Leadership vs. Management in Health Care: Key Distinctions

Leadership and Management in Health Care: Core Distinctions

The main difference between leaders and managers is that leaders have individuals who follow them, whereas managers have individuals who work for them. Getting people to understand and believe in your ideas — and then working with you to achieve shared goals — is leadership, while managing is more concerned with directing and ensuring that daily activities run as expected (go2 Tourism HR Society, 2015).

Management and leadership are both vital for good health care delivery. While the two are alike in some respects, they incorporate different behaviors, skills, and outlooks. Good managers should strive to become better leaders, and good leaders require management techniques to be effective. Leaders envision what is attainable, communicate that vision to others, and develop strategies to achieve it. They inspire individuals and are capable of negotiating for resources and other support needed for goal achievement. Managers, meanwhile, must ensure that available resources are well organized and properly applied. In the resource-constrained and demanding environments of many low- to middle-income countries, a manager must also be a leader in order to achieve the best outcomes (Burke & Barron, 2014).

Leadership in health care is therefore not a luxury — it is a core organizational function that shapes the quality and sustainability of care delivery at every level.

The Impact of Insufficient Leadership on U.S. Health Care Policy

Managers in public hospitals often lack final decision-making authority. National policies tend to be rigid, and flexibility to respond to local circumstances is frequently not permitted. Health ministries may develop universal policies for the entire country without adequately accounting for local factors. A manager may lack sufficient authority to change such policies and can only adapt to them.

Managers in health care also need greater authority in identifying and recruiting suitable employees to deliver quality services. As one perspective holds, if managers were empowered to recruit competent staff, many systemic problems would be resolved. Furthermore, managers frequently lack the authority to oversee physicians in the same way they oversee other workers — a structural gap that limits overall organizational effectiveness (Mosadeghrad, 2014).

Types of Health Care Consumers

Health care systems serve distinct categories of consumers, each with different roles and expectations:

Macro consumers are the primary clients of health care at the systemic level: insurers and government bodies. Because they pay for care, they function as clients in the sense that they hold high expectations for the product — that is, the care delivered — and are positioned to influence how that care is structured and administered.

Micro consumers are individual patients. Patient families and other involved parties also function as micro consumers when the patient acknowledges their role in care decisions and the care process itself (Finkelman & Kenner, 2015).

Defining Health Care Quality

The most widely cited and enduring definition of health care quality was developed by the Institute of Medicine (IOM) in 1990. According to the IOM, quality encompasses the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge. For the purposes of broader discussion, this definition has been expanded: quality comprises the degree to which health services increase the probability of desired health outcomes (quality principles), are consistent with current professional knowledge (practitioner skill), and meet the expectations of health care users (the marketplace) (Buttell, Hendler, & Daley, 2008).

Factors that may cause definitions to vary: Health care quality has several competing definitions. The traits that are emphasized differ depending on the perspectives of the stakeholders involved in crafting the definition and on how the definition is intended to be applied (Woodward, 2000).

Features common to most definitions: Quality care definitions generally include traits such as usefulness, competence, impartiality, comprehensiveness, appropriateness, and tolerability. Additional factors used to characterize quality health care include patient and family awareness of relevant health concerns, patient and family involvement in treatment planning and decision-making, and overall patient satisfaction (Woodward, 2000).