Being a Responsible Leader

People who administer organizations of various types, including medical practices, are finding it increasingly necessary to demonstrate leadership. The challenge is to understand the meaning of effective leadership and to have guiding principles with regard to its implementation. It is argued here that responsibility represents a key guiding theme that doctors and practice managers can use to chart their day-to-day actions as leaders. Responsibility implies accountability to a broad array of groups and individuals who increasingly expect that leaders act in a manner that is aligned with their interests. This new era of leader accountability raises the question, to whom and what are organizational leaders responsible? In an attempt to answer this question, The author elaborates a broad perspective of responsible leadership and address both internal and external stakeholders to which a leader is responsible. Recommendations and principles are provided for how to balance the needs and interests of various stakeholders when leading one’s practice. The article ends with a consideration of important caveats with regard to responsible leadership.

Are you a responsible leader? At first glance, this question may seem rhetorical. It is unlikely that many people in positions of leadership would answer no. Who does not want to think of himself or herself as responsible or for that matter, a leader? The answer is probably very few. But in reality, the demonstration of responsibility can be challenging, although it is also the key to leader effectiveness. Increasing scrutiny by employees, clients/customers, the broader professional community, and so forth demands accountability or responsibility on the part of doctors and practice administrators. At the same time, leaders often view responsibility in a narrow or incomplete manner and accordingly, might not meet a comprehensive definition of responsible leadership, at least in the perceptions of some people.

With all of that in mind, the goals of this article are 3-fold.

First, I define leadership and distinguish it from what can be characterized as management.
Second, I describe what responsible leadership is all about and why it is so increasingly important.
Third, I provide guidelines and principles for individuals who seek to be responsible leaders.

In doing so, internal (to the organization) versus external leader roles are delineated. My overall purpose is to clarify this important, and perhaps overlooked, aspect of leadership effectiveness.

What is leadership, and how is it different from management?

Before considering what it means to be a responsible leader, it is first important to understand the basics of what leadership is all about, how it is different from management, and why leadership is so important. Leadership is a process of influencing the behavior, attitudes, beliefs, and even values of people, willingly on their part, in the pursuit of organizational goals. In contrast, management is the process of controlling people, costs, equipment, and systems to maintain organizational performance. A few key differences should be noted with regard to these definitions. First, leadership is more clearly all about people and relationships between the leader and people who would be followers. Management could involve people but it is also focused on such things as cost control and systems (eg, human resource systems, machinery). Second, leadership is all about voluntary influence, in that people want to follow others whom they perceive as leaders. On the other hand, management is more about control and sometimes even coercion to get compliance.

I do not suggest here that a doctor or practice administrator should focus on one of these roles and exclude the other. Both management and leadership are important processes. However, I do contend that rather than leadership, management is often emphasized more in a variety of organizations. I further contend that this emphasis is unfortunate because it is increasingly clear that leadership, especially in the responsible terms described later, is necessary for the long-term welfare of an organization. Several positive outcomes have been associated with leadership practices including employee commitment, extra effort on the part of employees, and better performance.

When approaching the topic of effective leadership, it is best to have a guiding theme or model. Indeed, several characterizations of exemplary leadership have been put forward in recent years. The existing lexicon of descriptors includes terms such as transformational, charismatic, authentic, ethical, participative, servant, shared, and even spiritual leadership. So why introduce another term—responsible? I am not trying to reinvent the wheel of effective leadership here, and I recognize that each of the characterizations mentioned earlier above has something to offer. At the same time, I also propose that the responsibility element is somewhat missing from these descriptors and that it is actually this element that is at the heart of what effective leadership is all about. In a nutshell, to be not responsible is to be not effective as a leader.

The first step toward gaining a feel for this contention is to examine the precise nature of responsible leadership. To whom or to what should leaders be responsible, and how will responsibility be demonstrated?

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