Building a leader—the five 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 patients with AIDS, Princess Diana did something so unprecedented, so utterly shocking, that newspapers all around the world began reporting on it in a state of flabbergasted awe. She shook someone’s hand!

That hand, to be precise, belonged to someone with AIDS. She shook it. Without gloves. Just her hand in theirs.

In a world that was absolutely terrified of even going near a person with AIDS, the last thing anyone expected to see was a royal who not only went near, but went out of her way to defy the protocols of the day so that she could meet that person, skin-to-skin.

Diana was known for many things—her fashion sense, her philanthropy, and her looks, among 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 of the tributes and glowing reviews that have been dedicated to her. She was a leader!

With her simple act of kindness and compassion on that day, Princess Diana launched the kick-off that would begin to destigmatize AIDS in the eyes of the public. She didn’t have to. She could have kept her gloves on and no one would have batted an eyelid. But she knew that her actions spoke louder than words. She knew that 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 great names in history who shook the foundations of the world and left a legacy for us to follow, Diana bucked convention and the opinions of others 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 all about—making a difference! Leaders make tough decisions when others won’t. They envision a future that is different from the one they’re told to aspire to and, rather than just dream about it, they take the necessary steps to make it happen. Leaders don’t just accept the status quo. They redefine it. And the world comes along.

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 dedicated to 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?

Sir William Osler was the very definition of a doctor who rocked as a leader. Aside from being one of the founders of John Hopkins Hospital and the creator of the first medical residency program, he was also the first academic to bring medical students out of the lecture halls and into the hospital for clinical training at a patient's bedside. He was also a historian, a professor, an author, a serial practical joker, and a prolific mentor!

But before he led, he accepted being led. Far from being the type of doctor that refused 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.

Osler began as an apprentice, a student of medicine and of other wise teachers who came into his life at various stages. As he perfected his craft and lived out his ikigai (purpose), making individual contributions to medicine along the way, he grew in rank and became an increasingly effective mentor to those around him. Osler recognized that mentoring others would help him to 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.

According to biographer, Charles S. Bryan, Osler underwent four distinct stages of growth as a leader—apprentice, contributor, mentor, and 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 great leader as everyone else who has ever made a lasting impact.

This idea of moving through a certain trajectory before true leadership can emerge is reiterated by John C. Maxwell, one of today’s top leadership thinkers. According to Maxwell, there are five different levels of leadership growth that will drive individuals to the peak of their leadership potential.

Level 1: position

At this first level, the aspiring leader is given (or obtains) a position of leadership—managers with their subordinates, chief residents with their interns, specialists with their support staff. You have control over others who comply out of necessity. This is the lowest rung on the leadership ladder.

Level 2: permission

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

Level 3: production

Getting results separates true leaders from those who are simply thrust into positions of leadership. True leaders make things happen that have a demonstrated impact. They produce results. At this level, you not only get people to follow you, but you also walk the talk. This is the level that separates leaders who are good at influencing others from those who are actually making lasting change.

Level 4: development

Once you've proven your worth as a leader, are influencing people, and producing tangible results, you begin to transition into the mentoring / influencer realm. You are now in a position to begin supporting the development of the people around you. You go from making a micro-level impact to building your influence outward and further afield.

Level 5: pinnacle

This is the culmination of all four leadership levels. At this stage, you’ve made a tangible impact on the world around you and you've shaped a generation of people who have grown as a result of your leadership. You’re now at the highest levels of influence. You make waves wherever you go and buildsuccess-upon-successas you traverse through life. This is the rarest type of leadership 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 be questioning how to get on a rung. As a clinician, you may be wondering how you can nurture your leadership journey within the realm of medicine. But whether you’re an intern or a hospital director, there is one aspect of leadership that doesn’t change, regardless of your level of seniority—growth.

The levels of leadership, as outlined by Maxwell, may help you to determine where you currently are on the leadership ladder, but they don’t really explain the personal transformations that will occur in the process. These levels may identify the steps you need to take in order to get to the next level, but they don't tell you how you will need to grow, personally, to get there.

Self-awareness is critical for that personal growth and, subsequently, for growth into full leadership. Maxwell outlines 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 recognize 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 that your career doesn’t get bogged down and stagnate.

Phase 3: I know what I don’t know

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 these areas.

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

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

Phase 5: I simply go because of what I know

Thoughts become actions, actions become habits, habits 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 takes hard work. They give up before they see the fruits of their labors. But 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 can help you do that). But as a medical practitioner, you do have an opportunity to amplify your impact on this world by nurturing your own growth—and it would be a shame to let that go! You don’t need to become the CEO of a hospital, a startup, or a pharmaceutical company to have that impact. By committing to a plan of personal growth, you will grow as a person and, by extension, become a valuable source of knowledge, insights, and wisdom for others. People will 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 wll inspire others to do the same.

And isn’t that what leadership is really all about?

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