Healthcare Quarterly

Healthcare Quarterly 8(3) May 2005 : 30-32.doi:10.12927/hcq.2005.17170

Insight: How to Be a Leader


If leadership is so important, why are leaders so rare? Are leaders born or can they be taught? What does it take to be a leader? The editors of Healthcare Quarterly asked two healthcare leaders about leadership. Here's a roundup of their thoughtful and hard-won lessons.

Dwight Nelson

Dwight Nelson is President & CEO of Regina Qu'Appelle Health Region, a position he's held since 2002. He previously served as CEO of the Headwaters Health Authority in Alberta. His health career also includes service as a Vice-President of the Alberta Children's Hospital and as Assistant Executive Director at a rural hospital.

Dwight is a Certified Health Executive (CHE) and was recently elected to the board of the Canadian College of Health Service Executives. He served as Chairperson of the Council of CEOs in Alberta and has been elected and appointed to a number of provincial and national boards, committees and task forces over his 20 years in healthcare. He is currently on the board of the Association of Canadian Academic Health Organizations.

Dwight is a graduate of the University of Calgary (Bachelor of Arts) who also holds the professional designation of Chartered Accountant. He lives with his wife and two sons in Regina.

What are the attributes of the leadership mind?
I truly believe that leadership - more than anything else - determines the overall success of any organization. This is an absolutely mission-critical area for us. In our health region we've spent the last six months wrestling with issues around leadership. I struck a task group of 15 individuals to help create an explicit "leadership philosophy" for the region. We had perspectives from many areas - from the frontline and clinical areas to working supervisors and senior executives. Through our literature reviews and many hours of discussion and debate we came to better understand a few key precepts. Perhaps most important is that leadership is not a position, although some positions clearly entail leaderships responsibilities. Indeed, everyone in the organization can be a leader and can find opportunities to exercise leadership. In the end, it's a choice and it's about people. It's seeing the chance to make a difference and seizing it.

It's one thing for a leader to embrace the contradictions often found in healthcare. But how does he or she persuade colleagues to go along with this kind of thinking?
First, we have to be very clear and honest about "change" in the healthcare environment. It's not a temporary phenomenon - it's not going away and it's probably not going to slow down. Honesty is the foundation for good conversation. Next, leaders have to communicate a clear vision - people really want to know where we're heading, what it will look like when we get there. All of the experts are clear about this - we need to know what the destination is. So today's leader has a wonderful opportunity to not only convey the destination to others but also to help craft the road we use to get there. In the end, most folks want to know that their time, energy and talent is advancing us to a new and different future, and not just being consumed with "busywork."

Does developing the will to transform mean that you can actually will others to change?
I'd rather frame it in terms of helping others want to change because we've laid out such a clear and compelling sense of where we're headed … and why.

What advice can you give for turning a follower into the next leader? How do we bridge the leadership gap?
We haven't done a very good job of nurturing young or new leaders in healthcare over the past decade. We've pared down the management ranks and cut back on training and development since such investments are often viewed as "discretionary." It's time to turn that around and quit apologizing for seeking a reasonable quality and quantity of people to lead our huge enterprises. Those of us in formal leadership roles must dedicate the time, interest and resources to helping develop the next generation of health leaders. We have a mentoring obligation in my view - if we don't practise it, we shouldn't be in these roles. We have to make the leadership development one of our core organizational values, along with caring, quality and other important things. Then we need to support it.

What is your key advice for emerging leaders?
Make sure that people in your organization know that you have leadership aspirations and want to make a difference. You'd be amazed at the time and interest others will take in your career and your growth once they know that you really care about it! Ask a respected colleague to work with you on a professional development plan. Solicit feedback from others on your both your strengths and weaknesses. Add more tools to your skill kit over time. Network with your colleagues locally and more broadly whenever you can. And never stop looking for situations, especially the tough ones, to show your "stuff" to those around you. It's a great time to be an aspiring leader - the opportunities are nearly limitless - embrace them with enthusiasm!

Maura Davies

Maura Davies is the incoming CEO (effective June 13) of the Saskatoon Health Region.

Prior to that appointment, Maura was Vice-President, Planning and Performance for Capital Health, in Halifax, NS. Maura has over 30 years' experience in healthcare as a clinical dietitian, educator and senior executive. For the past 17 years, Maura has played a leadership role in helping to design and implement many changes in the Nova Scotia healthcare system. As a member of the Capital Health executive team, she provided leadership in the areas of human resources, professional practice development, information management, corporate planning, quality, patient safety, performance measurement, ethics, risk management and board development. She was a member of the part-time faculty of the Dalhousie University School of Health Services Administration and a member of the board of the Halifax Chamber of Commerce.

Maura is a member of the boards of the Canadian Centre for Analysis of Regionalization and Health and the Canadian Health Services Research Foundation. Maura has Bachelor degrees in science and education and a Masters degree in health services administration. She is a Fellow of the Canadian College of Health Service Executives and has been a surveyor for the Canadian Council of Health Services Accreditation since 2003. Her research interests include performance measurement of integrated health systems, organizational culture, and quality of work life.

What are the attributes of a "leadership mind"?
Intelligence, curiosity, and a constant desire to learn are critical attributes. They enable leaders to be stimulated and satisfied by their work, despite the many stresses and demands. Effective leaders are results-oriented and willing to take risks. They thrive on complexity. Leadership is all about relationships, so most effective leaders are naturally social animals. They listen well, genuinely care about and work well with others.

It's one thing for a leader to embrace the contradictions often found in healthcare. But how does he or she persuade colleagues to go along with this kind of thinking?
Leaders need to reach people's hearts. They need to try to understand how others are really feeling and perceiving things, at a personal level. I've learned, sometimes the hard way, that if you only deal with things at an intellectual level, people really don't "get it" and rarely commit, even though on the surface they may appear to be on board. I'm a big fan of John Kotter's work on leading change, and try to use it in my work.

Does developing the "will" to transform mean that you can actually "will" others to change?
No, I don't think so. People will only change if they want to, if they have sufficient reason to believe that change is really necessary and will make things better. Very few people follow blindly, thank goodness. People's willingness to change is influenced by their understanding of why the change is needed, what changes are envisioned and how it may affect them. The passion and credibility of visionary leaders does make a difference, by helping others see the art of the possible and by creating trust.

What advice can you give for turning a follower into the next leader? How do we bridge the leadership gap?
There is an art and a science to leadership. Many of us learn as we go. We can benefit from leadership development programs, especially ones that increase self-awareness. I have learned an incredible amount by observing other leaders. For me, mentors who have challenged, counselled and supported me have been invaluable. They probably know me better than I know myself. I would encourage aspiring leaders to find a mentor, seek out role models and look in the mirror, so you can better understand your strengths and areas that impede your effectiveness as a leader.

What is your key advice for emerging leaders?
Be prepared to take risks. Seek out opportunities, even when they seem like a big stretch. Don't be afraid to fail - we all do and can grow stronger as a result. Believe in yourself.


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