(1)Medical: relating to the science or practice of medicine
(2)Management, Medicine and Psychiatry: the treatment or control of diseases or disorders, or the care of patients who suffer them
(3)Leadership: the action of leading a group of people or an organisation, or the ability to do this
The above are some of the online Oxford Dictionaries definitions, there are other meanings which you can check out.
To me, it is very clear what medical or clinical leadership and management means. I was tempted to say it only means, but instead I will say it first and foremost means that our main role is to lead in the treatment or control of diseases and disorders and the care of patients who suffer them. Most of us are unlikely to be leaders in its guns and glory meaning; most of us will probably practise the important leadership that was described by Darren Kilroy in his post as the leadership with a little ‘L’. Assuming we want to be somewhere between the little 'L' and the glory spectrum, the starting point has to be superior clinical care (in its comprehensive holistic meaning).
The real success in a doctor’s management role is the management of knowledge, time and resources to provide clinically superior care. My personal view is that this point is often missed in the current management training for doctors and in appointing doctors to clinical managerial positions such as service directors or clinical directors. If a doctor has not managed his/her resources to deliver clinically superior care within his/her practice, there is probably little chance that he/she will be able to do it as a manager.
Then comes the issue of developing medical managers and leaders. For doctors, the development involves two separate sets a) technical skills and b) personal skills.
The technical skills consists of two steps; first is core professional skills (how to do the best) and core generic skills (how to do the best for everyone, everytime, everyday). Many of us are good at our core professional technical skills because that is what our training as a doctor is all about, but it is very well known that in healthcare many of us are unaware of core generic technical skills (evidence, shared baselines, operational data analysis, data tracking, data based decision making, reliable processes, quality theory, etc).
Once both components of the technical skills have been achieved and only after that should personal development happen. The NHS and the medical fraternity are focussed about developing personal skills (leadership, communication, situational awareness, listening skills, etc). There is a risk in personal development before technical development. Personal development is designed to enhance self-awareness, self-confidence and self-belief; if these traits were to develop before technical development, the ‘leader’ becomes so convinced about the correctness of what they are doing that they feel the technical development is irrelevant even though they may not have much knowledge about it. That will be a very dangerous position for a medical leader.
One must know what/how to do, before one begins to believe that they can do it well. Let us have core professional skills (good clinical specialty skills), core generic skills (quality improvement) and personal development; in that specific order, to create a cadre of credible medical managers and leaders.
Medical Leadership and Management
My view is this describes doctors who lead and manage. And of those two, most only have time to lead at best. The stock response about patient care being central does suggest medical leaders cannot detach themselves from medical practice. In medical practice, the patient is central and key.
In the leadership role, the patient population becomes key and as a consequence the needs of other stakeholders become very important. GPs and commissioner relationships assume a new importance. If you want to get anything done, you need a good working relationship with HR and union representatives. As a leader, you have to manage your team and the person you report to. This is not looking like medical practice at all.
In the leadership role, you are not there to represent doctors but deliver your organisation's healthcare strategy. This requires new skills which one might describe as business acumen. You do not have to run a business but be business-like.
I think we would do our patient population a disservice, if medical leaders were seen as representatives of the medical profession or self-appointed patient advocates. Both of these are well covered.
So I would describe a medical leader as some one who takes up a leadership role, who is medically qualified and assumes responsibility for the population his/her healthcare organisation provides for. In doing so, the leader becomes accountable to a wide range of constituents (both internal and external) as well as the patient population.