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How Effective Leaders Harness the Future

Souba, Wiley, MD, ScD, MBA; Souba, Matthew, MSc, MLitt

doi: 10.1097/ACM.0000000000001955

Human beings are fundamentally future oriented. Most of our decisions and undertakings are for the sake of a future to which we are committed or obligated. This future orientation is essential to effective leadership in health care, especially during this time of significant reform, when people are at risk of becoming cynical and disengaged. Conventional thinking holds that our effectiveness as leaders is primarily a function of what we have learned in the past—our knowledge, expertise, and experience. In contrast, the emerging model contends that our effectiveness is also a function of how the future (outcome) of our leadership challenges “shows up” for us. If, despite daunting circumstances, we can “see” an aspired future ahead, we are more likely to commit and engage. Our story of the future becomes the “narrative frame” through which we see and tackle leadership challenges today. Because organizations are fundamentally networks of conversations, an organization’s ability to create new language practices is tantamount to its ability to evolve. What makes the future compelling is the embodiment of our deepest convictions and ideals in our image of the future. Because health care reform has challenged the medical profession along the entire spectrum of its traditional values and roles, working toward a unifying vision of the future has been difficult. To enroll others in creating a better future, effective leaders must underscore the purpose and importance of their work and motivate them with inspiring stories.

W. Souba is professor of surgery and adjunct professor of medical education, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.

M. Souba is a PhD student, Department of Philosophy, Ohio State University, Columbus, Ohio.

Funding/Support: None reported.

Other disclosures: W. Souba teaches an Association of American Medical Colleges–sponsored course titled “Being a Resilient Leader.”

Ethical approval: Reported as not applicable.

Correspondence should be addressed to Wiley Souba, 3 Rope Ferry Rd., Hanover, NH 03755; telephone: (603) 650-1200; e-mail:

© 2018 by the Association of American Medical Colleges