When the tyrant has disposed of foreign enemies by conquest or treaty, and there is nothing to fear from them, then he is always stirring up some war or other, in order that the people may require a leader. Plato, Republic , Book VIII.
Physicians in training need to appreciate that people end up in formal leadership positions for all sorts of reasons. Some are drafted without having sought such a post. Others have been thinking about it for a very long time—in some cases, virtually their whole lives. There are chairs of departments, deans of medical schools, and hospital CEOs who attained their positions simply because they were the best people for the job, and then there are others who have organized their lives around such objectives and put their names forward again and again in an effort to achieve them. Some are nearly desperate to be appointed to leadership and eagerly move from one institution to another to achieve their goal.
This discussion concerns the latter group, people who have long sought out positions such as chair or dean or president. What animates them? In some cases, their passion for leadership does not grow out of a deep understanding of the organization’s challenges or a strong sense of calling to service, but rather a strong need for one of two things: prestige or dominance. Such people either see the desired leadership position as a clear ratification of their success or they want to increase their influence over other people by acquiring the formal authority of the person in charge.
People whose leadership aspirations are motivated by a desire to appear successful often operate with a very conventional notion of success. They believe that success is measured not so much by the quality of a person’s ideas or work but rather by the titles on a resume or business card. They are not so interested in tackling the day-to-day challenges of the position as in using the position as a kind of trophy to prove that they have reached a particular career summit. For this very reason, they often become restless in whatever position they have achieved. Before long, they feel the need to prove themselves again by moving further up the ladder.
Yet their motives in seeking a leadership position can doom them to failure. Because they are less interested in actually doing the job than in using the job as a springboard to their own success, they often find it difficult to become more than superficially engaged in the day-to-day responsibilities of the position. It is not leading that motivates them, but rather the opportunity to wear the mantle of leader, and the organization they lead, the colleagues they work with, and the patients it serves may all suffer as a result. One way such people reveal their true intentions is the intensity with which they talk about themselves and their accomplishments, omitting those with whom they work.
If such individuals are to avoid mediocre performance or outright failure in their leadership roles, they must learn to put the success of others before their own and begin to think increasingly in terms of the needs of their patients, colleagues, organizations, and profession. Their natural tendency up to this point has often been is to think in terms of “I” and “me,” but they need to learn to think in terms of “we” and “us.” The individualistic thinking that often enables them to achieve many individual accolades will not serve them well when they become responsible for a larger organization, a context in which their success will largely be judged by the success of others.
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