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e choose to go to the moon. We choose to goo the moon in this decade and do the otherhings, not because they are easy, but becausehey are hard, because that goal will serve torganize and measure the best of our energiesnd skills.

—John F. Kennedy

NTRODUCTION

ne of the oldest arguments abouteadership focuses on whether it isossible for leaders to be both suc-essful and ethical. Can they followrinciples in a highly competitiveorld, or do they need to play dirty,end rules, cut corners, and so on, toin? As the second decade of the 21st

entury opens, people across nations,ultures, and industries are suspicioushat winners, particularly in businessnd finance, are guilty until provennnocent. As the world recovers fromhat is now being termed the “Greatecession,” there is a strong senti-ent that principles and ethics have

ad little to do with successful leader-hip. Although there is some truth inhis viewpoint, the world has nevereen completely black or white. Fur-hermore, because I’ve worked withy share of the ethically challenged, I

on’t have illusions that cheaters al-ays lose and that principled individ-als always win.

In the short term, sometimes badehavior succeeds. However, forhose of you who adhere to reli-ious, moral, or ethical values inour work lives, there is good news.onger term success is more likely

or leaders who adhere to principlesnd can follow through with them.

TART WITHTEWARDSHIP

n considering what guiding princi-les you should lead with, begin withhe long view. If you are looking to

eave a legacy, you will seek principles l

010 American College of Radiology1-2182/10/$36.00 ● DOI 10.1016/j.jacr.2010.03.022

hat take you along the high ground.eople who can think only abouthort-term gains and who are lookingut only for themselves are moreikely to look for short cuts and breakules if they think that they can getway with it. However, if you con-ider yourself a steward of a worthynterprise or institution, then youroncerns will include that legacy.reserving and protecting that long-erm value is both more difficult butlso much more rewarding.

EADING WITH A PLANS FAKING IT

culture of principled decisionaking will also be a bulwark when

he hard decisions arise. Everyeader is eventually confronted withituations that fall into the grayones. Every time I go to a meetinguch as the ACR’s AMCLC or thennual meeting of the Radiologicalociety of North America, I heartories from leaders in our field whore facing things they felt theyeren’t prepared for. All of us

truggle with things that weren’t inur training, our classes, or anyextbook. Occasionally, the rightnswer is also the easy one: ask youruman resources expert or your

awyer. In many circumstances,owever, those people can only ad-ise, and you still have to sweat itut yourself. Having guiding prin-iples is the only way to get past thefaking it” style of some leaders.rinciples are part of your plan, and

eaders need to have plans. Grown-ps can’t just come into work andwing it” and hope that they will suc-eed. The stress of the times that were now living through makes it al-ost impossible to thrive for very

ong without detailed planning. t

HE LEADER IS SPECIAL

ormer NBA star Charles Barkleynce said, “I’m not a role model.. . Just because I dunk a basketballoesn’t mean I should raise yourids.” Although some politiciansnd sports stars make remarka-ly bad role models, for better ororse, most leaders are held up as

xemplars. At the local level, this islso true for you in your group orepartment. As the leader, yourersonnel will look to your exam-le. This is particularly true fororal and ethical guidance. If you

re seen as unethical and hypocriti-al, then you shouldn’t be shockedhen that behavior starts to perme-

te your organization. Professionalsre supposed to have a strong inter-al compass, but there is still atrong tendency even among sea-oned physicians to look aroundnd see what the leadership is do-ng. If the rules are bent by those onhe top, the outcomes are likely toll be poor. Usually this is a combi-ation of either becoming pro-oundly cynical and dysfunctionalr following the leader down thelippery slope of bad actions.

Because you can’t possibly over-ee every decision in your organiza-ion, you should be very concernedbout the ethical culture in yournstitution. As a leader, you are set-ing that tone and example for ev-ryone. Be concerned about smallnfractions because these may leado other people acting ever moreuestionably. As a leader, you willave to clean up the mess if yourembers do things that are over the

ine. Remember every day that youre setting an example. You mayesent this, but it comes with the

erritory.

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530 Profiles in Leadership

HOM DO YOU TRUST?

eading by example and using prin-iples to guide your professional lifere essential to successful leadership.roups are built on trust, and your

rustworthiness as a leader is the cor-erstone of building a team that canin. All groups require commitment

nd some form of sacrifice. This isossible only if the leader has the in-egrity to inspire trust and confidencen the rest of the group.

I’d like to share several pieces ofard-won wisdom that I have both

earned myself the hard way andeard repeatedly from many leaders

n our field. The first is to be carefulhat you promise. Of all the sins of

eaders, one of the worst is to break a

romise to a colleague. You will be i

een as either a liar or a fool. How youandle it determines which of thoseredominates, but either way, youave blundered very badly. The sec-nd is that this shouldn’t make youverly cautious, wandering throughife never making bold plans. Greateaders need to make promises. Thereatest are remembered for makinghe biggest promises. Finally, whenou stick to your principles and havesetback, remember that all great

eaders do fail from time to time, soove forward, explain, be honest,

nd start to rebuild. In difficult times,am reminded of the quotation fromresident John F. Kennedy thatpens this column. Doing greathings is usually quite hard, but that

s why they are worth it.

UMMARY

. Leadership is not just a set ofactivities; it is also about visionand character.

. Principles matter: for you, foryour coworkers, and for thegroup or institution you serve.

. Individuals and groups can suc-ceed only through a climate ofcommitment and trust. Your in-tegrity and principled leader-ship are the cornerstones forbuilding an effective team.

. Following principles doesn’tmean that you will win everytime, but having a plan andsticking to it even in toughtimes is a strong element of

long-term success.

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