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Book Reviews   |    
Effective Medical Leadership; Early Development and Leadership: Building the Next Generation of Leaders

Effective Medical Leadership
by Bryce Taylor.; Toronto, Ontario, Canada, University of Toronto Press, 2011, 256 pages, $24.95

Early Development and Leadership: Building the Next Generation of Leaders
by Susan E. Murphy. and Rebecca J. Reichard.; New York, Routledge Academic, 2011, 388 pages, $50

Reviewed by Eric D. Lister, M.D.
Psychiatric Services 2012; doi: 10.1176/appi.ps.20120p514
View Author and Article Information

The reviewer reports no competing interests.

Dr. Lister is managing director of Ki Associates, Portsmouth, New Hampshire.

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These two volumes raise a basic question about why we continue to publish books on leadership. A search of www.amazon.com's database in January 2012 revealed that readers can choose among 72,000 books on leadership. So, absent compelling and novel approaches to the subject (think of the psychiatrist Ronald Heifetz' seminal Leadership Without Easy Answers, published in 1994), do we really need more?

I would propose that the answer is no. The field may benefit from fewer books rather than more reiterations of accepted knowledge. Defensible as that position may be, it does not do justice to the possibility that a “new” book might be in fact useful if it captures interesting insights in a way that is helpful to those readers looking for a contemporary packaging of existing knowledge.

Because neither of these volumes passes the first test—of truly adding value to the study of leadership—let me assess them according to the second, more modest, framework.

From this perspective, Dr. Taylor's book earns a solid pass. It is not the comprehensive primer that he describes in his introduction—it is too anecdotal and ungrounded in theory—but it has practical utility.

Dr. Taylor is a practicing surgeon who has, over a 25-year career, held a number of leadership positions in the Canadian health care system. Effective Medical Leadership represents a distillation of what he has learned “in the trenches” during that time. The book is case-based, thoughtful, and extracts from real situations a variety of lessons for medical leaders, regardless of their specialty. He touches upon management theory, ethics, resource stewardship, and self-efficacy in ways that are down to earth and in language that is accessible. Although his takeaway aphorisms are sometimes painfully obvious, they are true. The examples used and recommendations in terms of leadership practice translate readily to the United States. I would recommend this book to a neophyte physician leader anywhere. Reading it is like following a skilled attending physician on rounds through the work of leadership, with the attending explaining his thought processes and interventions in the transition from one ward to another. For more experienced leaders, however, the book has virtually no utility. For a scholar of leadership, the only interest would be in how Dr. Taylor has extracted the lessons that he proposes from his life's work; the lessons themselves fail the test of innovation.

Early Development and Leadership, however, puts itself forward as being a contribution to an emerging field and in fact falls short of being either meaningfully innovative or practically useful. With 29 authors contributing 15 quite separate chapters, united only by a common theme, the volume gives the appearance of providing an excuse for the collaborators to celebrate each other. It in fact represents in large measure the proceedings of the 17th annual Kravis-de Roulet Leadership Conference, which took place in Claremont, California, in February 2007 with the theme “The Early Seeds of Leadership.”

The book is organized around the truism that there is a social need for more [effective] leaders and the derivative assumptions that a study of adult leaders is insufficient to provide an understanding of how leaders develop and that it should prove useful to understand the genetic, experiential, and circumstantial factors that predispose to the later development of adult leadership competencies.

So far, so good.

The problem with this volume has to do with the superficiality of the work summarized, the extent to which academic language is used to affirm the obvious (“Important leadership skills develop throughout one's life”; “a significant factor in leadership is positive health of the leader”), the lack of any organizing construct beyond the obvious, and the lack of any breakthrough research solidly linking early experience to adult competency. This set of deficiencies perfectly captures the problem that clinicians so often have with social science research.

Early Development and Leadership is relevant only to the small audience of researchers in this field. Ideally, it should challenge and galvanize those readers to a higher standard of scholarship. It has very limited utility to any other audience.




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