By Franz Wiesbauer, MD, MPH - 14th Oct 2018 - The Medmastery show

Building a leader: the 5 levels of leadership

It was just another engagement for Princess Diana the day she changed the world.

Opening the first medical unit in the UK dedicated to treating AIDS, Princess Diana does something so unprecedented, so utterly shocking, that newspapers all around the world are reporting on it in a state of flabbergasted awe: she shakes someone’s hand.

The hand of someone with AIDS, to be precise. Without gloves. Just her hand and theirs.

In a world that was absolutely terrified of going anywhere near someone with AIDS, the last thing you would have expected to see was a royal who not only went near someone with AIDS, but went out of her way to defy the protocols of the day so she could offer skin-to-skin contact.

Diana was known for many things; her fashion sense, philanthropy, and looks, amongst other things. She was well-loved by those who knew her and hailed for her kindness and compassion. But there’s one label that often gets forgotten in all the tributes and glowing reviews dedicated to her: leader.

That day, with her simple act of kindness and compassion, she kicked off the push to destigmatize AIDS in the eyes of the public. She didn’t have to. She could’ve kept her gloves on and no-one would’ve batted an eyelid. But she knew her actions spoke louder than words. She knew she had an opportunity to change people’s perceptions and she took it.

Diana was a leader, in the truest sense of the word. Like many of the great names in history who shook the foundations of the world and had a legacy to show for it, Diana bucked convention and the opinions of those around her in order to make a tangible difference.

Leadership may come in many different forms but at its core, that’s what it’s about: making a difference. Leaders make hard decisions when others won’t. They envision a different future to the one they’re told to aspire to, and rather than just dream about it, they take steps to make it happen. Leaders don’t just accept the status quo. They redefine it. And the world then follows.

Leadership is one of the most heavily discussed, researched, and written about topics in the modern world. There are countless university faculties dedicated to studying it, companies based on nurturing it, and Youtube videos dedicated to inspiring it.

But can a path of leadership be chosen? Is it something you can cultivate for yourself?

The 5 Levels of Leadership

Osler was the very definition of a doctor who rocked the whole leadership thing. Aside from being one of the founders of John Hopkins Hospital, the creator of the first medical residency program, and the first to bring medical students out of the lecture halls and into the hospital, he was also a historian, professor, author, serial practical joker, and prolific mentor.

But before he led, he accepted being led. Far from being the type of doctor that refuses to admit to his own fallibility, Osler was obsessed with learning from those who were smarter than he was. He had many of his own mentors and was a very keen reader, gleaning whatever insights he could from the giants of the past.

First, Osler was an apprentice, a student of medicine and of wise teachers that came into his life at various stages. As he perfected his craft and lived out his ikigai, making individual contributions to medicine along the way, he grew in rank and became an increasingly effective mentor to those around him. Osler recognised that mentoring others would boost his own personal influence and legacy. And he was right. As that influence grew, he soon found himself influencing the world of medicine at large.

So he went through four distinct stages of growth as a leader according to Osler biographer, Charles S. Bryan: apprentice, contributor, mentor, then influencer. Osler wasn’t born into wealth or prestige. He may have shown an aptitude for leadership from a young age but he had to go through the same growing pains to become a leader as everyone else who has made lasting impact has.

This idea of moving through a certain trajectory before true leadership can set in is reiterated by John C. Maxwell, one of today’s top leadership thinkers. According to Maxwell, there are five different levels of leadership that someone can go through to reach the peak of their leadership potential:

Level 1: Position

Here, the aspiring leader is given (or obtains) a position of leadership. They are managers, with subordinates. Chief residents with their interns. Specialists with their support staff. They are given control over others who comply out of necessity. This is the lowest rung of leadership.

Level 2: Permission

This is the first transition into real leadership. Here, people do more than just comply with your orders. They want to follow. The leader now influences with relationships, not just position.

Level 3: Production

Getting results separates the true leaders from those who are simply thrust into positions of leadership. They make things happen and make an impact. They produce results. These leaders not only get people to follow them, they also walk the talk. This is the level that separates leaders who are good at influencing others from those who actually make a lasting impact.

Level 4: Development

Once you prove your worth as a leader, have people who follow your work and your words, and produce results, you begin to transition into the mentoring/influencer realm. You’ve started making an impact and you are now in a position to develop the people around you. You go from making a micro-level impact to building out your influence further afield.

Level 5: The Pinnacle

This is the culmination of four other levels. Here, you’ve made a tangible impact in the world, you built a whole generation of people around you who have grown thanks to your leadership, and now you’re at the highest levels of influence. You make waves wherever you go and build success upon success as you traverse through life. This is the rarest type of leader and according to Maxwell, does require some level of natural aptitude for leadership.

Some of you may already recognize your place on this ladder or wondering how to get on in the first place. As a clinician, you may be wondering how you can nurture your leadership journey within the realm of medicine. Whether you’re the intern or the hospital director, there is one aspect of leadership that doesn’t change regardless of your level of seniority: growth.

How to grow as a leader

The levels of leadership as told by Maxwell may tell you where you are on the leadership ladder but they don’t really explain the personal transformations that occur on your way there. It tells you what you need to do to get to the next level but doesn’t explain how you need to grow to get there.

Self-awareness is critical for personal growth and subsequently, growth as a leader. Maxwell defines the leadership growth journey through five key phases:

Phase 1: I don’t know what I don’t know

You don’t think of yourself as a leader and don’t recognise that you have the potential to become one

Phase 2: I know that I need to know

You discover that you need to learn how to lead so your career doesn’t get bogged down and stagnate

Phase 3: I know what I don’t know

Here, you know that you need to develop a personal growth strategy that identifies your strengths, weaknesses, and opportunities as a leader and begin to work on them.

Phase 4: I know and grow and It starts to show

You begin the daily discipline of personal growth and you commit to the long-term process of becoming an effective person and eventually, an effective leader. You begin seeing results which catapults you further down this path.

Phase 5: I simply go because of what I know

Thoughts become actions, which become habits, which become you, right? This axiom finds its way into various sayings because it’s true. As you commit to growth, the changes become automatic and so too does your leadership. Most people don’t get to this point because it’s hard work. They give up before they see the fruits of their labor. The only way to get to this point is to put in the work and trust the process.

I’m not going to prescribe an exercise or tell you how to become an effective leader because that’s not the point of this article (and there are literally millions of other resources out there that will help you do that). But as a medical practitioner, you have the opportunity to amplify your impact on this world by nurturing your growth and it would be a shame to let it go. You don’t need to become the CEO of a hospital, startup, or pharmaceutical company to have that impact. By committing to a personal plan of growth, you will grow as a person and by extension, become a valuable source of knowledge, insights and wisdom for others. People then follow you and want to do more of what you’re doing because they see the benefit in doing so. And just like that, by working on yourself and making a big impact in your little nook of the world, you inspire others to do the same.

And isn’t that what leadership is?

"As a medical practitioner, you have the opportunity to amplify your impact on this world by nurturing your growth– it would be a shame to let that go"-Click to Tweet