Three Kinds of Leaders — Why Health Care Struggles

Master and Commander

Three kinds of leaders populate healthcare leadership.

They look similar, sit at the same tables, and often parrot other leaders. But they could not be more different.

Three Kinds of Leaders

I. Hobbyists

These people find leadership and politics interesting, even titillating, like collecting stamps or trivia.

II. Altruists

These people see leadership as a way to solve problems and improve the world, whether the world wants it or not.

III. Servants

These leaders also want to solve problems, but they work to help, not dictate.

(Dear Reader: Please help me find a better word. I tried to come up with something different than ‘servant’, but could not. Make a suggestion, and we can change the label. What matters is the concept, not the name.)

Hobbyists are often fun. When meetings get raucous, they suggest snacks or libations.

They do not get angry or too serious.

Nonsense in a meeting means nap time.

Hobbyists are benign until coopted to a cause they have not fully considered. Their desire for peace makes them twist and bend to emotion or opinion.

Altruists are sincere, serious, and never sleep. Armed with the purity of their cause, nothing stops their quest for good.

Conviction justifies any means to achieve better ends.

Tireless campaigners, they have little patience to consult those they aim to lead.

They are meliorists: every day is better than the one before. Leadership means progress towards perfection.

Altruists have an unconstrained vision, no problem is too big given the purity of their intention.

Servants see limits, foremost in their own abilities. They know they are a potential problem of any plan they propose.

Where altruists see clear solutions, servants see trade-offs and compromise.

Servants submit to the painful work of considering alternatives, especially ones that seem to make no sense. They work to change minds, starting with their own.

They seek ambiguity and massage it against the knotted problems.

Servants and altruists often agree about issues, but not solutions.

Imperfection

As such, servants fear altruists and remain uncertain about hobbyists.  Servants see hobbyists as mostly safe but also potential converts to altruism. Hobbyists create big problems if they wake up long enough to support tyranny.

To be clear, servants are not faultless. Sometimes servants appeal to service as an excuse just to please people: Service might be a ruse for populism. A servant blown with the wind of popular opinion is almost as useless as a hobbyist and often as dangerous as an altruist.

A servant’s main strength lies in a conviction of their limits.

Visionary Leader?

What about visionary, charismatic leaders? Can leaders force followers out of Plato’s cave?

This is where altruists and servants part. The altruist will insert himself into a power structure and force his comrades out.

Argument and convincing takes too long and often fails. He knows his comrades will thank him eventually, and if not, they would never have been convinced in the first place.

The servant follows the advice of Antoine de Saint-Exupery, author of The Little Prince,

“If you wish to build a ship, do not divide the men into teams and send them into the forest to cut wood. Instead, teach them to long for the vast and endless sea.”

Hobbyists work to survive their tenure. Altruists fill their tenure with urgency and chasing after wind. Servants hunt for leaders who will keep working at all the problems the servants will have left undone when she retires.

So What?

Stating the obvious without a point attempts to fill a void created by our own insecurity.

Leader types matter because leaders can make our lives miserable. But more importantly, types matter because people can change.

Servants can become frustrated. They might use slowness to change or resistance in their followers as an excuse to pursue altruism as an excuse to ‘lead’.

All leaders risk becoming hobbyists, holding the fort until their term ends.

And even some altruists change. Given enough maturity and support in adversity, some people soften and come to respect those they deem to lead.

The most important reason to understand leaders is to know how to lead from behind. All of us, even leaders, are following someone. If we understand leaders, we can encourage them towards serving: Some call it followership.

34 thoughts on “Three Kinds of Leaders — Why Health Care Struggles”

  1. Great post Shawn! We need all three, and ideally there are enough people transitioning from hobbyists to ‘servants’.

    I find it interesting that there is no easy single word for a long term, big picture leader that thinks beyond themselves.

    Makes me think of historical people that took part in building monuments or castles that took generations to build. Dedicated to doing their part for the bigger cause, knowing that they may never see the finished product.

    1. Good thoughts, Rohit.

      You make a solid point about the many good things in selfless, visionary leadership that forged ahead. I only worry that too many modern leaders of this type think nothing of crushing those they lead in pursuit of their cause.

      Thanks again for reading posting! Hope you have a great long weekend.

      Cheers

  2. Great post with interesting insights!

    Too many hobbyists in my neck of the woods. They tend to enjoy hearing themselves speak. They feed on the “networking”. They are easily influenced by group think. And they stick around too long. Some have been sitting on committees for years and years. I believe that they are an impediment to real progress.

    1. Great point. Renewal helps revive organizations for sure.

      How can you help the hobbyists find a new one?

  3. Interesting topic …
    Unfortunately,physician ‘leadership’has too many who are prepared to take administration’s vision and force/cajole/browbeat/nag physicians into incorporating/accepting that vision…..they can be hobbyist/altruist/servant.
    The altruist is most dangerous….agreed.
    Physicians are natural leaders,so have difficulty ‘herding’ other physicians into doing what they don’t want to do …. that’s a good thing with the previous OMA boards as an example.
    Physicians need more independence (like those in European systems)so that they can fill voids in conglomerate systems like ours.
    Now THAT would be visionary ….

    1. Good point about all types being at risk of falling for a failed vision.

      Physician freedom seems to have died. Evidence based medicine’s primary goal was to demonstrate why we were more stupid than we realized. This was good to a point. But it has become an excuse to control medical madness that would reign in the absence of tight reins.

  4. Over the years I think I have been all 3. Sometimes in my role as Servant Leader I lost track of the focus and drive of an Altruist for the sake of building others or was too “hobbyist” to be taken seriously. I think there is value in reflection and good feedback. Maybe it’s about creating an environment for the right mix of all three at the right time for the right work. Maybe there’s a “5 rights” for leadership? Thoughts for a next blog for you, Shawn.

    1. Brilliant comments, Leslie!

      I agree. We often morph depending on the team, timing, and our own internal reserves.

      You aren’t the first person to suggest that there are many more layers we could peel off this topic.

      Thanks so much for reading and posting a comment! Have a great long weekend!

  5. Interesting Shawn . I love your originality.
    From my time in Corporate America and a little from my time in Ontario (OMA) etc , I agree with your assessments .
    Mostly in management we were given personality assessments and told we fitted here or there.
    Oddly , I ended up given a profile I was surprised by but more importantly I saw that all classifications are essentially bunkum.
    Sorry to be so skeptical.
    As party/country leadership contests show are showing all over the world , there really is no way of predicting a leader .
    All the Leadership Forums/Courses I was asked to attend or attended out of interest attempted to mold me .
    I went to them solely to see what the “system” wanted from me!
    as you know Shawn I usually agree with you , but the “servant category” does not exist as well as being “politically incorrect” but of course I love that too . (Canadian Medical Politics need a a bit of a s’ stirring )
    We get the leaders we deserve in my opinion .
    It will be interesting to see who is the next Prime Minister of Canada , in 5 years time the new leadership of the OMA etc (I say 5 years as the OMA still have the hated “Legacy System ” that we almost got rid of completely in the “Young Turk” rebellion and the replacement of the “Old Guard”.
    Best Regards
    Patrick

    1. Great comments, Patrick.

      I like this part especially, “I went to them solely to see what the ‘system’ wanted from me!” We often think we’re being hired because of our wonderful skills and experience, when often we are the right peg for a hole the system needs plugged. That is fair, but less romantic.

      Thanks again for posting!

      1. Welcome Shawn. Keep up the good work . I see there are some great ideas coming forward here so maybe I should not be too skeptical . (There is hope 🙂 )
        Patrick

  6. Perhaps catalysts is a better than servants. They enable change through the people that they lead and hopefully aren’t consumer by it.
    -LD

  7. I like Gerry Goldlist’s “Pragmatist” and Loonie Doctor’s “Catalyst”, but I’ll throw out another idea: “Minister” – not in the religious or popular political sense, but at the roots of both; the word comes from Middle English and means “servant or attendant”. More deeply than this, it derives from “minus” – i.e. less. It strikes me that unlike the other two, this archetypal leader cares less about his/her own opinions and ideas, more about collaboration, fundamental needs and finding a balanced solution. As a physician selflessly ministers to the needs of his/her patient, so should a leader minister to the needs of those he/she serves.

    1. Oh Matt,

      Minister: Fantastic word, “…it derives from ‘minus’ — ie. less.” This is exactly what I was trying to grasp at — something to capture the supporting feature of leadership.

      Thanks again for taking time to read and post! Looking forward to another summary guest post when you get home.

      Safe travels,

  8. I think your cynical side is a bit overactive Shawn. I think there are more kinds of leaders. I would add the dedicated leader, the one who knows the job needs to be done but is clearheaded enough to not throw the baby out with the bathwater in compromise. Those who oppose change will often try and blunt the force of change by seeking compromise that effectively blocks change. A dedicated leader is not selfish and does not want fame, they want to get the job done. Re-direction via compromise must be seen for what it is. True co-operative change is welcomed as long as it serves the main purpose. The dedicated leader fixes problems with a view towards enduring solution instead of election cycle short term goals.

    1. Fantastic comments, Ernest. Maybe “dedicated” was the word I could not find.

      You give a great description of what we hope to find in those who lead us. I only wish we could convince those who don’t get it to agree.

  9. Thanks Shawn
    Great insight and intel….In my experience when an organization has a mix of these three types of leaders the organization flies and does amazing things. When certain attributes are missing…say “altruism” what is the net effect on the organization and what is impact on the “larger system” that organziation sits in? What exactly is the recipe? Does the recipe change depending on size???

    My experience is..when the Leader is a “Servant” (Aka “good human”) they tend to attract and create the recipe…..they are the chefs in the kitchen ….when the leader is not a ” good human” well this doesnt really result in great organizations…
    That’s my experience
    My opinion
    Ian

    1. Excellent comments, Ian.

      Your “good human” makes me think of “mensch” — a person of integrity and honour. How can we bring out those features in those who lead us? How can we encourage ‘good humans’ to run for office and serve as leaders? How can we keep them from becoming sour?

      Thanks again for posting!

      1. Thanks for feedback Shawn…..its. a great question. Running for office has become about money and power. Until those two factors are minimized then we will continue to have the leaders who act in either best interest or the interests of the special interest that supports them.
        Sadly, i think e mpires will need to collapse until we realize what has happened.
        Of course …money is the greatest equalizer…….basic income could be the key to level the playing field, but I’m afraid power and politics will not allow that happen.

  10. Great post and good reflection of what is… I would be interested to read more about what should be… now that we have a picture of today I encourage influencers like yourself to help paint the picture of what should be, what can we learn from other industries, other leader, other governance structures that will give us all as consumers of healthcare services the individual confidence in the system … I mean the fully system is working for me… mind and body… me the tax payers who is ultimately footing the bill and expecting to be taken care of by our Canadian healthcare system… I’m interested in that story…

    1. You nailed the million-dollar question, Tyson.

      Great service starts with a vision, but it is never enough. Because great service pivots in the moment to deliver the exact needs of the one you are trying to serve in real time. This is why central planning is so tough (impossible, in my opinion). Even the smartest people will never be able to design plans that serve the unique needs of the individual in the moment.

      But I take your challenge! I hope to offer a springboard that opens discussion along the lines you want in the future.

      Thanks so much for taking time to read and post a comment!

    1. Great question!

      I don’t know enough about him to say for sure. Maybe others could comment. I see him more as an inventor or futurist than a leader in the usual sense…but again, that probably shows my ignorance.

      Thanks for asking this. No doubt, tyrants often get things done.

  11. Shawn,

    Interesting read as always. I think you should read Robert Greenleaf’s “Servant Leadership”. Like a teacher who is truly learner-centered, Bob felt that a leader could only be effective if he/she truly served the needs of the people in an organization. He was a quaker, researcher, thinker, writer, and very humble guy who had a great impact on AT&T in its glory years.

    Another book for your library is “Leadership Jazz” by the then-CEO of Herman Miller, Max DePree.

    1. Thanks Matt!

      I love books, and you have a special skill at recommending titles I would enjoy. Really appreciate this.

      Sorry for the delay responding. I’ve been working at the cottage. We spray foamed it last fall. Now I’m covering up the super ugly foam with cedar.

      Hope you are enjoying your weekend!

      Cheers

      1. I’m pretty sure it’s safe to apply cedar siding with beer. Lots of beer. And no ladders.

        Happy Canada Day, eh?

        1. Haha! I’m doing Whole 30 this month. Very strict.

          Happy Canada Day back at you!

          Cheers

  12. “They seek ambiguity and massage it against the knotted problems.”

    This beautiful phrase has been working on my mind ever since you wrote this post. It is at once collaborative and subversive.

    It reminds me of Benjamin Franklin, manipulating the legislative process in Philadelphia through the formation of secret debating societies assembling members of different tendencies, to test drive policies and iron out wrinkles before even the supposed contending parties were aware of their existence, and then to orchestrate their introduction on the floor. Now, that was a leader.

    Best Regards,

    Gordon Friesen, Montreal
    http://www.euthanasiediscussion.net/

    1. Thanks Gordon! Very cool comments about Ben Franklin.

      Hope you are enjoying your weekend!

      Cheers

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