Education And Debate

Values and leadership

BMJ 2002; 325 doi: (Published 07 December 2002) Cite this as: BMJ 2002;325:1352
  1. David Pendleton (, chairman,
  2. Jennifer King, managing director
  1. Edgecumbe Consulting Group
  1. Correspondence to: D Pendleton

    In the face of bureaucratic change and low staff morale, what can medical institutions learn from the commercial sector? Using their experience in working closely with both medical and commercial organisations, the authors consider the role of values and what leaders in the medical world need to do to put values into practice

    Values are deeply held views that act as guiding principles for individuals and organisations. When they are declared and followed they are the basis of trust. When they are left unstated they are inferred from observable behaviour. When they are stated and not followed trust is broken. In this paper we explore the place of values in two contexts: values that underpin the work of “good doctors” and values that define what medical organisations stand for. For the past 20 years we have worked closely with medical organisations and commercial organisations; we will draw from both worlds in considering the impact of values on an organisation's performance and on its members.

    Summary points

    Values act as guiding principles for individuals and organisations

    Commercial companies that take their values seriously tend to outperform their competitors

    Medical organisations rarely declare their values, which can leave their members unclear about what the organisation stands for

    Medical morale is low, and leadership is required that describes the vision that organisations are working towards and the values that will guide the journey

    Values in the commercial world

    Values have recently become more prominent in the commercial world. Research in business organisations is notoriously poor, because it often uses little other than correlational evidence, without any controls or attempts to establish causality. Nevertheless, several studies over the past decade have indicated how powerful an organisation's values can be in improving its performance. Three such studies are worth considering here.

    Waterman studied nine companies that satisfied three criteria.1 They had …

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