Smart Governance through Managers Who Lead

Jim Rice

Former LMG Project Director

Sylvia Vriesendorp in the MSH eHandbook correctly observes that “Managing and leading go together, each working toward a common goal but contributing in ways that the other does not." Because the two functions are complementary, the concept of “managers who lead” has gained acceptance as a holistic approach to running a health care program, organization, or facility.

We define “managing” as planning and using resources efficiently to produce intended results. Managing is focused on making sure present operations are going well—namely, that the energy of the people who give their best to the job at hand is not wasted on unnecessary activities or unfair practices. We define “leading” as mobilizing others to envision and realize a better future. Leading is about the future. It is involved in the creation of work that generates new energy or reactivates untapped skills that lie dormant because there is nothing to which they could be applied.

Managers who lead enable themselves and others to set direction, face challenges, and achieve intended results. Producing results is what sets a manager who leads apart –and producing results means that they are able to improve the health of the people they are tasked to serve.

The last piece of this leading and management puzzle is good governance. Governance provides the policy context, work conditions, and culture that enable those who manage and those who lead to flourish and be optimized. As Gbenga Osundara Jumorota, a recipient of LMG’s Leadership Development Program Plus (LDP+) in Nigeria stated: “The LDP+ brings in a new dimension, which is governance…and that governance part was so practical because it helped me see that you need to be accountable.” As Jumorota learned, governing is about making decisions and assuring that they are implemented. He went on to say that within their health clinic “we actually noticed that there was a tremendous change…there is a pragmatic shift from cynicism to hope and a brighter future.”

While there are differences between management and leadership, these differences enrich the value of both and allow them to work harmoniously in the context of good governance. Leaders optimize the upside, managers minimize the downside. Leaders envision possibilities, managers calculate probabilities. Leaders focus on the ends, managers focus on the means. When working together, both achieve more, and as Jumorota noted, they work together to create a brighter future for health systems.

James A. Rice, Ph.D., is the Project Director for the Leadership, Management & Governance (LMG) Project.