A Guide to Leadership Styles in Healthcare

Many aspiring healthcare leaders attend a master of healthcare administration (MHA) program to learn how to effectively run a healthcare organization. In doing so, they gain a strong foundational understanding of accounting, finance, marketing, and operations. But just as critical to the successful management of a healthcare organization is an administrator’s leadership style.

Leadership is distinct from management. Management is related to the strategic division of resources and application of talent, while leadership is more ineffable. You don’t need to be the leader of a healthcare organization in order to have a leadership style: one’s leadership style is an ethos that has applications in team-based roles at every level. Leadership embodies both science and creativity, and it bears the majority of the responsibility for a healthcare organization’s success or failure.

There are as many different styles of leadership as there are different leaders: Khan, King, and Gandhi would all define leadership a little differently. However, some general archetypes of leadership do exist, and in healthcare, those archetypes can be as important to know as the proper methods of marketing and accounting.

The three major archetypes of leadership are authoritative leadership, democratic leadership, and laissez-faire leadership. As the labels imply they are, respectively, defined by top-down, collaborative, and hands-off leadership. Others may define the same leadership archetypes across different axes, such as innovative leadership, distributed leadership, and delegated leadership.

But today’s healthcare leaders rarely adhere to a single archetypal leadership style. Healthcare is beset by a number of different crises: the shift to value-based care, the rise of digital medicine, the protection of patient data, the threat of pandemics, the persistence of health disparities, and the constant struggle to improve patient outcomes while meeting an institutional bottom line.

The best leaders will switch between leadership styles as the circumstances demand, combining the best parts of different leadership archetypes into novel forms that match well with the tasks ahead.

To learn more about the four most powerful leadership styles in healthcare today and their strengths and weaknesses, read on.

Charismatic leadership has no structure beyond personal influence. Related to authoritative leadership, charismatic leadership relies on confidence, personality, and charm to draw together and motivate different groups.

Charismatic leaders can be particularly effective when paired with a strong vision, and operate best where clear organizational structures are lacking. This style is adept at motivating others. However, it may struggle when faced with technical problems and regulatory constraints.

According to a 2012 article in Sociology of Health & Illness, a group of health practitioners in the UK used charismatic authority to establish themselves as specialists in diabetic foot care and open a specialized diabetes foot care practice, which resulted in a 50 percent reduction in major amputations in their patient group.

In servant leadership, a leader puts the needs of others ahead of their own. Related to laissez-faire leadership, the servant leader is focused on the service of others and imbues a similar sense in those around them.

Servant leadership works best in healthcare organizations with strong teams who are focused on improving the value of patient care. This style is best for empowering others. However, it may struggle when faced with disorganized staffing and complex technical challenges.

When the term was first used by Robert Greenleaf in 1970, it was not with full-throated optimism: Greenleaf believed servant leadership was used by the very best leaders, but unlikely to catch on as a trend.

But servant leadership still has many champions today, including the Mayo Clinic, which also believes that when people feel a sense of autonomy over their environment, they are more motivated to change and grow. That’s not only a benefit to Mayo Clinic staff, but also to the patients they serve.

Transactional leadership is a process-oriented leadership style based on the principle of social exchange: good performance is rewarded, and poor performance is sanctioned.

Related to democratic leadership, it prioritizes technical competence and order to achieve clear organizational goals. Transactional leaders are particularly effective when facing technical and measurable challenges, such as those related to budget or regulatory compliance. This style is ideal for meeting key performance indicators, but it can struggle when faced with the need for innovation or thinking outside the box.

Transactional leadership has fallen out of favor in recent years, but perhaps unfairly. A 2020 article in Nursing Standard found that transactional leadership was still useful in achieving short-term goals and completing clear tasks, but should be combined with other leadership styles to maximize its effectiveness in healthcare settings.

Transformational leadership is based on instilling an organization with a strong shared vision. Combining key aspects of both democratic and charismatic leadership, it utilizes influence, motivation, and collaboration to bring about a radical organizational change.

Transformational leadership works best in organizations either facing or anticipating facing major existential crises. It is adept at harnessing innovation and embracing change. However, it may struggle when deployed in less urgent settings when pushing for radical changes causes more harm than good.

Since the onset of the Covid-19 pandemic, transformational leadership has been perhaps the most in-vogue leadership style in healthcare. But this is an industry where there’s always another crisis either at the door or on the horizon, and transformational leadership has always been of use: a 2004 report published by the Institute of Medicine called transformational leadership an essential precursor to effecting change in healthcare organizations.