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The Management Moment
Column Editor: Edward L. Baker, MD, MPH
Leadership and Management—Guiding Principles,
Best Practices, and Core Attributes
Edward L. Baker, MD, MPH
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I n previous Management Moment columns, we have discussed a range of leadership and management is-sues. This column is designed as a review of guiding
principles and best practices of effective leaders along
with a discussion of the distinction between manage-
ment and leadership.
There are many definitions of leadership and many
perspectives on what leaders do. John Gardner in his
book, On Leadership, defines leadership as “the pro-
cess of persuasion or example by which an individual
or team induces a group to act.”1 Warren Bennis and
Bert Nanus2 provided a simpler way of expressing the
essence of the 2 processes:
� Leadership is doing the right thing.
� Management is doing things right.
If we consider the practice of leadership, it is useful
to consider what exemplary leaders do1-3:
� Leaders ask good questions.
� Leaders impact the way others feel—usually, people
will remember how you make them feel long after
they forget what you say.
� Leaders emphasize vision, values, and motivation.
� Leaders are system thinkers.
� Leaders have political skills, focusing on external
relationships and trends.
� Leaders think in terms of renewal of the organization
and of self.
Since most leaders are also engaged in management,
it is useful to distinguish between these 2 interrelated
processes. As noted in a previous Management Mo-
ment column,4 we find it useful to consider 4 elements
of the leadership/management continuum:
J Public Health Management Practice, 2014, 20(3), 356–357
Copyright C 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
� Vision
� Strategy
� Operations
� Tactics
Leaders must be skilled at the process of creating a
shared vision and to do so in such a way that other
can visualize it. “A vision is something that you can
see.” In Peter Senge’s5 classic book, The Fifth Discipline,
he discusses the importance of creating a vision that
is shared by others and provides useful perspectives
on how this can be accomplished. Leaders must also
lead the process for identifying and communicating the
broader strategies (“the how” and “the why”) needed
to bring the vision (“the what”) into reality.
Management involves translating strategies into op-
erations. In public health, this step often involves the
creation of programs or projects designed to advance
the process of achieving the vision. Management also
involves identifying and tracking specific tactics (the
details of program execution) that are integral elements
of program operations.
Typically, individuals vary in their competence in
and inclination toward these 4 elements of the leader-
ship/management continuum. Although a leader must
be skilled in fostering a shared vision and in creation of
core strategies, he or she must also understand and
highly value the essential nature of operations and
tactics in realizing the vision. It has been said that
Author Affiliation: Department of Health Policy and Management, UNC Gillings
School of Global Public Health, Chapel Hill, North Carolina.
The author declares no conficts of interest.
Correspondence: Edward L. Baker, MD, MPH, Department of Health Policy
and Management, Campus Box 7411, University of North Carolina at Chapel Hill,
Chapel Hill NC 27599 (elbaker@email.unc.edu).
DOI: 10.1097/PHH.0000000000000063
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
356
mailto:elbaker@email.unc.edu
The Management Moment ❘ 357
“a vision without operations and tactics is simply an
hallucination.”
Leaders will be successful as they become skilled,
sometimes forceful, in practicing these core elements
of vision, strategy, operations, and tactics. But the most
successful leaders also blend these with other core lead-
ership attributes of gratitude, humility, and caring. The
opportunity to provide leadership should be seen as a
gift, not an entitlement. All too often the leader may
feel that he or she should have all the answers. As
noted earlier, leaders should be skilled at asking the
right questions, rather than holding themselves to the
impossible task of being all knowing. Finally, inspira-
tional leaders demonstrate that they care about others,
first, for who they are and, second, for what they can do.
In other works, exemplary leaders regard others first as
“human beings,” rather than as “human doings.”
REFERENCES
1. Gardner JW. On Leadership. New York, NY: The Free Press;
1990. pg. 1.
2. Bennis W, Nanus B. Leaders. New York, NY: Harper Collins;
1985.
3. Baker EL, Menkens AJ, Porter JE. Managing the Public Health
Enterprise. Sudbury, MA: Jones & Bartlett; 2010.
4. Baker EL, Orton SN. Practicing management and leadership:
vision, strategy, operations, and tactics. J Public Health Manage
Pract. 2010;16(5):470-471.
5. Senge PM. The Fifth Discipline—The Art and Practice of the Learn-
ing Organization. New York, NY: Currency Doubleday; 1990.
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
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