Introduction by Croakey: Collaboration, communication and adaptability have proven to be crucial skills among national and health care leaders in efforts to confront the myriad challenges presented by COVID-19.
Leaders who have embraced cooperation, flexibility and empowerment in responding to the crisis have helped to steer their communities away from the precipice of the pandemic.
In The Conversation last month, New Zealand Prime Minister Jacinda Ardern’s pandemic response was described as a ‘masterclass in crisis leadership’.
In Australia, the speedy adoption of a National Cabinet has been applauded, but whether this ‘cooperative regime’ will continue to flourish remains to be seen.
Here, Professor Jennifer Martin of the University of Newcastle, explains why she hopes the ‘softer’, collaborative leadership approaches adopted in health care, and a new generation of medical leaders, are here to stay.
Jennifer Martin writes:
‘Leadership’ has too often been equated with leadership titles in health, politics, universities and industry.
What we are seeing with COVID-19 is the emergence of a usually less overt leadership style that increasingly values human-focused leadership skills and activity. This style is exemplified by the leaders of New Zealand, Germany and several of the Nordic countries, and contrasts with the leadership style in the US.
Skills of communication, teamwork, decision-making, problem-solving and empowerment – often called the ‘softer’ leadership skills – will be needed to lead complex teams to tackle unusual challenges.
In lesser challenges, depending on the organisation, this valuing of people, intrinsically and also for their skills in different spheres, has helped overcome problems in fixed management and bureaucratic systems to maximise societal outcomes.
Beyond the title
This contrast between leadership skills and leadership positions is no more vivid than in the way in which leaders across the world are coping with common health challenges of COVID-19. This is particularly so in countries where health leadership has been enabled to rise to the challenge, supported by state and national political leadership.
Only time will tell which approach is the more effective in protecting the community’s health. At this stage, however, New Zealand and Australia appear to be on track to eradicate the virus, at least until the international borders are reopened, with the countries together seeing only 123 deaths.
Both countries have adopted a collaborative leadership style with health and have appreciated that a high performing economy requires a healthy – and alive – workforce.
Debates around whether health drives the economy or economy drives health will require further academic interrogation post pandemic to ensure we are prepared for the next one.
From experience, as a physician and leader of multidisciplinary academic teams and programs, healthy, well-trained, flexible and adaptable people are our biggest asset, without such there are big problems for the economy.
Working as a physician on the front line of COVID-19 gives an opportunity to reconsider what the role of a leader is in health, in the absence of formal leadership positions, and how such leadership titles may not enable the flexibility and adaptability to human progress and health outcomes needed in crises.
Australia’s public health system is facing one of the biggest medical challenges I can recall in my practicing career.
From medical student teaching and exams to be held offline, to making contingency plans for final-year students to be competent to back up a sick or exhausted junior doctor workforce, change is already required and starting to happen. The COVID-19 crisis has also seen physicians rework their methods of practice, changes to patient flow through hospitals, elective surgery reduced or ceased, and surgical wards and theatres used for medical patients.
We are also initiating, often for the first time, teleconferencing of team and multidisciplinary meetings, we have ceased clinical teaching for students, junior doctors and physician trainees, potentially stressing the future health workforce needs.
The variety of leadership skills in society needed here is clear, and we are hoping that emerging leaders step up. On the positive side, this may be an opportunity for some long-lasting changes in the way we lead and deliver health.
I hope the following wish list can be considered for publicly funded health service leadership going forward:
- A new generation of medical leaders that has emerged in this pandemic is given opportunities to lead and introduce the softer skills into health care, to engage a larger population in leadership for the future.
- A consideration that age is not always correlated with being a good leader. Promotions to leadership positions and their turnover needs to be more frequent and transparent than current promotional decisions.
- Working in one health jurisdiction for a lifetime has been helpful in the past, where allegiances and trust have been developed between people. But unless new or alternative ideas have a safe space to be raised, particularly in a crisis where new ideas are needed, there may be difficulty with flexibility and adaptability that could have direct effects on patient care. Engagement and consensus with experts and teams outside can also benefit from diversity.
- Consideration and use of alternative leadership skills in the health workforce need to be mandated.
- Being good at one’s job is not the same as having the skills to lead. Job descriptions for leadership roles need to be able to interrogate such skills.
- More discussion regarding professional attributes of a doctor and individual patient care versus the trade-offs with public health and public service directives are needed.
Overall, although this is a major health crisis, the likes of which many have not previously witnessed, there are opportunities for leadership, and for innovative and creative solutions to emerging problems.
Being open to critical scrutiny of such suggestions helps younger leaders develop, and often provides inexpensive and efficient solutions to problems facing health.
These opportunities should be encouraged, the challenges of the current system documented, and an emerging generation of leaders supported into more formal leadership roles after the pandemic.
Professor Jennifer Martin is Chair of Clinical Pharmacology at the School of Medicine and Public Health, University of Newcastle.