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Simone's OncOpinion: Boss, Manager, or Leader

Simone, Joseph V. MD

doi: 10.1097/01.COT.0000369696.88476.3f


In recent weeks I have visited and spoke at a number of academic institutions. My agenda generally included private and small group meetings with senior faculty, junior faculty, and trainees. I am struck by how often I am asked questions about specific issues that we in academia or the practice of medicine must deal with. The top three issues of those in positions of authority concerned: (1) personnel problems; (2) personnel problems; and (3) personnel problems. As a friend once told me, “this job would be easy if I didn't have to deal with people.”

On the other hand, my discussions with those without authority consisted mainly of questions concerning career choices and navigating through the organization. I believe I benefit as much or more than they do from the exchange because every session has offered a viewpoint or an issue in a slightly different light, thus refining my own thoughts and leading me to read up on certain topics. And that sometimes leads to a column in OT.

This time the rumination led to exploring the different styles employed by those in positions of authority. The words “boss,” “manager,” and “leader” are often used interchangeably—e.g., in casual conversation the boss is the top person in the workplace hierarchy who often has the ability to hire and fire individuals.

But I would like to refine the usual all-purpose definitions as a means of exploring the nuances of people and their behavior in those positions and creating a hierarchy. But listing such a hierarchy is not entirely objective, of course; experience plays a large role in judging authority when one gets older, and one's own rank in an organization colors one's perception of persons in authority.

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For me “the boss” is a very powerful, largely dictatorial, judgmentally mysterious, and unpredictable character. He is someone to be feared more than respected. He is more likely to lose his temper and threaten violence (rarely physical, but by other means such as demotion or assigning the worst tasks).

The archetype of “the boss” in my life was the foreman of a construction crew that I worked with for three summers. The crew of laborers worked very hard for long hours in the hot, humid Chicago summers with a 30-minute break for lunch. We dug ditches, lugged 50- to 70-pound wooden forms for the concrete curbs and sidewalks, backfilled the forms, and loaded the equipment on trucks. There was no room for innovation or improvements of the processes; they were fixed in concrete.

At the end of summer I was in the best physical shape of my life. The job paid relatively well, but there was an air of fear at the worksite, and we always were alert to where the foreman was. I have had other bosses, but none as threatening as the foreman.

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The “manager” for me is typified by the men with that title at the A&P supermarkets that I worked at during high school. They assigned work, checked progress, occasionally relieved cashiers (in those days all were women). They had the power to hire and fire, but they didn't really scare anyone; they were largely benign.

Some were collegial and personable, some were all business, but they all went about their jobs in workmanlike fashion. Most worked their way up the system from stocking shelves to running the produce department and finally, manager. They didn't inspire loyalty or admiration or dazzle anyone with their brilliance or imagination.

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The “leader” is a person who inspires the troops to follow his or her plan and exemplifies important values such as integrity, candor, decisiveness, and fairness. The leader may have a touch of charisma and at least seem approachable, a value that makes him or her a bit more like the rest of us.

He or she has a clear and well-articulated vision, an essential factor so all the troops are, or can be, on the same page.

A leader has many of the skills of the boss and the manager, but sees the bigger picture, has more patience for success and takes pleasure in seeing individuals who work in his organization become successful and rewarded with accolades or lucre. The leader gets his kicks out of seeing others do well—which, of course, makes him/her look good because he/she is the leader of a successful team.

For me Dr. Donald Pinkel, the first Director of St. Jude Children's Research Hospital, typifies a leader as I have defined it. He was the brains of our pediatric oncology program but was very generous in giving us the opportunity to share the credit with him. He put us forward for speaking engagements and as representatives of the program. He was charismatic and eminently approachable. But he also was firm in his core beliefs about ethical standards and our societal responsibilities as a children's research institute.

One example: We became engaged in nutritional studies of poor children in our Memphis community and we helped obtain surplus food from the U.S. Department of Agriculture for those children in need. Pinkel took heat from some St. Jude trustees and faculty for these efforts, but he prevailed, and Dr. Paul Zee, who was the leader of the studies, was asked to testify before the U.S. Congress on our program. Zee demonstrated that nutritional status influenced school performance; this would surprise no one today, but in the maelstrom of the 1960s, this was important ammunition for like-minded people.

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Many, Many, Few

My conclusion from these many years of experience is the following: There are many bosses and managers in most organizations at all levels from CEO on down, but there are relatively few leaders.

You are blessed when you serve a true leader because he/she can help you by example to become a leader yourself. That may be the greatest gift of leadership.

© 2010 Lippincott Williams & Wilkins, Inc.
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