In Pursuit of Increased Leadership Effectiveness

By Dale Benson, MD, CPE, FAAPL
April 18, 2018

As you strive to develop your craft as a leader, some fundamental elements have the potential to deliver a huge impact on your effectiveness.

As a leader, you should be able to clearly and concisely articulate your philosophy of leadership. Every action, every decision, every reaction, every plan should be filtered through your philosophy. Your philosophy becomes your compass. It keeps you on track. It becomes your true north.

Your leadership philosophy also gives you consistency. Without a leadership philosophy, your actions and your reactions can reflect the tensions of the moment. There is fear in the organization. “You never know what he will do!” “You never know what she might say!”

You will be more effective as a leader if you ride the horse in the direction that it is going.

With a leadership philosophy, your actions and responses are driven by your philosophy. Your actions and reactions are in context. They are predictable. There is less fear of the unknown. Your philosophy gives you consistency. Your philosophy should be based upon a foundation of principles or values that are important to you — the “vital few.” These principles guide you in the practical affairs of leadership. They become the first of the three components that should comprise your leadership philosophy.

VISION: Your philosophy should describe your vision of what you hope to be able to achieve throughout your career, your desired results. It should describe what you have determined to be your mission as a leader, the legacy you hope to leave at the end of your career. Your philosophy should constantly point you in the direction of your desired results. Stephen Covey advised us all to “begin with the end in mind.”1 The objective of the desired results component is essentially to describe the end that you have in mind.

Finally, your philosophy should incorporate a description of the kind of leader you want to be and how you want to go about leading in an effective and transformational manner. This describes your process for accomplishing your desired results, the relationship you desire to establish with your people and your method of operation.

Here is the key: Creating your leadership philosophy is an opportunity to design who and what you want to be as a leader. So design the kind of leader you want to be, embed that design into your leadership philosophy and then live the design.

Let me share my philosophy with you. My philosophy as a leader is to be transformational, visionary and supportive; to build value by increasing the loyalty of patients, community and employees; and to accomplish this by “enlightened” empowerment.

The first three key words are basic principles that I have integrated into my philosophy; principles that drive and guide me every day — transformational, visionary and supportive. These three principles become my mental model for leadership, the way I think about leadership. They also become the foundation for my leadership philosophy.

The second part of my leadership philosophy is to be working all the time toward building value by increasing loyalty of patients, community and employees. This is the desired result that I am striving for, or my mission as a leader. It’s the legacy I want to leave.

The final piece has to do with process. How to accomplish this. In my philosophy I use the term “enlightened empowerment.”

dale benson

Dale Benson

What does this mean? Basically, empowerment is the understanding that the people who work for me are likely to know and understand what they do better than I do. Their ideas about how to improve things are likely to be better than mine. Empowerment is the understanding that no organization will be as effective as it could be if all the decisions are left to management. It is letting the decisions be made at the level where they are most relevant. Empowerment means involving the people who work for me, tapping into their brain power and taking advantage of their abilities. It means letting them play a pivotal role in the decision-making and in the transformation of their part of my organization.

Enlightened empowerment involves decisions at the level of the action. My job is to be certain that the people whom I empower understand reality, believe the vision and are heading in the direction that the organization needs to go — alignment.

I then have to be willing to accept the results of the empowerment — that is the enlightened part. Enlightened empowerment means first aligning my people, then unleashing their talents.

This leadership philosophy has served me well. Understanding the importance of creating and then living a principle-based leadership philosophy is an element that will contribute to your effectiveness as a leader.

DRIVE: The second fundamental element is understanding what drives the people in your organization. It has been said that you should ride the horse in the direction it is going.2  We are talking here about the employee culture in your organization. The employee culture drives the people.

All organizations have an employee culture. Usually it is driven by top leadership. It may be a culture that is all about profit or sales. It may be a culture that is all about “me” increasing my salary, moving up in the pecking order and owning more turf. It may be a culture of intelligence that includes great thinking, academic prowess and publishing papers. It may be a culture of innovation driven by great ideas, great designs always something new. It may be a culture of altruism that involves helping others, doing good works and making this world a little bit better.

There is nothing intrinsically wrong with any of these cultures. Every organization needs a sprinkling of each. The point is that every organization has a predominant culture. As a leader, you need to understand what that predominant culture is.

What if, in your view, the horse is going in the wrong direction? What if the predominant employee culture is not the culture you would like to see in your organization? Your challenge becomes immeasurably greater. You have to turn that horse around. And turning a culture around is a long and arduous journey. It can be done, but it will take a long time. It is better to ride the horse in the direction it is going. If the horse is going in the wrong direction, you may be a leader in the wrong organization.

We cannot understand an organization merely by looking at its balance sheet (important as that might be) or its statistical reports or its promotional material. We understand an organization by looking into its soul, its culture. Recognizing this as a fundamental element will contribute to your effectiveness as a leader.

Listen. In every office you hear the threads of love and joy and fear and guilt, the cries for celebration and reassurance, and somehow you know that connecting those threads is what you are supposed to do and business takes care of itself.

James A. Autry

RESPONSIBILITY: The third fundamental element is an understanding of our overarching responsibility to connect the threads. In this wonderful and insightful poem by James A. Autry, he challenges us as leaders to connect “those threads” in our organizations because that “is what you are supposed to do.”3

Ultimately, you will find that connecting the threads is about alignment, and that alignment has to happen at two levels. The first level is helping each person in your organization to reach his or her fullest potential. Aligning the individual. The second level is aligning your people so that your group or department reaches its fullest potential. Aligning your organization.

Each of your people has to be maximally effective if your group is to be maximally effective. If one of your people is compromised, your leadership effectiveness will be compromised. Your employee may be compromised by the stress of life, family problems, financial problems or interpersonal problems.

If your employee is going to be maximally effective, if your employee is going to reach her or his fullest potential, the internal and external threads need to be in alignment and they need to be connected. You are not responsible for their internal and external threads, but you need to understand where the threads are out of sync and be supportive. You need to understand where the threads are frayed and help if you can.

At least once a year I sat down with all of my direct reports one-on-one. The conversation was about how is life going? How is the family going? How is the career going? What direction do you want to go in life? Are you heading in that direction? I had several reasons for doing that, but a key one was that I was gently probing for disconnected or frayed threads. Not to be nosey regarding their private lives, but rather to be interested and supportive.

There are three steps to creating alignment. The first is to set the direction; everyone needs to understand where the organization is going. The second is to chart the course; everyone needs to understand the organization’s specific strategies, priorities and objectives. The third is for you, the leader, to “talk the walk.” As John Kotter has written, “Alignment is a communications problem, not a design problem.”4 Leadership is about alignment. Alignment is everything. You must be constantly talking the walk.

I have one final perspective to share with you now. This perspective is that it all has to do with people. Every person we lead is unique. And therein lies the challenge. If it weren’t for the fact that we are leading and managing people, and no two people are the same, leadership and management would be easy.

Our role as leaders, managers and supervisors is to affirm, motivate, support, serve and inspire the people in our organization so that they — in turn — will affirm, motivate, support, serve and inspire our patients.

Dale Benson, MD, CPE, FAAPL, is the former vice president of innovation, quality and practice management, and director of the leadership development institute at AltaMed Health Services in Los Angeles, California.  He was the founder, and for 30 years, the CEO of HealthNet, a community health center network in Indianapolis, Indiana.  


  1. Covey S. The 7 Habits of Highly Effective People. New York, NY: Simon & Schuster, 1989, p. 95.
  2. Werner, E. Author and lecturer on leadership theory and practice.
  3. Autry JA. Threads. Love and Profit: The Art of Caring Leadership. New York, NY: William Morrow & Company, Inc., 1991, p. 32.
  4. Kotter JP. A Force for Change. How Leadership Differs from Management. New York, NY: The Free Press, Simon and Schuster, Inc., 1990. Chapter four.

Topics: Leadership Journal

The Role of the Physician Leader in the Independent Medical Practice
Telling Stories to Lead, Influence, Teach, and Inspire