Why Lead?

Eric Postal, MD

The potential impetus behind wanting to take the reins of leadership.

In the 11th hour of purchasing my current home, I found out the block had a homeowners’ association (HOA). The horror stories I’d heard about such entities fortunately only warranted a brief panic; this one was about as benign as they get. In the subsequent six-plus years, the HOA has, happily, proven closer to impotent than tyrannical.

One manifestation of this turns up in the solitary meeting of the HOA each year (sans 2020, as that meeting would have occurred at the height of everyone minding their COVID P’s and Q’s): When it’s time to elect the block’s president, secretary, and treasurer, pretty much nobody wants the job.

This isn’t an issue when those currently holding the titles are willing to continue in their roles, which has been the case pretty much ever since I’ve been here. The floor is opened to nominations, no challenging hands are raised, and that’s that; status quo maintained.

Two years ago, however, the prez wasn’t inclined and/or able to stay in office, and this year, the other two officers declared they’d had enough. On both occasions, this resulted in a prolonged, uncomfortable silence in which nobody stepped up. People even avoided eye contact, lest they betray some sign of being coercible into taking on the task.

I’m told this was also an issue before I moved in. On one occasion, the solution was to nominate some unfortunate absentee who was known to be a good egg. His consequence for not attending the meeting was to get elected…and, evidently, he had the temperament to take that in good grace and execute the office as best he could.

Why would nobody want the job? Put another way, why would anybody want to lead?

Sometimes, there’s an obvious answer: Leadership has rewards that appeal to those seeking it. Money, for instance…if leading a group has financial benefits, the right price will make people willing to do the job. Even compete for it. There’s also the circumstance of safeguarding one’s holdings…if you started your own radiology group, for instance, it makes perfect sense that you’d want to maintain control of it.

Then, there’s power. Some folks like it for the pure sense of being higher on the pecking-order. Others might want it because they feel smarter, more experienced, or otherwise best suited to be calling the shots. Alternatively, they might not be so eager, but of the opinion that someone else wouldn’t do as good a job…and they’d rather not abide by such substandard leaders.

There’s also what I call the “keys to the washroom” phenomenon. For better or worse, society seems to have decided that someone who has been at the executive level is always preferable for such positions over others who have not. Even if that someone did horribly. A chief executive officer who presided over a major corporation that went down in flames, for instance, tends to be a shoo-in for another chief executive type of job if no other candidates have had those magical three letters to their credit. Being in leadership usually means you’ll have more chances at it in the future.

In situations like my HOA, leadership might be accepted with a shrug. Someone has to do it, why not me? Or: Everyone else has taken their turn, I guess I have to step up now.

Way back, before I’d even made it to high school, it was a dictum (first parental, then vocational): You had to seek leadership positions if you wanted to go anywhere in life. You needed it on your applications to college, then med school, residency, etc.

Fast-forward some years, and I was in a population of physicians who were selected, in part, for their track records of leadership. Some of them might have wanted to be leaders in the first place, others learned to want it, and yet others just did it because that’s what they had to do to make the cut.

In ordinary society, for every person who’s got the ability and desire to lead, you’ve got a bunch of people who don’t. Plenty of followers to go around for each would-be leader. Not so, after the process that creates doctors. We’re a bunch of selected (or honed) leaders, most followers having been weeded out of our crowd. Is it any wonder that leading us has been likened to herding cats?

So the question arises: When there’s a choice to be made at all, how do you decide who’s the right one to lead?

A cynical response that often comes to my mind when contemplating politics: Anybody who wants the job should probably not be allowed to have it. At least, when there’s money, power, or other potential for personal gain.

But, what’s the alternative? A lottery or a draft-like system? If the random number generator says it’s your turn, or if everybody else has had a go and you’ve got no solid reason to be exempt, time for you to wear the badge, Sheriff. Doesn’t matter if you’ll do a lousy job, or somebody if else would be amazing, but they already had their turn.

It would be nice if we could read minds, run reliable lie detector tests, or administer something a little more fine-tuned than sodium pentothal when assessing prospects for leadership: Are they pursuing the job for the right reasons? Do they really think they are best for it? Or is there something at hand that’s less pure than “love of the game” and a personal conviction of capability?

Failing that, I suppose our best options are good ol’ democratic mechanisms, maybe with something resembling term limits. Not absolute, since that wouldn’t make sense in certain outfits, such as a small group of rads, working together for decades. Maybe something along the lines of no more than one or two terms in a row, surmountable by a two-thirds or three-quarters majority voting hurdle.

Follow Editorial Board member Eric Postal, M.D., @EricPostal_MD.