Servant and supervisor: contrasting discourses of care and coercion in senior medical school leadership roles

Abstract

ABSTRACTThis paper examines an important aspect of academic medicine leadership, in which leaders are expected to be highly collaborative yet responsible for organizational control and compliance. Management studies identify two coherent yet competing discourses that shape our understanding of leadership: discourses of coercion and discourses of care. This paradox serves as a useful position for our analysis, as leaders are required to mediate the effects of these contrasting elements. Using discourse analysis of published career advertisements (2000–2004 and 2010–2014), the results indicate coercive and caring formations are embedded and normalized in senior academic leadership roles, and the two competing discourses simultaneously escalated over a relatively short period of time. The dominant discourses are presented in ironic pairs – colleague/controller, professor/police officer and servant/supervisor – to provide a useful nomenclature for illustrating the disconnects in our perceptions of senior leaders. Referring to management theory, we offer guidance for enabling positive coping.