Authority in Leadership – you need a balance to see success.
As practice owners, we are in a position of authority, and how we choose to use that authority in leadership will directly impact the nature of our practice culture.
Doctors and practice managers who rely on their authority alone can create highly productive practices, but how sustainable are cultures driven by authoritarian leadership? Furthermore, how does our staff react to authority?
For example, authoritarians may have highly productive staff, but staff respond to authoritarians and their directives out of fear. The job is getting done according to the doctor’s directives, but a culture driven by fear is a culture of compliance as opposed to commitment.
Compliant cultures tend to stagnate over time as team members lose their will to think independently and no longer offer creative feedback that is vital for practices to thrive. It has been our observation that cultures of compliance are unstable, unsustainable, and are typified by blame, low staff morale, and increased turnover.
Influencers are a different breed of leaders.
Like authoritarians, they can create highly productive practices, and a casual observer would have trouble distinguishing between the two types of cultures. This is where the similarities end, however.
A more discerning observer would quickly and easily notice significant differences between the two leadership styles and the cultures they create. Whereas staff submit and comply with the directives of an authoritarian out of fear, the followers of an influencer act out of trust and their belief in the leader. Their culture is one of commitment and is typified by collaboration, cohesiveness, shared values, and their belief in a well-defined future vision.
To be clear, there are significant distinctions between “authority” and “authoritarianism” that must be recognized. Authoritarianism is defined as tyrannical, autocratic, and even dictatorial whereas authority is defined as the power to give orders or make decisions.
Being in a position of authority in leadership, like practice owners or office managers, has many benefits, not the least of which is the ability to act quickly on decisions and effect change. Leaders who combine their authority with a high degree of influence are by far the best leaders and get the most out of their followers. Numerous studies have validated this assertion.
The sad and unfortunate truth is that many doctors and managers would prefer to be influencers but operate as authoritarians due to a multitude of blind spots. Simply put, many of us are unaware of how we show up for our staff, and we fail to see alternative forms of leadership that would better serve our needs and the needs of our staff.
To this point, the greatest service a leadership coach can provide for a client is to facilitate a high degree of personal self-awareness.
As we become more self-aware we are able to adopt a more realistic vision of how we show up for others. Assessments like the Leadership Circle Profile 360 are valuable aids in developing personal self-awareness. These assessments are often the very first time doctors/managers get to view their leadership through the eyes of those they lead.
We get a close up view of ourselves from the other side of the mirror and learn what our followers view as our strengths as well as our reactive tendencies that are creating barriers and diminish our influence with our staff. Armed with these valuable insights we can work to diminish our reactive tendencies, leverage our strengths, and expand our influence; all of which can occur simultaneously.
The day of the command-and-control authoritarian leader is long past. What may have worked during the industrial revolution is at best no longer effective and at worst extremely destructive. Societal changes have altered the nature of effective leadership over time, and those of us that remain stuck in an authoritarian mindset do so at our own peril.
Influence now trumps authority in leadership but combining both is the secret sauce to becoming the very best and most effective leader.
It is important to realize that authority in leadership is not a prerequisite for influence. Anyone can be an influencer no matter what position they occupy. Some of the most influential people in healthcare practices hold no position of authority, yet their co-workers and even their doctors will seek their counsel and look to their input and guidance when making important decisions. Doctors and office managers should consider seeking buy-in of their team’s influencers before introducing change to their staff. These are the people that will most likely determine how change is perceived by the entire team. Making influencers early adopters of a change initiative will often determine whether it is successful or not.
As an exercise, take a moment to reflect on the most impactful people in your lives; those that helped shaped who you are. Were they authoritarians or influencers? What are you bringing forward into your current reality because their impact? You can bet that there are some aspects of their impact that are being manifested in your leadership. Which of these manifestations do you want to keep, and which would you like to discard? Sometimes leadership is as much about letting go as it is about acquiring new skills.
Letting go of an authoritarian mindset would be a wonderful first step in becoming the effective leader that you are meant to be.
At Line of Sight Coaching, we have created a quick ten-question self-assessment Leadership Quiz. Take this opportunity to gauge your leadership effectiveness and get an answer to the question…”Have you ever wondered about your ability to lead?” Take our Free Leadership Quiz.

Dr. Joel Small and Dr. Edwin McDonald, the founders of Line of Sight Coaching, are dental practitioners, authors, speakers and Business Leadership Coaches who work with healthcare professionals to help them build more successful practices so they can live the balanced life they seek.
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