“I tell you this: you do not lead by hitting people over the head. Any damn fool can do that, but it’s usually called ‘assault,’ not leadership … I’ll tell you what leadership is. It’s persuasion – and conciliation – and education – and patience. It’s long, slow, tough work. It’s the only kind of leadership I know – or believe in – or will practice.”

– President Dwight D. Eisenhower

Wise words from a wise man. Many of us have, at one time or another, held a leadership position professionally, in the military, in the community, or in politics. Reduced to its simplest form, a leader is a person who tells people what to do, and they follow his/her request(s). There are many types of leaders – good, bad, democrats, dictators and micromanagers. What is common to all successful leaders is a grasp of 12 essential leadership skills. Some of these are taught in seminars; some are learned on the job.

  1. Understanding the characteristics and needs of the group

Groups are composed of many individuals from varying backgrounds who have a common goal of furthering the interests of the organization and seeing it prosper. The diversity of its members means that everyone in the group is unique. It is important for the leader to understand each individual and to recognize any special talent(s) that group members may have. The military is well-known for following this principle. Furthermore, it is important that the leader oversee the group so that every member has a sense of ownership. Southwest Airlines is a good example, wherein all employees also are stockholders. Motivated group members strive for the group to be successful.

  1. Knowing and using the resources of the group

A resource is any talent or object that can be used for the successful operation of the group. It may be a special skill, or something that is more tangible, such as a large SUV or pick-up truck with a trailer hitch to transport a scout troop. Everybody has special talents, and successful leaders make use of these individuals’ talents. In our radiology group, several of us really enjoyed giving didactic conferences to residents and students and were called upon to give many more than other group members. Utilizing these special talents also allows the sharing of leadership.

  1. Communication

Good communication skills are a prerequisite for any leader. As a leader, you give and get information. When communicating to the group or to individuals, it is important that the leader discuss the issues rather than simply tell the information. A discussion should allow feedback from the group or individual. Ask them, “What do you think?” When an issue is discussed with the whole group, the group will feel a sense of ownership when a decision is made. A leader with good communication skills engenders good morale within the group. Poor communication often produces mumbling and dissent.

  1. Effective teaching (managed learning)

A leader often is called upon to teach new procedures or protocols to group members. A good example is teaching new coding for medical practice as the myriad of government alphabet soup that has invaded our practices expands. Effective teaching entails managing the learning process. There are several ways of doing this. Mentoring, a subject discussed several times in the Bulletin,1-3 is one way. Mentoring is a form of paying it forward – repaying a debt to those who taught us by passing on our skills and knowledge as did our own mentors. In managed learning, emphasis is put on the needs of the learner rather on what the instructor does. Group members should be actively involved in the learning process: Teach me, I forget; show me, I remember; involve me, I understand. For this process, I prefer a three-pronged method: see it, do it and pass it on (teach it).

  1. Evaluating

It is important to do some evaluating before and after any policy implementation or change. We are all creatures of habit. Here in Western Pennsylvania, we often are trapped in what the Romans called the mos maiorum, the way we’ve always done things. Change is a fact of life, and often the requested/required changes are not of our own invention or to our liking. The effective leader needs to assess how any changes in practice or protocols will affect the group. Furthermore, once there is a change, the leader also must assess its effects on the group and the mission.

  1. Planning

Proper planning is at the core of any successful venture. There is an adage that says, “Plan your work and work your plan.” A good leader has a plan and a vision for how that plan should be implemented. Several years ago, I chaired a search committee for a new president of my alma mater, Albany College of Pharmacy and Health Sciences. The committee settled on three candidates who met our criteria for the position, and according to our charge, presented the three to the Board of Trustees for the final selection. The individual selected (unanimously by written ballot, it turned out) had a vision and a plan for the institution that was not only practical, but also fit into the needs of the college. The other two candidates had “pie-in-the-sky” ideas and were vague on the specifics of how their plans would be implemented. To date, we have not regretted our decision.

  1. Counseling

Leaders will be called upon, from time to time, to counsel members of the group. This may simply involve explaining how an assignment is to be handled or praising a group member for a job well done. In many instances, however, it may be necessary to reprimand a group member for not performing up to expectations. Praise should be given publicly; criticism should occur in private and should always be constructive. The late “Badger” Bob Johnson, who coached the Penguins to their first Stanley Cup, was a master at this. When the team played poorly, his after-game talk to the team always stressed the positive things the team did. He said, “I didn’t have to criticize them. They knew where they screwed up.”

  1. Representing the group

The success of any group or organization is measured when each member feels that he/she has had a part in decisions and/or actions taken by the group. A responsible leader is the front person for the group. The leader often is called upon to present the organization’s policies to the public. In some instances, the leader will appoint a proxy to represent him/her, if unable to attend in person. It also is the leader’s responsibility to assure that every member not only has input on decisions affecting the group (and its reputation), but also to recognize that as individuals they represent the group. Every time I wear my Scout uniform, I am aware that I represent not only myself but also my troop and Scouting in general. For this reason, many of the Editorials and Perspective pieces that appear in the Bulletin or letters or op-ed pieces in the local newspaper contain a disclaimer to the effect that the opinions stated are those of the author alone and are not those of the group.

  1. Controlling the group

Some form of group control is necessary to assure success in the organization and in its program. A successful program keeps all members of the group happy. The most common form of control is the agenda for each meeting. For large society meetings, Robert’s Rules of Order are used. Unfortunately, a dictatorial leader (see below) will control the group through intimidation. I have previously written about the importance a moderator has during a scientific meeting.4 The moderator has the responsibility of making sure speakers keep to their time limit. However, they also have the discretion to permit a session to go overtime if an important issue is being discussed.

  1. Sharing leadership

Sharing leadership allows others in the group to share in decision-making without the leader giving up final responsibility. One of the first examples of this is mentioned in the Hebrew Bible in Exodus 18:13 – 22, when Jethro, Moses’ father-in-law, saw how overburdened Moses is from sitting as magistrate for the people. He advised Moses to “seek out from among the people capable … and trustworthy men who will spurn ill-gotten gain … and let them judge the people. Have them bring every major dispute to you but let them decide every minor dispute themselves … and let them share the burden with you.” Sharing leadership shows the group that you trust the judgement of the designated deputies. At the time of my retirement my group had, in addition to the Chair, the Vice Chair, a Residency Director, and Division or Section Directors for each of our specialized diagnostic modalities – Chest, Bone and Joint, Body Imaging, Neuro Imaging, Interventional, and Nuclear Imaging.

Whether leadership is shared will depend on the style of the leader. There are four basic types of leader: the democrat, the dictator, the bully and the micromanager.

The democrat is open to and solicits the ideas of others. He/she seeks consensus from the group. The democrat is always willing to share leadership and is not afraid to admit he/she has made a mistake and apologize. The democrat also is not intimidated by better talents in his/her underlings. Ronald Evens, longtime chairman of the Mallinckrodt Institute of Radiology in St. Louis, often said, “I want to hire the best and the brightest people available. I don’t care if they’re smarter than me; I want them to be smarter than me.”

The dictator, on the other hand, solicits no input from others or from the group. He (yes, it’s usually a man) is never wrong and does not tolerate dissent. Dissenters are quickly removed. With the dictator, it’s “my way or else.”

The bully is usually a dictator, who controls by threats and intimidation. He is the very antithesis of Eisenhower’s ideal of leadership. His criticism of underlings is public and usually brutal. He never praises. The bully never admits he has made a mistake, never apologizes and blames underlings for his failures. He frequently lies to boost his ego and cover for his shortcomings.

The micromanager often is a democrat who encourages and supports group ideas. Although he/she often will delegate tasks, he/she tells his underlings how to implement group ideas. The micromanager always has his/her fingers in the stew and interferes with the group doing their jobs. Micromanagers often are insecure, and their actions convey a sense that he/she does not trust the group members to do their jobs. As a result, the mission of the group may not be accomplished.

Sharing leadership also allows the leader to demonstrate four traits: humility, openness and approachability, gratitude, and honesty. As the humble leader climbs the ladder of success, he/she should be nice to those who are passed. Why? He/she often will pass them again as they fall off the ladder. The humble leader acknowledges that those who made him/her a leader also can unmake him/her.

The effective leader also is open and approachable for ideas from their underlings. They should not be aloof. They also should realize that they’re not the smartest one on the block, even if they think they are. The effective leader should have a sense of gratitude, remembering his/her roots. Always give thanks generously whenever it is due. Remember, a “thank you” and a smile cost you nothing. Finally, the effective leader should have a sense of honesty (see below).

  1. Trust

It is important for the leader to instill a sense of trust in the group. The group must be able to trust the judgement of the leader to make the right decisions for the group. Conversely, the leader must trust the members of the group to fulfill their responsibilities so that when a decision is made, the group will be fully supportive. A trustworthy person shows their inner character. If a mistake is made, he/she will admit it and make amends.

I like the quote of General Martin Dempsey, “Trust. Years to build, seconds to break, forever to repair. The one non-negotiable, indispensable ingredient of leadership. An everyday, all-the-time factor in any productive relationship.”

  1. Setting the example

This is the key skill, so perhaps it is listed last. We set the example by accepting the responsibility of a leadership post through our behavior. The leader should be the first to pitch in, often taking the dirty jobs. As a Scoutmaster I would tell my Patrol Leaders to be the first one to clean up after cooking a meal. By doing so, they would show the younger scouts in their patrol that they were not afraid to get their hands dirty. Dressing professionally, using proper language and courtesy are other ways to set the example.

The effective leader also avoids hubris and overconfidence. Hubris is defined as excessive pride, self-confidence or arrogance. Remember, you’re not as smart as you think you are. Overconfidence makes you underestimate your opponents. General Robert E. Lee suffered from both at Gettysburg. Up until that point, he had not lost a battle. He failed to realize that his success was not so much due to his own considerable military genius, but rather from the incompetence of the Union generals.

Leadership and decision making

One of the prime duties of any leader is decision making. There are three types of decisions: trivial, right versus wrong, and wrong versus right. Trivial decisions have no great import. A good example is choosing what color tie to wear with your suit. On the other hand, choosing right versus wrong may take a bit of thought. For example, it it’s so easy to tell right from wrong, why would you ever choose to do the wrong thing? Right is right, even if no one else is doing it. Wrong is wrong, even if everyone else is doing it.

When a decision is made by the leader, all options should have been carefully analyzed, and all information related to the issue should be considered. The leader should consider the consequences (cause and effect) of his/her decision. Decisions should be made with consideration of the goals of the group and doing what is best for the group. The decision should be evaluated during and after its implementation.

The Twelve Essential Leadership Skills list (Table I) can serve as a guide and as a “report card” for assessing a leader’s performance. Do all leaders measure up to all twelve skills? Certainly not. However, the successful ones receive A’s and B’s in most categories.

Author profile
Richard H. Daffner, MD, FACR

Dr. Daffner is a retired radiologist who practiced at Allegheny General Hospital for more than 30 years. He is emeritus clinical professor of Radiology at Temple University School of Medicine and is the author of nine textbooks.