Management or leadership?

Is it important to make a distinction between leadership and management? Some people feel that they are very seperate ideas, but others argue that the skills and attributes needed to be effective in both are two sides of the same coin.

The emphasis upon leadership in the Medical Leadership Competency Framework (MLCF) has almost certainly been important in its widespread adoption, as the term is more attractive to doctors than management, and more relevant to a constantly changing environment. However, this raises the issue of whether we are using the terms management and leadership in separate, clearly defined ways.

The literature is divided on this, and some authors argue that the terms are quite distinct. If we think of management as largely concerned with working within current systems and seeking to improve efficiency and effectiveness in existing practice, then this certainly feels different to notions of charismatic leaders seeking to challenge, possibly disrupt and motivate people to embrace new approaches.

There is, however, a danger of polarising the two processes too much. Management is more concerned with systems and achieving specified goals whilst leadership is probably more focused on motivating and inspiring others. Nonetheless, both are essential to effective organisations. Management alone can lead to stagnation and a failure to change. Leadership alone can create a constant state of flux, perhaps chaos.

Spurgeon and Cragg (2007) offer a more integrated approach, which suggests that they might be thought of more as a dimension, with individuals giving more or less emphasis to certain attributes depending on their role and position in the organisation. For example, many clinical leaders will look to inspire others to accept new models and ways of working. Yet within this vision there will be more mundane (and managerial) tasks, such as preparing a business plan, putting in place operational systems such as staffing and rotas, and performance monitoring. If these processes are not integrated both elements are likely to founder.

It is interesting to note that when asked at consultant interviews for an example of their leadership experience many specialist registrars quote “managing rotas”. Is this leadership or management? It could be both. The task is largely managerial, but there may be much persuasion or influencing required to make them acceptable. The reality is that most people will touch upon management and leadership skills to varying degrees at different stages of their careers.

Chambers R, Mohanna K, Spurgeon P, Wall D (eds). How to succeed as a leader. Oxford: Radcliffe Publishing, 2007.