How To Be A Leader

By Alex Lickerman, M.D.

Created Nov 23 2009 - 8:09am

In 2001, just as I was about to take over as Medical Director of Primary Care at the University of Chicago, I expressed reservations to a previous Director about my ability to run a clinic that included several clinicians who were not only older than I but who had actually been my teachers ten years earlier. What she said in response did more to shape my tenure as Director over the next seven years than any other advice I ever received: "What people really want," she told me, "is leadership."

We all want our doctors to be "the best" (if such an animal exists); we want our nannies to convince us our children are safe with them; we want our friends to give us sage advice and support that makes us feel as if we can do it (whatever "it" may be); we want waiters and waitresses to give us great recommendations about what to eat ("leading the table" my wife, the foodie, calls it). In short, we all want our lives to be populated with great leaders. Not people who tell us what to do but people with our best interests in mind who guide us expertly—even when we think we don't (as toddlers actually want their parents to lead them even as they protest being denied their wants).

Which means we all have the ability to provide leadership in some way: as professionals, as parents, as spouses, and as friends. To find a reason to want to lead we only need remember that when we provide leadership, we create value. And value creation creates happiness. Few things bring as much satisfaction as a job well done.

All people in formal leadership positions, myself included, occasionally look around in the middle of whatever they're leading and wonder to themselves why anyone would let them be in charge of anything ("I mean, I'm just a kid..."). And yet what I've learned from being a leader is not only that absolutely anyone can provide leadership, but that the attributes that make a great leader in a formal, corporate setting also make a great leader in life.

In my view, then, to be a great leader you must:

1. Be confident. Requiring an entire post unto itself, suffice it to say for the purpose of this post that a world of difference exists between saying, "I don't know" nervously and uncertainly and saying "I don't know" confidently. To say "I don't know" nervously and uncertainly communicates incompetence. To say "I don't know" confidently not only communicates competence but also that it's perfectly acceptable that you don't know the answer to the specific question you were asked. I listen to medical students say "I don't know" all the time. The ones who say it confidently do tend to be more competent than those who say it nervously and uncertainly. Not knowing something doesn't make you a bad leader. Allowing that lack of knowledge to sap your confidence, or worse, not having confidence in the first place, does.
2. Be kind but firm. Being a leader means having to set boundaries, but boundaries can be set angrily and condescendingly or gently and compassionately. Do it gently and compassionately and people will not only respect the boundaries you set but you as well.
3. Be an expert. However long it takes, whatever you have to do, know what you're talking about. Don't ever try to fake content knowledge. If you don't know what you need to know, find it out.
4. Be decisive. A great leader listens to a diversity of opinions, asks probing questions, debates issues, challenges positions---but when the time to discuss and debate is over, makes a decision and moves on.
5. Be willing to have people disagree with you. If you're setting appropriate boundaries and taking strong positions, some people may not only disagree with you but actively dislike you. But that's more about them than it is about you. Don't take it personally.
6. Know when to spend time building a consensus and when to make an executive decision. Sometimes everyone (or almost everyone) involved needs to agree before progress can be made. Other times waiting for a consensus risks failure. Learn to recognize when it's time to take over.
7. Have a vision. A vision that excites the people who follow you, that inspires them in such a way that they perform (or want to perform) at a level they didn't know they could.
8. Care about the people you lead. Genuine concern is always perceived and appreciated—and far more motivating than any punitive measure could ever be.
9. Mentor people. Great leaders always have people who want to learn from them. Someone is always watching you, whether you realize it or not. If you're ever unsure about what decision to make, think about what each of your choices will teach the people around you. Try to pick the choice that demonstrates the greatest virtue.
10. Fully visualize every repercussion of each of your decisions in advance. Plans often fail because of unforeseen consequences. Follow the predicted results of your decisions into every nook and cranny and take a 360 degree look around in your mind. The more concretely you can do this, the more likely you'll be able to predict results no one else can.

Prior to my becoming the Director of Primary Care, I couldn't really have said why the quality of the leadership in an organization actually mattered, thinking as I did that the people on the front lines were the ones who did most of the real work. Though I still believe that to be true, I now understand that without quality leadership the environment in which those front line people perform will often become poisoned, sometimes dramatically impairing the quality of their work. The only antidote available for the poison of a poor leader (other than replacing him) will then be the quality of the leadership of the front line people themselves. I was reminded of that lesson every time I made a poor decision and learned I was actually leading a group people who were far better leaders than I.