrain 2 Even though, motivated, it is extremely hard to get anywhere if your goal is unknown. This is the essence of having a vision as a leader. In today's complex world, extensive research and problem solving must precede vision and goal setting. These should result in a strategic plan with a long-term focus. "Practices adopted without a deeper understanding of what they represent and why they are important to the organization may not add up to much, may be unable to survive internal or external problems, and are likely to produce less than stellar results"3 . Having a vision allows a leader to guide individual practices towards a coherent whole, providing subordinates with a reason to persist. A leader with a vision, which is clearly communicated, acts as an adhesive to a system of values and goals, which are the basis of success. The leader must be an effective communicator to achieve high-level of motivation and visionary success. Good communication skills are a must in building confidence and loyalty among the group. It should be the goal of the organization to create a two way communication system that allows information to flow from leader to follower and vice versa, including dissent, should it occur. This provides the opportunity for followers to attain a degree of empowerment and authority in their own right. Achieving such communication requires a leader to have emotional intelligence in order to work with the basics of needs-based motivation, and to encourage a cooperative teamwork. Managing relationships and communication delivery with people is an unquestionable facet of leadership. The umbrella that holds the previous conditions of leadership together is effective time management. "Time is life. It is irreversible and irreplaceable. To waste time is to waste life, but to master time is to master life and make the most of it"4 . Time management is essential for achieving desired results. Therefore, leaders should emphasize upon themselves and their followers the importance of deadlines in order to effectively accomplish organizational activities. Control of time starts with planning, which essentially allows us to advance the future so that it can be dealt with in the present time. Without such planning it becomes excessively difficult to predict unexpected events leading to time being spent dealing with one crisis or another; scenarios that should never have happened and could have easily have been avoided. However, to manage time effectively does not simply mean planning in advance. It should also mean putting time and effort into refining the plan. Just as essential as the original plan is the follow-through. As time passes, a leader should continuously check to see how he is following through on his plans. This allows the leader to look for problems, false assumptions, and difficulties, making corrections as necessary. There is no set plan a leader can follow in every situation. Situational models assume that appropriate leader behavior varies from one situation to another. According to the Least Preferred Co-worker theory (LPC Theory) which was first developed by Fred Friedler, a leader's behavior should either be task-oriented or relationship oriented, depending on the favorableness of the situation. A task-oriented leader will concentrate on the organization, planning, and control of work. A relationship oriented leader would seek and develop trust and respect between subordinates, endorsing friendliness, consultation and communication, as well as being approachable and responsive to suggestions5 . 3 It is obvious that a balance of both approaches is the ideal one, for as much as the subordinate needs a leader, the leader needs the subordinates' cooperation and trust. Considering this, and that healthcare providers are competent professionals, and leaders in their own right, it's equally important that they feel empowered to share in the vision, planning, and decision-making in the healthcare system. In the conventional model, people want to know whether followers believe in their leader; a more searching question is whether the leader believes in the followers. Machiavelli, the ultimate realist advised the prince "you will always need the favor of the inhabitants, it is necessary for a prince to posses the friendship of the people"6 . All this considered the characteristics that make a good leader are influenced by the context in which he/she emerges. Healthcare workers by training tend to emphasize the instrumental aspects of understanding, compassion, goodwill, and sharing. On the other hand, in management, the need is to emphasize the instrumental aspects of organizing, manipulating, investigating, and integrating. These seemingly opposing perspectives tend towards creating tension between healthcare service providers and the managers within that system. Only in balancing these two aspects, can a good leader revitalize shared values and beliefs in order to accomplish effective group action. In conclusion, many factors contribute to the making of a good leader. Whatever the ingredients are, a person rises to leadership not only because of the ideas that take shape in his/her own mind, but also through energy, hope and imagination, and motivation, all the while serving the bonds of loyalty with his colleagues. When a leader has faith in his vision and line of work, it can communicate itself to followers with powerful effect. Some of our most difficult problems have recognizable solutions, but oftentimes they need the exemplary inspiration of a leader who can mobilize required resources and recharge our energies in order to sustain commitment and future development. Concurrently these essential characteristics of a good leader should be teamed with a cooperative system of healthcare professionals that is able to face the challenges of this century.

1) write a summary of the article and critique it

2) how the information in the article relates to healthcare management

3) how the article relates to college classes

4) considering the information gathered from the article, what kind of general statements can be made about trends, problems, projections, and/or issues in the field?