Journal of Public Health Management & Practice:
The Management Moment
Baker, Edward L. MD, MPH
Section Editor(s): Baker, Edward L. MD, MPH; Column Editor
Department of Health Policy and Management, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina.
Correspondence: Edward L. Baker, MD, MPH, Department of Health Policy and Management, Campus Box 7411, University of North Carolina at Chapel Hill, Chapel Hill NC 27599 (email@example.com).
The author declares no conflicts of interest.
In previous Management Moment columns, we have discussed a range of leadership and management issues. This column is designed as a review of guiding principles and best practices of effective leaders along with a discussion of the distinction between management and leadership.
There are many definitions of leadership and many perspectives on what leaders do. John Gardner in his book, On Leadership, defines leadership as “the process of persuasion or example by which an individual or team induces a group to act.”1 Warren Bennis and Bert Nanus2 provided a simpler way of expressing the essence of the 2 processes:
* Leadership is doing the right thing.
* Management is doing things right.
If we consider the practice of leadership, it is useful to consider what exemplary leaders do1–3:
* Leaders ask good questions.
* Leaders impact the way others feel—usually, people will remember how you make them feel long after they forget what you say.
* Leaders emphasize vision, values, and motivation.
* Leaders are system thinkers.
* Leaders have political skills, focusing on external relationships and trends.
* Leaders think in terms of renewal of the organization and of self.
Since most leaders are also engaged in management, it is useful to distinguish between these 2 interrelated processes. As noted in a previous Management Moment column,4 we find it useful to consider 4 elements of the leadership/management continuum:
Leaders must be skilled at the process of creating a shared vision and to do so in such a way that other can visualize it. “A vision is something that you can see.” In Peter Senge's5 classic book, The Fifth Discipline, he discusses the importance of creating a vision that is shared by others and provides useful perspectives on how this can be accomplished. Leaders must also lead the process for identifying and communicating the broader strategies (“the how” and “the why”) needed to bring the vision (“the what”) into reality.
Management involves translating strategies into operations. In public health, this step often involves the creation of programs or projects designed to advance the process of achieving the vision. Management also involves identifying and tracking specific tactics (the details of program execution) that are integral elements of program operations.
Typically, individuals vary in their competence in and inclination toward these 4 elements of the leadership/management continuum. Although a leader must be skilled in fostering a shared vision and in creation of core strategies, he or she must also understand and highly value the essential nature of operations and tactics in realizing the vision. It has been said that “a vision without operations and tactics is simply an hallucination.”
Leaders will be successful as they become skilled, sometimes forceful, in practicing these core elements of vision, strategy, operations, and tactics. But the most successful leaders also blend these with other core leadership attributes of gratitude, humility, and caring. The opportunity to provide leadership should be seen as a gift, not an entitlement. All too often the leader may feel that he or she should have all the answers. As noted earlier, leaders should be skilled at asking the right questions, rather than holding themselves to the impossible task of being all knowing. Finally, inspirational leaders demonstrate that they care about others, first, for who they are and, second, for what they can do. In other works, exemplary leaders regard others first as “human beings,” rather than as “human doings.”
1. Gardner JW. On Leadership. New York, NY: The Free Press; 1990. pg. 1.
2. Bennis W, Nanus B. Leaders. New York, NY: Harper Collins; 1985.
3. Baker EL, Menkens AJ, Porter JE. Managing the Public Health Enterprise. Sudbury, MA: Jones & Bartlett; 2010.
4. Baker EL, Orton SN. Practicing management and leadership: vision, strategy, operations, and tactics. J Public Health Manage Pract. 2010;16(5):470–471.
5. Senge PM. The Fifth Discipline—The Art and Practice of the Learning Organization. New York, NY: Currency Doubleday; 1990.
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