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Redefining leadership in health care

BMJ 2001; 323 doi: (Published 01 December 2001) Cite this as: BMJ 2001;323:1263

Leadership is not the same as browbeating

  1. Tom Treasure, professor of cardiothoracic surgery
  1. Cardiothoracic Unit, Guy's Hospital, London SE1 9RT

    O wad some power the giftie gie us, To see oursels as others see us! It would frae monie a blunder free us, And foolish notion. Robert Burns, To a Louse

    Arecent workshop run by the Royal College of Surgeons and the NHS Confederation on the leadership role of consultants took as “a given” that the medical staff of a hospital are a central resource and that without them there would be nothing worth calling a health service to manage or administer. This struck a chord with the consultants. It was also recognised that the consultant workforce is riven with disaffection.1 Less overtly stated but evident in group discussions was the perception of hospital managers that consultants are inclined to be headstrong and do not always use their influence and abilities in the best overall interests of the organisation that employs them. This prompted various versions of the “doctors know best” gambit and the ploy which runs “I can go to the private sector where they will provide the facilities my patients need.” When this current of righteous indignation runs hottest it is worth asking for Robert Burns's “giftie” to see ourselves as other see us. This workshop, with its mix of eloquent and knowledgeable surgeons and managers, was an opportunity for consultants to glimpse how others see them—as leaders or otherwise—rather than merely ruminate on their disgruntlement.

    The personality types of qualifying doctors include the range found in the working population, but after qualification those who become consultants in acute clinical specialties—who traditionally take the …

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