The Being of Leadership

Abstract

The ethical foundation of the medical profession, which values service above reward and holds the doctor-patient relationship as inviolable, continues to be challenged by the commercialization of health care. This article contends that a realigned leadership framework - one that distinguishes being a leader as the ontological basis for what leaders know, have, and do - is central to safeguarding medicine's ethical foundation. Four ontological pillars of leadership - awareness, commitment, integrity, and authenticity - are proposed as fundamental elements that anchor this foundation and the basic tenets of professionalism. Ontological leadership is shaped by and accessible through language; what health care leaders create in language "uses" them by providing a point of view (a context) within and from which they orient their conversations, decisions, and conduct such that they are ethically aligned and grounded. This contextual leadership framework exposes for us the limitations imposed by our mental maps, creating new opportunity sets for being and action (previously unavailable) that embody medicine's charter on professionalism. While this leadership methodology contrasts with the conventional results-oriented model where leading is generally equated with a successful clinical practice, a distinguished research program, or a promotion, it is not a replacement for it; indeed, results are essential for performance. Rather, being and action are interrelated and their correlated nature equips leaders with a framework for tackling health care's most complex problems in a manner that preserves medicine's venerable ethical heritage.

A Qualitative Study of Faculty Members' Views of Women Chairs

“…[1][2][3]66 Nevertheless, our three women chairs appear to have met all Souba's criteria for desirable physician leaders in academic medicine. 2,65,[68][69][70][71][72] …”

The Science of Leading Yourself: A Missing Piece in the Health Care Transformation Puzzle

“…innovate, and execute (Souba, 2011a;Souba, 2011b). Once these constraints are revealed, options for leading more naturally and intuitively become possible.…”

“…Virtually everyone acknowledges that the status quo isn't working and that a radical overhaul of our health care system is needed. But when it comes to changing, we often overlook a fundamental truth: systems don't change in any meaningful kind of way until and unless people change first (Wind & Crook, 2006;Souba, 2009;Souba, 2011a). In Peter Block's words, "If there is no transformation inside each of us, all the structural change in the world will have no impact on our institutions" (Block, 1996).…”

“…We must change how we think about health care, how we speak about its future, and how we work together to correct its failings. In order to reframe how we approach our health care challenges, a renewed context for leadership is needed, one that distinguishes being a leader as the foundation for what leaders know and do (Souba, 2011a;Souba, 2011b). If you're not being a leader, it is impossible to act like a leader.…”

“…Unless one knows how to lead one's self, it would be presumptuous for anyone to be able to lead others effectively… Leading one's self implies cultivating the skills and processes to experience a higher level of self-identity beyond one's ordinary, reactive ego level… To get beyond their "ordinary, reactive ego", effective leaders relentlessly work on "unconcealing" the prevailing mental maps that they carry around in their heads (Souba, 2011a;Souba, 2011b;Erhard, Jensen, Zaffron, & Granger, 2011). This unveiling is critical because leaders are more effective when they are not limited by their hidden frames of reference and taken-for-granted worldviews.…”