Academic Plastic Surgery Leadership

Abstract

Sir: The academic plastic surgeon leader is part of the hierarchy (university linkage) and tends to be identified by position. Peers look to him or her when they do not know what to do, or when they cannot be bothered to work things out for themselves. The academic plastic surgeon leader becomes the focus for answers and solutions; can give direction with emotional stability; has vision and initiative; is strongly motivated; and has ambition, energy, and tenacity. He or she demonstrates desire to lead but not to seek power as an end in itself. Plastic surgery is very competitive. Where there are leaders, there are followers. To lead involves influencing others. Frequently, plastic surgeons will confuse leadership with authority. Authority is often seen as the possession of powers based on a formal role. Leaders can be seen as people who have the right to direct us. They do not simply influence, they also have to show that crises or unexpected events do not faze them. Leaders may have formal authority, but they rely in large part on informal authority. This flows from their personal qualities and actions. They may be trusted, respected for their expertise, or followed because of their ability to persuade. Leaders have authority as part of an exchange, because if they fail to deliver the goods, to meet people's expectations, they run the risk of authority being removed and given to another by those who have formal authority over them. However, we also need to consider the other side, the followers, who knowingly or unknowingly accept the right of the person to lead, and he or she is dependent on this. The leader also relies on followers for feedback and contributions. Without these, they will not have the information and resources to perform their job. Leaders and followers are interdependent. Leaders can respond adequately because they have a clear idea of what they want to achieve and why. Thus, leaders are people who are able to think and act creatively in nonroutine situations,1 and who set out to influence the actions, beliefs, and feelings of others. In this sense, being a leader is personal. It flows from an individual's qualities and actions. However, it is also often linked to some other role such as chief or expert. Not all chiefs are leaders, and not all leaders are chiefs. Chiefs are generally good managers and trained to administer. Leaders are more charismatic and flexible, have creativity, and will innovate. The chief will ask how and when, leaders will ask what and why; chiefs will focus on systems, leaders will focus on people; chiefs will do things right, leaders will do the right things; chiefs maintain, leaders develop; chiefs rely on control, leaders inspire trust; chiefs have a short-term perspective, leaders have a longer term perspective; chiefs will accept the status quo, leaders will challenge the status quo; chiefs have an eye on the bottom line, leaders have an eye on the horizon; chiefs imitate, leaders originate; chiefs emulate the classic good doctor, leaders are their own person; chiefs copy, leaders show originality.2 Finally, followers will recognize leaders for their integrity, self-confidence, professional credibility, personal commitment, quality improvement behaviors, cognitive ability, knowledge, and skills. DISCLOSURE Neither of the authors has any conflicts of interest to disclose. Arturo S. Prado, M.D. Patricio Andrades, M.D. School of Medicine Plastic Surgery Hospital J. J. Aguirre University of Chile Santiago, Chile