In their exploration of leadership among physicians, McKenna and Pugno (2006, p. 59ff) not only introduced the DISC model of leadership and provided richly insightful quotations from practicing physicians regarding leadership, they also provided concepts from other authors and results from research they conducted regarding the competencies most valued among physician leaders. In focusing on competencies, McKenna and Pugno look at knowledge, skills and abilities. These are all competencies that can be learned through training, education, and ongoing experience in preparation for and while serving as a physician leader. Alongside competencies, we find character in the writing of McKenna and Pugno. While character usually refers to attributes such as ethics, consistent alignment with certain values, and enduring commitment to certain actions, many of the physician leaders that McKenna and Pugno turn to will provide a list that includes both competencies and character.
While it is common and appropriate to intermix competencies and character (since they are often closely connected to the actions taken by leaders), it is also important to note that Character is often not learned. Like personality, the character we display in our lives often is either inherited or formed early in life. It is also molded, in part, by the culture in which we live. We can offer courses on ethical behavior (and might even mandate them in our organization): however, the actual engagement of ethical behavior (especially under stressful conditions) will often abandon some leaders—unless there are specific incentives or penalties associated with engagement or non-engagement of this behavior. We know that perspectives on ethics and the acquisition of accompanying values can evolve (Kohlberg, 1984; Gilligan, 1982; Gilligan, 2023); however, some people (and some leaders) never seem to move beyond an early stage of development concerning ethics and values (Perry, 1970).
These reflections on competencies and character are being offered because the mixture of these two elements of leadership can often lead to confusion regarding the goals of a leadership development program or, more broadly, the assessment and modification of ongoing leadership performance. Certain elements of leadership can be learned and modified (given useful feedback). However, other components are much more difficult to influence and often provide some of the greatest challenges concerning the training and education of leaders and their initial selection.
