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FRANK JAMES LEXA, MD, MBAPROFILES IN LEADERSHIP

228

aking the Grade: Levels of Leadership, Part 2

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hange Is Coming.Presidential campaign slogan

John McCain, 2008

hange.gov—Name of the official Web site

used in 2008 by the president-electof the United States

Barack Obama, 2008

NTRODUCTION:VALUATING A LEADER

s we have discussed previously inhis column, leadership becomesven more important in times ofhange. Change in the health carerena (and a lot of it, very quickly)as an idea that both major party

andidates shared in the 2008 USresidential elections. With thelection over, that change is nowmminent and will test our leader-hip in ways that few generations ofadiologists could have imagined.

Part of taking the mystery out ofeadership is developing objectiveriteria for evaluating your leader oreaders. At the outset, let us separateeadership characteristics from sim-le numerical goals. Both are objec-ives, but there is a substantial dif-erence in their use and their impactn decisions and outcomes.

At some institutions, the evalua-ion of a leader, along with its atten-ant rewards (or penalties), is basedn quantitative external or internaloals. For example, a hospital admin-strator may get her bonus or promo-ion on the basis of the hospital’s bot-om-line economic performance forhe year. The head of a sales teamay get most or all of his compensa-

ion on the basis of the number ofnits he sold or leased. Even in a not-or-profit, such as a zoo, the leader’sompensation package can be tied toata such as money raised, the num-er of annual visits, membership re-

ewals, or other objective criteria. F

These examples, commonly usedhough they are, are not the kind ofriteria we will discuss in this in-tallment. As we will see, thoseypes of goals, although valuable,o not have the predictive impacte need in times of rapid change.

nstead, we will return to Jim Col-ins’s system, introduced in the lastolumn [1], because of the value itas over the longer term in deter-ining which leaders can work suc-

essfully in stressful times such ashese.

It is important here to take a mo-ent to clarify that the system in-

olves both a person and a position.ome may have what it takes to beevel 5 leaders but are stuck in posi-ions in which they cannot exerciseheir abilities. Some radiologistsay be in positions in which their

obs give them little or no opportu-ity to develop a vision for their

nstitutions, or at least not untilhey move up in their organiza-ions. Because our topic here is thevaluation of those now in leader-hip positions, we will use a work-ng assumption that our currenteaders, the ones we are evaluating,re in positions in which they canchieve level 5 leadership.

We will now apply Collins’s cri-eria to understand what it takes toe an outstanding leader, and weill ask the hard questions abouthy we don’t have enough of them,

t least not yet.

EVIEW: COLLINS’SEVELS OF LEADERSHIP

et’s start with a quick review ofollins’s system for levels of leader-

hip. We will skip level 1, merely aighly capable individual, and level, a contributing team member.

or the general definition of leader- d

0091

hip, these “levels” are really justesirable employees, not peopleho should have designated leader-

hip roles or positions in your orga-ization. For example, a good neu-oradiologist who can read filmsell, contributing to the work of

he practice but doing little else, islevel 1 leader. Those who showore initiative, helping their col-

eagues improve their productivitynd achieve a group’s objectives, areemonstrating level 2 leadershipharacteristics.

For the remainder of the discus-ion, we will focus on the Collinsevels that are more apt for thoseho can or should be in designated

eadership roles: competent manag-rs (level 3), effective leaders (level), and true executives (level 5).ere are some details for each of

hese levels.

evel 3: Competentanagers

competent manager is a leader whoorganizes people and resources to-ard the effective and efficient pur-

uit of predetermined objectives” [2].his is the stereotype of the personosted in a middle managementosition at a Fortune 500 com-any. Such leaders manage a groupr team toward objectives that areet by others elsewhere in the firm,sually above them. These are oftenhe types of annual goals we dis-ussed in the introduction. Theirobs and their performance ratingsre based on how well they meet orxceed those goals and objectives. Inadiology, that might mean reducingeport turnaround time by a certainmount of time this year, or cuttingperating costs by 10% this fiscalear. People in this role may still havefair amount of latitude in how they

ecide to meet the objectives, and

© 2009 American College of Radiology-2182/09/$36.00 ● DOI 10.1016/j.jacr.2008.12.006

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Profiles in Leadership 229

hat is part of the boundary betweenhis level and the ones above and be-ow. These would be practice leadersr chairpersons who take directionrom others and meet those individ-als’ objectives, rather than develop-

ng a vision for the groups or depart-ents they nominally lead.

evel 4: Effective Leaders

level 4 leader “catalyzes commit-ent to and vigorous pursuit of a

lear and compelling vision, stimu-ating higher performance standards”2]. The key differentiator from theext lower level is the element of vi-ion, the difference between meetingpredetermined goal and creating a

ision of where an organization needso go and then getting commitmentrom one’s team. This is the chairper-on or president who has an indepen-ent vision for the practice and where

t needs to go and can rally the troopso improve their performance and,here necessary, make changes to

chieve it.

evel 5: The Executive

his is the type of leader we shouldspire to be or to have at the helm inur organizations. A level 5 leaderbuilds enduring greatness throughparadoxical blend of personal hu-ility and professional will” [2].evel 5 leaders are the kinds of ex-cutives who can put their own egosecond to the needs of their institu-ions. Sometimes people read thisnd misinterpret it to mean thathey are not ambitious leaders.

hat misses the point that their M

ersonal ambition is subsumed intoheir drive for the success of the in-titutions they head. This is unfor-unately the rarest form of leader-hip. Another way to think of this iso think how a charismatic level 4eader both helps an organizationnd limits its growth. As long as therganization can’t grow past the egof the leader, progress and change inhe organization is limited.

Instead, the very best leaders un-erstand that their personal ambi-ions will be met when their orga-izations succeed, not when theirwn egomania and narcissism areulfilled. The first time I camecross some of these concepts wasn a text a bit older than the one were using today. In the Chineselassic Tao Te Ching, also known ashe Book of the Way (putativelyritten by Lao Tzu, 600-531 BC),

3] there is a memorable quotationn leadership: “A leader is besthen people barely know he exists,hen his work is done, his aim ful-lled, they will say: we did it our-elves.” This is the extreme oppo-ite of leaders who create crises theyan then heroically solve. It is aorm of leadership that is as valu-ble as it is uncommon.

PPLICATION

ithin your organization, examinehere your leaders are now. Askourself, “Is this the right person toead?” Can this person become a

ore effective leader? Ask yourselff the leader can move up a level.

ost importantly, is this person

evel 5 material? Take a hard look atour institution to see if there arenvironmental or organizationalhanges you can make to open uphe opportunity (if necessary) toake higher level leadership possi-

le. Always remember that it isoth the position and person.

ONCLUSION

reat leadership is both preciousnd rare. In these times of rapidhange in our field, there will beignificant challenges to the currentractice, and the very future of ourrofession is at stake. Great leader-hip is not a luxury but a necessityn times such as these.

MPLEMENTATION

. Have the courage to evaluateyour leaders.

. Use objective criteria and goals.

. Look at both the person and theposition. Sometimes in our field,the position may limit a leader’sability to lead.

. Ask, “Is this a level 5 leader?” Ifthe answer is no, why not?

. Find, encourage, and facilitate level5 leadership in your organization.

EFERENCES

. Lexa FJ. Making the grade: levels of leader-ship, part 1. J Am Coll Radiol 2009;6:12-3.

. Collins J. Laboratory: level 5 leadership: whatlevel are you? 1, 2, 3, 4, or 5. Available at:http://www.jimcollins.com/lab/level5/p3.html. Accessed February 9, 2009.

. Tzu L. Book of the way. Available at:http://www.brainyquote.com/quotes/authors/

l/lao_tzu.html. Accessed February 27, 2009.

rank James Lexa, MD, MBA, Wharton School, University of Pennsylvania, GCP, 306 Gypsy, Wynnewood, PA 19096; e-mail:exa@wharton.upenn.edu.