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What is the Difference Between a “Leader” and a “Manager”?


I notice that you often use the term “leader” instead of “manager.” Is there really a difference or is it just a question of semantics?


The dictionary defines a manager as someone who “handles, controls, or directs.” I see leadership as this and much more. Leaders also:

Use horizontal thinking: Most leaders are good vertical thinkers. (They know how to impact their own department or implement steps to get a task accomplished.) The art of maximizing people and gains comes in horizontal thinking and communication. How can the information, story, and steps be transferred across the organization? This is horizontal thinking. An example: I remember a department manager who was transitioning to a new vendor for housekeeping service. Not only did he ensure the new leaders were in place, outline the steps to transition, and set clear expectations (vertical thinking), but he thought, “Who else would benefit from this information?” and shared information about the transition to those leaders who had the most day-to-day interaction with housekeeping (horizontal thinking). It’s inclusion rather than exclusion.

Maximize wins: Many times, we fix or improve a situation or issue but we do not go back and connect the dots. We spend hours—or even years—responding to a concern or an issue. Then, instead of leveraging the win, we move to another issue.

With a win, always ask: “What do we need to communicate about this win? When and to whom do we need it communicated? What method needs to be used to communicate effectively?” I feel hospital leaders do many things for which they never get recognized. And I think this often occurs because they are not good at maximizing the win. If patient satisfaction is rising, for instance, it’s key for leaders to communicate this to physicians. Otherwise they won’t know about steps the hospital is taking to improve the perception of care for their patients.

Think like the CEO. Whatever your job title is, look for what’s working across the organization and duplicate it. Organize lunches or retreats. Take notes at meetings and carry information back to staff. Unit managers can copy best practices on other units. Don’t wait. Duplicate what works. If you were the owner of your area, you would not stop until you had great service, high quality, low cost, the best employees, and market growth. Leaders who get results don’t need to worry about job security. In fact, they have great autonomy in their role.

Take a fresh look. Let each day be your first day. An organizational turnaround expert I heard recently explained that while he couldn’t replace all of the leaders in the organization, he was invited in because of the poor performance of leaders who were not addressing key issues.

Aggressively ask for input from staff at all times. While it’s not easy, great leaders know that employees are closer to the action and will make or break any change. By asking for input early, the service/product will be better and implementation will go more smoothly. Hardwire rounding on staff.

Are comfortable with not being comfortable. Role model change for your employees. Today in health care, leaders are going to have to be uncomfortable to achieve quantum improvement in results. When staff and employees are asked to do a job with fewer employees than in the past, the first several months will be uncomfortable. Eventually, directors and managers will change the systems, confront non-performers, and pull together to get the results. The same is true of upper management changes.

Create burning platforms. Even success can breed future failure. It is sometimes necessary for all leaders to take a stand and create a platform for increased commitment and a renewed focus of their energy. Burning platforms will also help leaders to lay a foundation for success. • Maximize leader meetings. If you hold such meetings, (and if you don’t, please start) use them to reward and recognize leaders, provide information for others, show support, and glean information. When leaders do not routinely attend these meetings, they lose opportunities. They need to represent their area or division and make sure they send notes out to leaders who did not attend.

Be a player, not a spectator. You do not become the best without passion, ownership, and urgency. • Reward and recognize. When you let up on this, the results will let up.

Treasure diversity. Hire a diverse team. Hire people whose skills complement but don’t duplicate others. Hire people who want to be students and learn. Diversity is good, so hire it and celebrate it.