I used to be CHRO for 1700 HR specialists. Each of those 1700 people was expert in something, and they knew more than me. In my team I had experts who new more about Comp & Ben, Talent, Facilities, Communication, Safety and Prevention, Customer experience, … than I did.

Even though I had (and have) some expertise, in daily life and in comparison to the “real” experts, a leader is quite ignorant.

When you don’t know what people know, how can you lead them? Some people suggest that you should start studying. But that seems a lost battle, you will never catch up.

Promoting the Expert

So, many organisations resort to promoting the best expert to manager. But that is then often a dead end. Being the expert is not a guarantee for being able to lead other experts.

Many experts feel uncomfortable in many aspects of leadership. They feel they have not been trained for this. Or they feel that the time to lead people, keeps them away from their work as expert. Management is seen as a burden, a nuisance.

Physician Leadership

One of the clearest examples of this is physician leadership. Teams of medical doctors are led by a colleague, who is often elected. There are many reasons why a physician is candidate for a leadership role. Not all of these reasons are positive. Sometimes there is nobody else. Sometimes they feel forced to do it.

And the context is not always supportive either. Sometimes a physician leader is not compensated for the time they spend. Sometimes colleagues monitor the leader’s activities and criticise the time they spend on managerial activities: every minute that is spent on management is not spent in clinical activities.

Also the organization might have difficulties with the physician leaders. A hospital is composed of many people with different backgrounds: physicians, nurses, paramedical professions, psychologists, administrative personnel. As physician leaders are elected by their colleagues, it means they are not selected. The head physician might try and influence the choice, but nevertheless they are confronted with the result of a democratic but sometimes cumbersome process.

Moreover, physicians are independent and do not “take instructions”. If a hospital wants to develop its leadership and culture, it can only do so by getting the buy-in of the other physicians. As nurses are in practice led by both physicians and head nurses, they are possibly confronted with two types of leadership. That does not make it easier.

So the least one could say is that there is a risk of some tension.

So How Does One Lead Experts?

Most people are experts in what they do. Some are so by degree, others by experience. People want to be an expert in something. Being competent in a field of work is motivating.

And probably understanding that is the key to leading experts. They are motivated by being good at what they do. They thrive when they perform a service that corresponds to or is even superior to the current professional norms.

Making mistakes is always hard to take. And especially in medical environments where mistakes can have catastrophic results, the standards are high. But mistakes are inevitable.

Leadership is Another Expertise

How does a leading physician tell his colleague they should do it differently? How do they deal with mistakes? How do they inspire colleagues in a certain direction?

These are tough questions. Some leading physicians call themselves “primus inter pares”, the first among equals. Still, they might be very reluctant to intervene and therefore they limit themselves to budgets, lunch meetings, information sessions.

And like in any other environment, they need to understand that leadership is not easy.

Physician Leadership is Difficult Anyway.

The truth is that many physician leaders feel incompetent as leader. They are not as thoroughly trained as leaders as they are as physicians. And dealing with people might be harder for them than performing a complicated surgery.

But I can always reassure them. Nobody is trained for leadership. Leadership, like parenthood , is not learnt in a classroom but learnt by being a leader. Training is useful, but does not avoid that they have to go through a personal development process.

And that’s the biggest challenge for an expert. There is no absolute science of leadership. Leadership is very contextual. And everything people know is at best probabilistic. This is hard for an engineer or physician to accept.

And I get often the question: why don’t people do what they are supposed to do?

And that question, is vital for every leader.

Learning from Other Professions

It’s good to look beyond the own profession. Physician Leaders could learn a lot from experts who are leading in engineering. Or from the performing arts.

Otolith invited conductor and musician Bart Naessens to discuss the challenge of expert leadership and leadership expertise. Bart is a renowned conduct-tor and continuo player. He is facing exactly the same problems as other expert leaders in other fields. Confronted with an orchestra of expert musicians he has to lead them towards a certain musical performance. He depends on their expertise as violinists, flutists, harpists, …

It’s not by barking instructions that he will motivate musicians to go along with his vision, like it’s not by barking medical instructions that a medical doctor will win the hearts of the nurses. And it’s not by treating the cleaning staff like dirt, they you will motivate them to keep the operating theatre bug free.

It’s about humanity

So, if leaders can base their leadership on empathy, kindness, fairness, reciprocity instead of on position, power, pressure or popularity, they will win.

By doing it like this, leaders will inspire trust and psychological safety. And that is what it takes to increase the leadership impact for any leader.

Growing the Impact of Physician Leadership

But this is not as easy as it sounds and sometimes goes against convictions, assumptions or training experts have undergone.

But what if many of those assumptions would weaken the position of a leader? Could you think of a balance between what you know as an expert and what you do as a leader?

Could we imagine that leading the group of fellow physicians could make it better for all of the group? Could we design a solution that balances all expectations (as well as possible)?

And could we help physician leaders to develop certain skills and the courage to lead other physicians without worrying about how that may come across? Primus inter pares expresses it well/ It’s “inter pares”, amongst or with the others, but it still is “primus”.

And that is valid for all leaders. they all struggle with balancing these aspects of leadership and how to have a positive impact on the group.