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Simone's OncOpinion: Leadership Lessons from Abraham Lincoln

Simone, Joseph V. MD

doi: 10.1097/01.COT.0000422181.61564.a6


My last three columns addressed various aspects of leadership, such as what conditions make good leaders. The columns make up a three-layer cake as I had planned, but I forgot to mention what some believe to be the best part of the cake—the frosting. This column is the frosting on the series. Lincoln doesn't tell us what makes a good leader, he shows us through his well-documented actions.

As part of my research on leadership, I have read several books that address the leadership skills of President Abraham Lincoln. They include a book by the eminent scholar Doris Kearns Goodwin: Team of Rivals: The Political Genius of Abraham Lincoln, for which she was awarded the Pulitzer Prize.

The apparent oxymoron in the title hints at the skills of Lincoln. In a keynote address at the Society for Human Resource Management 2008 Annual Meeting, she focused on Lincoln's leadership skills derived from her extensive research for the book. A news summary of her findings can be found here: (“10 Qualities that Made Abraham Lincoln a Great Leader,” by Catherine L. Moreton, JD).

Kearns Goodwin described the characteristics of Lincoln's leadership that I shall list below; all are directly applicable to leadership in the health care community.

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Capacity to Listen to Different Points of View

Lincoln created a climate where Cabinet members were free to disagree without fear of retaliation. At the same time, he knew when to stop the discussion and after listening to the various opinions, make a final decision.



The striking thing about this approach is that Lincoln used it despite the well-known animosity and lack of respect that some Cabinet members had for him. Lincoln's coarse features, tall and gangly body, and rural roots may have been part of the reason, but rivalry and competition for power played a large role. Nonetheless, he understood that the men he had chosen were talented and he believed they could contribute to overcoming the severe obstacles that they faced. So he listened.

We all have experienced leaders who can't or won't listen to other opinions. Egocentricity is not a rare phenotype in academic medicine or in community medicine. But being a good and sincere listener is the first step in molding a team.

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Ability to Learn on the Job

Kearns Goodwin notes that Lincoln was able to acknowledge errors, learn from them, and then move on. In this way, he established a culture of learning in his administration.

Albert Einstein said, “Insanity is doing something over and over again, but expecting different results.” Some people never learn. We see it in leaders who cleave tightly to the “way we have always done things” despite changes in circumstances that should lead one to question the approach.

Sadly, physician-leaders also fall into this comfortable rut more often than we admit. The danger of not learning from errors and “missing the boat” by the leader and his team increases with the years out of training or the years in a particular leadership position.

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Ready Willingness to Share Credit for Success or Blame for Failure

In response to concerns expressed by friends about the actions of some of his Cabinet members, Lincoln stated that the “path to success and ambition is broad enough for two.” When there was success, he shared the credit with all of those involved. When members of his Cabinet made mistakes, Lincoln stood up for them. When contracts related to the war effort raised serious questions about a member of his administration, Lincoln spoke up and indicated that he and his entire Cabinet were to blame.

This is another indication of the “Team” in the title of Kearns Goodwin's book. Lincoln always viewed his Cabinet as part of a team that shared the ups and downs of his administration. In time this approach paid large dividends to Lincoln and the team. He didn't throw anyone under the bus, and they gradually learned to appreciate his support.

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Awareness of Own Weaknesses

Kearns Goodwin noted that one of the weaknesses acknowledged by Lincoln was his tendency to give people too many chances, and because he was aware, he was able to compensate for that weakness. For example, as she relates, George McClellan, Commander in Chief of the Union Army, refused to follow directives about the war effort. Lincoln eventually set a deadline and subsequently removed McClellan from the position.

Self-awareness is an invaluable characteristic for any leader in any field of work. If one can acknowledge one's pettiness, short temper, tendency to publicly humiliate a subordinate, or bullying everyone else in the room into silence or acquiescence, there is a chance to soften and improve. But if one believes this behavior is justified, there is little hope for him as a leader.

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Ability to Control Emotions

According to Kearns Goodwin, Lincoln treated those he worked with well. However, he did get angry and frustrated, so he found a way to channel those emotions.

He was known to sit down and write what he referred to as a “hot letter” to the individual he was angry with but would then set the letter aside and not send it. If he did lose his temper, Lincoln would follow up with a kind gesture or letter to let the individual know he was not holding a grudge.

A true story: Mary Kledzik, my secretary when I was director at St. Jude, would type my hand-written letters (this was back in the day before widespread wordprocessing). If it was a “hot letter,” she would hand carry it to me, smile, and say, “I would put that in the drawer for a day or so.” Needless to say, I learned the wisdom of that lesson.

“Hot letters” are even more dangerous today with the “Reply All” and “Send” buttons so easily (and, at times, mindlessly) clicked. I watched a dean of a medical school lose his job for pushing the Send button on an incendiary email.

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Know How to Relax and Replenish

Lincoln understood the importance of relaxation and humor to shake off the stress of the day and replenish himself for the challenges of the next day. He had a wonderful sense of humor and loved to tell funny stories. He encouraged a healthy atmosphere of laughter and fun in his administration. He also enjoyed going to the theater and spending time with friends.

The workaholic so admired in today's society is doubly dangerous. First, he creates an atmosphere that implies that work is all that matters to him and his charges. Some cannot consistently work those long hours without a physical or psychological breakdown. Short bursts of such work are OK and sometimes necessary, but morale, teamwork, and family life often suffer if this becomes the norm.

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Go Out into the Field and Manage Directly

During the Civil War, many soldiers died, and there were many ups and downs. Lincoln established lasting connections with the troops by visiting the battlefield and hospitals, which also helped bolster morale.

Lincoln also spent time talking with members of the public, taking “public opinion baths,” according to Kearns Goodwin. He held public receptions and made a point of shaking everyone's hand and speaking to each individual.

There is simply no substitute for “managing by walking around.” People want to feel part of the team. Some time ago I received a sad note from a former clerical employee in my unit expressing her disappointment with the current leadership by saying, “we are no longer a team.”

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Strength to Adhere to Fundamental Goals

As Kearns Goodwin relates, in the summer of 1864 the war was not going well for the North. Members of his political party came to Lincoln and said that there was no way to win the war and he might need to compromise on slavery. Lincoln, however, held firm on the issue of slavery and turned away from this advice.

In most leadership circumstances, there are values that should never be compromised. A loss of integrity at the top may be a slippery slope to believe the leader doesn't care or that it is OK to bend on such basic and important issues.

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Ability to Communicate Goals and Vision

Lincoln had a “remarkable ability to communicate his goals to his countrymen.” He made concepts simple and communicated with an understanding of the concerns of the citizens.

When the war ended and he won reelection, Lincoln did not focus on his achievements, Kearns Goodwin notes. Rather, in his second inaugural speech, he focused on bringing the country together as expressed in the following excerpt: “With malice toward none, with charity for all, let us strive on to finish the work we are in, to bind up the nation's wounds, to care for him who shall have borne the battle and for his widow and his orphan, to do all which may achieve and cherish a just and lasting peace among ourselves and with all nations.”

All I can say is that it is no wonder that historians and others have named Lincoln the greatest president in our history. What a great speaker! What a great guy! What a great leader!

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Conclusion of a Series

This is Part 4 of a series on leadership. Parts 1, 2, and 3 appeared in the three previous issues, and here is a link to a Collection of them on

© 2012 Lippincott Williams & Wilkins, Inc.
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