We all talk about it, read about it, even try to develop it . . . but what is “leadership”? What makes a great leader? Are we born with it? Do we learn it? Does it require age and experience, or is it an inherent ability to trail blaze in the absence of precedence?

Having just completed the inaugural ASCO Leadership Development Program and the Executive Leadership in Academic Medicine (ELAM) program, (both of which are excellent, by the way), I continue to be fascinated by these questions.

One of the best definitions of “leadership” I have come across is from BusinessDictionary.com:

“In its essence, leadership in an organizational role involves (1) establishing a clear vision, (2) sharing (communicating) that vision with others so that they will follow willingly, (3) providing the information, knowledge, and methods to realize that vision, and (4) coordinating and balancing the conflicting interests of all members or stakeholders. A leader comes to the forefront in case of crisis, and is able to think and act in creative ways in difficult situations. Unlike management, leadership flows from the core of a personality and cannot be taught, although it may be learnt and may be enhanced through coaching or mentoring.”

Leaders come in all shapes and sizes, from all walks of life, of all genders, races, religions, creeds, and sexual orientations. Leadership is not limited by age, physical ability, economic circumstances, political views, or social situations. We can all think of leaders who came from a variety of backgrounds, who overcame seemingly insurmountable challenges, to achieve remarkable ends. Chronological age, to my mind, is neither a necessary nor sufficient criterion for leadership. While certainly experience and maturity are great, there are plenty of examples of enduring leadership that has taken advantage of the dynamism, energy, and creativity of youth (just look at Bill Gates who started Microsoft at the age of 20, and John F. Kennedy who became U.S. President at 43).

So what makes a great leader? One of the largest one-on-one CEO interview studies was recently completed (“2010 Global IBM CEO Study”), in which 1,541 CEOs, general managers, and senior public sector leaders from 60 countries and across 33 industries were surveyed. Here’s what they thought were the most important leadership qualities that would be required over the next five years: creativity, integrity, global thinking, influence, openness, dedication, focus on sustainability, humility and fairness. Some of you may think “that’s business, this is ASCO,” and while it’s true our mission is different than many for-profit industries, I would submit that many of these leadership traits cross disciplines and will be equally relevant to us.

How do we ensure our leaders have these traits? In other words, is leadership something you’re born with or is it teachable? In my view, it’s both. There are some things that just cannot be taught – integrity, humility, fairness, and discipline are inherent traits, which you either have or you don’t. On the other hand, some things require training and experience – we can learn strategic planning, organizational structure, financial models, and global thinking/sustainability. I suppose you could think of leaders kind of like diamonds . . . they are the result of the combination of the right quality raw materials that are subjected to the right conditions (often involving high pressure and a lot of heat!) to unlock their inner brilliance. Ultimately, they all shine brighter when appropriately polished and placed in a setting that showcases their strength and beauty.

ASCO realized (much to their credit) that cultivating leadership, particularly among the younger members of the society, is important – these are the people who will lead the organization into the future, and it behooves us to ensure that they are well-prepared for the challenges ahead. It was a true pleasure and honor to be among those chosen for the inaugural class, and I think it was a phenomenal experience. But I’d be interested in knowing what you, the membership, think. What are YOU looking for in the next generation of leaders? How would you ensure their success? What does “successful leadership” look like? After all, this is YOUR organization, and you should make your opinions known.



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Robert S. Miller, FASCO

Jul, 12 2010 9:26 PM

Your essay summarized well so many important qualities of leadership. I would add empathy as an attribute - the ability to understand what someone is feeling or experiencing. While the word implies a certain emotional context, that is not necessary. To me an empathetic leader is someone who has the ability to take the issues of someone whom he/she leads and treat those issues as if they were his or her own. That is not to say that it means the empathetic leader lurches from issue to issue or strays from the collective goals of the organization, but rather has the ability to move in and out of character and feel the same degree of pride, indignation, fear, etc. that another feels.

Michael Jordan Fisch, MD, MPH, FASCO

Jul, 28 2010 2:46 PM

This blog about leadership really resonated with me. It made me realize that while I have various conceptual models in mind to help me navigate complex topic areas (quality of life, suffering, personalized medicine, etc.), I lack such model when it comes to leadership. Yet leadership is so intrinsic to our role as physicians that it seems absurd that such a gap would exist. But the good news is that Dr. Chagpar's essay fills this gap, particularly with the excellent definition of leadership.

Too often, it seems that leaders act as individuals who feel their appointment or election makes them primarily responsible for a certain scope of things, and they perceive that they are entitled (or expected) to exercise their authority to fulfill their responsibility. Under conditions of this more narrow view of leadership, important attributes such as creativity, integrity, openness, humility, and fairness can fall by the wayside. To me, leadership is every bit as challenging as the notoriously difficult act of hitting a baseball. Leadership requires an awareness of one's own attitude, approach, intensity, and toughness. In this case, "toughness" refers to the ability to maintain the proper attitude, approach, and intensity in the face of adversity. And sustaining leadership skills requires ongoing feedback and coaching. This helps us notice and make adjustments when we develop a "hole in the swing" (which happens from time to time, inevitably).

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