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Leadership 101 – Commitments, Character, Competencies

April 5, 2021

Written by Clay Smith

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A healthcare leader keeps certain commitments, shows character, and learns defined competencies that enable their teams to flourish and succeed.

Why does this matter?
Leadership in healthcare is essential. From a two-person resident/intern team to the CEO of a healthcare system, leadership in healthcare is needed. We may assume that having what it takes to be a doctor lends itself to also being a leader, but I can personally attest that is a flawed assumption. I began a leadership role in 2017. I had to Google almost everything that was discussed in our meetings when I first started – what is exempt vs non-exempt; what’s KPI stand for; what’s a 340B; what’s a run rate; what’s EBITDA and how do I pronounce that? And I still feel like an idiot most days! How can we learn to be better leaders?

“One of the most effective ways to gain acceptance of a philosophy is to show it in your daily actions.” Abraham Lincoln

Physician leadership is important, since a respected physician or clinician has “street credibility” with those she or he leads. However, “physicians have not been traditionally selected nor trained to be team players.” The author points out five leadership commitments that are based on seven classical virtues.


The five leadership commitments are as follows. I have made all five start with E, for ease of memory.

  1. Explore – Great leaders look for ways to grow, change, and innovate and are willing to take risks and give people room to try things and learn from mistakes. They know they have not yet “arrived.” Leaders are curious.

  2. Envision – Leaders are realistic but optimistic and envision a bright future. They create a unified vision for their teams by appealing to their shared values, interests, hopes, and dreams. Leaders are hopeful.

  3. Enable – Leaders give away their power to others and trust others to do difficult, critical tasks by delegating, helping, and backing those they lead. Leaders are selfless.

  4. Example – Leaders walk the walk and don’t just talk the talk. Leaders are servants.

  5. Encourage – Leaders recognize individuals for how they’ve contributed to the success of the team and celebrate team victories. Leaders are encouraging.

Did you notice the overarching theme in all five? Great leadership requires humility.


The seven classical virtues of a leader are: trust, compassion, courage, justice, wisdom, temperance, and hope. It’s easy to get behind a leader like this!

  • Trust – All human relationships are built on trust, whether family, friend, coworker, corporate, or national. When we trust someone, we don’t waste energy defending ourselves; rather, we flourish. Trust is built when leaders keep promises and speak the truth.

  • Compassion – A leader understands and feels the pain of the ones he or she leads. Lack of compassion causes alienation. Compassion grows by being close to your team and really listening and getting to know them personally.

  • Courage – A leader must take risks. Without it, we shrink from challenges and may take the easy way rather than the right way, which is more difficult. Courage does not mean absence of fear. It means acting and doing the right thing even when you are afraid.

  • Justice – A leader treats his or her team with fairness. Without justice, all relationships suffer because our teams feel they are wronged. And without a commitment to be just, they are wronged. Injustice erodes #1, trust.

  • Wisdom – A good leader makes careful, thoughtful decisions and listens to advice. A foolish leader makes flawed decisions and doesn’t listen to counsel.

  • Temperance – A leader is under control, disciplined, and doesn’t make rash decisions, rush to judgment, or take unnecessary risks. A big personal struggle for me is controlling my own emotional reactivity. It is counterproductive when I, as a leader, get angry or upset.

  • Hope – A leader inspires people to be and to do their best and points to and models a better future. A leader doesn’t allow despair or cynicism to creep in and cloud their thinking.


Leadership isn’t only about commitments and character. There are six competencies a leader must possess (or at least develop over time).

  • Technical knowledge and skills – Operations, finance and accounting, IT and systems, HR, strategic planning, policy.

  • Knowledge of health care – Reimbursement strategies, legislation, regulation, quality assessment and management

  • Problem solving – To resolve organizational challenges and manage projects

  • Communication – Leading groups, negotiation, conflict resolution

  • Commitment to lifelong learning (in the context of a rapidly changing environment and need for new skills to cope and manage)

  • Emotional intelligence

You can learn these competencies over time. It’s OK, in fact it’s essential, to ask for help, get advice, and learn from your coworkers. Also, in many of these areas, we rely on our teammates with vast skill and experience in these areas, such as finance and accounting, healthcare legislation, health policy, and IT infrastructure. If you’re not getting formal training in business, you need to read a lot to become facile with these items.

Finally, there are different leadership styles that may need to be employed in different circumstances. These are: visionary, coaching, affiliative, democratic, pacesetting, and commanding. The latter two should be used infrequently. It takes emotional intelligence to know which style to employ in a given situation.

Leadership Essentials for CHEST Medicine Professionals: Models, Attributes, and Styles. Chest. 2021 Mar;159(3):1147-1154. doi: 10.1016/j.chest.2020.09.095. Epub 2020 Sep 19.

What are your thoughts?