All great leaders must first learn to follow
Author: Erwin Loh
Published online: 17 February 2014
To the Editor: Health services understand that they need strong medical engagement and leadership in order to achieve their organisational goals and performance targets. Doctors, by the nature of their duties, have a direct impact on patient flow, quality of care and clinical costs. The need for clinical leadership by doctors is now well established in the literature and, as such, leadership as a competency is taught in most medical schools and postgraduate medical specialty training programs. Leadership is also evaluated in most performance appraisal frameworks, including those for doctors. Despite all these endeavours, employing hospitals have found it difficult to engage medical staff on their payroll. It is possible that the medical leadership competency may only be part of the puzzle.
A medical followership competency relevant to doctors may need to be developed, so that doctors can learn to not only effectively manage down and sideways, but also manage up. We now train doctors to be leaders, but we do not teach them to be good and effective followers. Aristotle noted that all great leaders must first learn to follow.1 In other words, leaders are also followers, and followers can also show leadership.2 Followership is defined as the ability to effectively follow the intent, and support the efforts, of the leader, in order to maximise the organisation’s objectives.3 In addition, effective followers accept the leader’s authority and provide legitimacy to the leader’s vision.4 Furthermore, the ability to adapt to constant change in the workplace and to let go of past experiences are essential for followers.5 As such, effective followers are dependable, cooperative and open to new ideas.
Therefore, a doctor who is an effective follower will also be a much better clinical leader, because such a doctor will not only be able to lead his or her own team, but also support his or her own leaders, as well as the organisation as a whole. This is an area that deserves further research. Meanwhile, the time may now be ripe for followership to be given as much emphasis as leadership when it comes to training our current and future doctors.
Competing interests
References
- Goffee R, Jones G. Followership: it’s personal, too. Harvard Business Review 2001; 19: 79-148. CBBDEAIC
- Hackman JR, Wageman R. Asking the right questions about leadership. Am Psychol 2007; 62: 43-47. i1142865
- Bjugstad K, Thac EC, Thompson K, Morris A. A fresh look at followership: a model for matching followership and leadership styles. Journal of Behavioral and Applied Management 2006; 7: 304-319.
- Hansen TJ. Management’s impact on first line supervisor effectiveness. SAM Advanced Management Journal 1987; 52: 41-45. CBBECDAE
- Kellerman B. Leaders and followers. Leadership Excellence 2008; 25: 4-7. i1142872
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