A couple of months ago, the Guardian wrote a gloomy piece on the role of Medical Leadership. After having a rant on Twitter, I thought it was time to set the matter straight. Why is it that Medical Leadership has such bad press, when it is such a vital and rewarding (as well as challenging) career? Like it or not, those of us who are employed as doctors in the NHS are all both leaders and followers. And- we all need lots of other leaders and other followers to get our jobs done. Once you start as a first year medical student, you’re already in a leadership role!
There are huge pressures on the NHS budget as we all know, and whether we are in primary, community or hospital services, we can all play a part in how the limited resource available is spent. Should we buy more smoking cessation services and try to prevent illness, or should we spend more on end of life care and ensure that we get that right for people? Do we get better health outcomes for the same cost for this procedure or that one? Where should we focus our efforts in the next year, the next ten years?
Medical leadership deals with ‘wicked problems’. There are very few simple solutions to modern healthcare issues. If we tell everyone to wash their hands, we still won’t eradicate hospital acquired infection. If we stop prescribing all antibiotics, there are very complex trade-offs. The reality is that providing healthcare is a complex, adaptive, volatile and uncertain business to be in – which needs highly skilled Medical Leaders. One of the Medical Leader’s roles is to shape the direction of their teams and organisation, set the culture ‘the way we do things round here’ in a way which brings out the best in their followers and other leaders. They also need to be looking up and outwards across systems and health economies, and horizon scanning with a thirst for new knowledge, always seeking to learn from the best in the world. Another skill is that of learning to develop both a compass (to set the direction of travel) and a radar (the ability to constantly give and receive feedback in all directions) to know whether they are on track, and to support their staff to flourish in their working lives and to bring out the best in their colleagues. And they also need to take care of themselves, have a quality of life, and be good doctors at the same time. Pulling all these skills together is no mean feat! Medical Leaders, you are often vilified and misunderstood: at this time of very stretched resources, you and your skills are needed now more than ever.