In bringing this brief review of McKenna and Pugno’s lists of leadership competencies to a close, I wish to share what I think is one of their most insightful summaries of what makes a successful leader in contemporary health care. McKenna and Pugno (2006, p. 129) frame this list as a set of “stepping stones” that one should take into account when preparing to be a physician leader:
Stepping Stones to Successful Leadership
Credibility
Successful leaders exhibit competence (skills, knowledge, ability) and character (values, beliefs and behaviors). Credibility is the starting point for anyone who desires to earn other’s trust and respect.
Clarity
Successful leaders provide clear direction; they clearly communicate a compelling vision that attracts others to contribute toward the achievement of that vision.
Collaboration
Successful leaders create cohesive teams of diverse individuals who respect one another and are deeply committed to the purpose they share.
Coordination
Successful leaders ensure decision and actions, resources and processes are aligned with key goals and priorities; they manage and measure the achievement of results.
Change
Successful leaders equip themselves and others with the resilience and the capacity for renewal that are necessary to withstand the pressures of continuous change and the ongoing quest for further innovation and improvement.
While this list of “stepping stones” is certainly “softer” (more relationship-oriented) than the list offered by Birrer, I propose that it provides just as relevant tools (competencies) for mid-21st Century leadership as those identified by Birrer. Many of the “executive” actions to be taken by Birrer require that we first gain credibility, often clarity, engage in collaboration, provide coordination—and most importantly be “equipped” for the change and change curves (Bergquist, 2014) that inevitably are required given the volatility, uncertainty, complexity, ambiguity, turbulence, and contradiction (VUCA-Plus) to be found in contemporary health care systems (Fish and Bergquist, 2023b).
I would also suggest that effective leadership requires the engagement of five best practices. Jeannine Sandstrom and Lee Smith (Sandstrom and Smith, 2017) identified and described these. No one leader in a healthcare system needs to provide all five practices—this is to be the “Christlike” leader that John MacArthur describes. However, one should be aware of the benefits these five best practices serve and ensure that all five practices are provided by one or more leaders in one’s healthcare system. Furthermore, critical, accompanying competencies, values, perspectives, and practices have been identified by McKenna and Pugno–as I shall note in the next essay in this series regarding each of the five best practices. Joined together, the insights regarding healthcare leadership offered by McKenna and Pugno and more general insights regarding the best practices of leadership offered by Sandstrom serve as valuable guides for anyone seeking to provide these critically needed services in our current healthcare system.
