During a workshop last month, I asked participants to pantomime the difference between leadership and management. Without words, and with hilarious gestures, they demonstrated an understanding that management is about reacting and getting things done, while leadership is about seeing a destination and inspiring movement toward that destination.
Grasping the difference between leading and managing is easy, but leading is far more difficult to find in EMS, both at a national and organizational level. At a national level there is a dearth of leadership in dealing with the most fundamental challenges facing the industry: replacing or augmenting an inadequate fee-for-transport funding system and addressing the burgeoning shortage of EMS workers in rural areas. At a local agency level this absence of leadership can be seen in the failure to establish EMS as a vital community infrastructure deserving of the same support as law enforcement, fire service and street repair; the lack of clear and compelling visions of the future; and the inability to create internal cultures that attract and nurture workers.
So why is EMS weak in its capacity to lead? It could be argued that leadership does not come naturally to anyone or any industry, but I believe this is especially difficult to develop in EMS because it challenges the fundamental working paradigm, carries a fair amount of risk and is not immediately rewarding.
Most EMS leaders come from the field, where providers are steeped in reactivity and management. Tones sound, they respond. Symptoms present, they react. Problems are identified, they manage them. Trauma, MIs, CVAs and cardiac arrests are all events to be managed. When the field provider reacts and manages well, the sense of accomplishment is immediate and clear.
As field providers become supervisors and move into management, they bring this paradigm along. Their approach becomes one of managing challenges, reacting to crises, getting things done, and ensuring that protocols and policy are followed. In the course of a day’s work, the manager fills a scheduling hole, implements a best practice borrowed from another service, referees a dispute between employees and works on next year’s budget. Management is busy and active, a mode that allows items to be checked off a list. This is not bad. In fact, on many days it’s all that’s needed.
However, the inadequacy of a management-only approach shows up when the organization (or the industry) needs to address a major challenge, faces competition at any level, encounters significant workforce issues or is confronted with a threatening problem. As Einstein famously said, “We cannot solve our problems with the same thinking we used when we created them.” The “same thinking” Einstein refers to is often the reactive thinking (and non-thinking) of simply managing the immediate issue.
The capacity to lead presents an entirely different paradigm. It is about seeing possibilities, imagining a future and identifying a clear destination. It is about telling a compelling story and inspiring followership. The daily actions of leadership often include reflection, climbing to the tallest organizational vantage point to look ahead, reading, day-dreaming, questioning and engaging in conversations that begin with, “What if ...” and “Let me tell you about where we’re headed and why you matter .…” Management is a taskmaster and safe keeper. Leadership is a dreamy storyteller and risk taker. Management says, “Get things done.” Leadership says, “Take some time to figure out the best things to do.”
Aw, but these days, who has the time to lead?
John Becknell is the founding publisher of Best Practices and a consultant who helps individuals and organizations clarify destinations and tell stories. He can be reached at jmbecknell@gmail.com.
