BOOK REVIEW: Bringing Leadership to Life in Health: LEADS in a Caring Environment
Graham Dickson and Bill Tholl, editors
Springer Nature Switzerland, 2020
Reviewed by Johny Van Aerde, MD, PhD
The first edition of this book focused on the evidence and research methods used to develop the LEADS framework. For those unfamiliar with the framework, LEADS is an acronym for the five domains of physician leadership: L for Lead self, E for Engage others, A for Achieve results, D for Develop coalitions, and S for Systems transformation. Each domain comprises four “capabilities.”
In this second edition, Dickson and Tholl add new information, collected over the last six years, about how LEADS has been used in many organizations, regions, and provinces, with dozens and dozens of national and international examples. Anecdotal evidence of the framework’s usefulness from the perspectives of patients, different cultures, and various health professions has also been added. Reflective learning moments, each with its own set of questions, make the book one large learning experience for the reader.
The book is almost double the size of the previous edition, with a whopping 330 pages. If this is your first exposure to LEADS, I suggest you start with chapter 3, which explores the essence of LEADS, and then move on to chapters 5–9, which each cover one domain. These chapters are well structured and clear. The danger lies in reading them too fast; go slowly, one capability at a time, keeping in mind that all 20 capabilities are intertwined.
Once you are familiar with the framework, chapter 10 would be an interesting continuation of your journey, as it shows how LEADS can not only be used as a framework for leadership development, but also for change management (in this context, it should really be called change leadership). All remaining chapters can be read in a sequence of your choice.
While chapters 1 and 2 are aimed at the theoretical and academic reader, chapters 11–16 use a set of lenses to focus on different parts of our health care system. Chapter 14, “Seeing with two eyes: Indigenous leadership and the LEADS framework,” by Dr. Alika Lafontaine and colleagues, uses a double lens, as it not only highlights different worlds of experiences and thinking around health, but also provides food for thought on how the content of that chapter could be used across the entire health care system. The authors also give specific examples of how the L, E, and D domains can be applied to Indigenous leadership and culture.
In Canada’s health care system — which is highly fragmented constitutionally, geographically, and structurally — LEADS might serve as a common language across silos. How can it be used to improve continuity of care across those silos? How can we embed LEADS in the structure and culture of the health system, such that we will practise real distributed leadership by advancing diversity and inclusion. How can we use LEADS to help improve physician well-being systemically?
Finally, the LEADS framework can be used as the foundation to professionalize leadership and leadership development across the health care system and to measure and evaluate individual and organizational leadership capacity. The Canadian Certified Physician Executive (CCPE) credential, for example, is based on the LEADS framework. Introduced 12 years ago, it is the only certificate in Canada recognizing a standard for professionalized physician leadership. (See ccpecredential.ca)
One final piece of advice: don’t buy the electronic version of this book; get the printed one, as you will grab your copy from the shelf many times, to re-read or highlight a section, or to delve further into the abundance of references. This book is a keeper for anyone who touches the health care system — which means all of us.
Johny Van Aerde, MD, PhD, FRCPC, is co-editor-in-chief of the Canadian Journal of Physician Leadership and executive medical director of the Canadian Society of Physician Leaders.