Anything Goes—Is It True for Leadership Styles?

There is no doubt that, over the next few years, we will need more leaders in radiology that can fill the shoes of the mighty baby boomer generation. Many early career radiologists believe they do not have what it takes for leadership. But is that true? Is it a matter of “nature versus nurture?”

I have concluded that “(almost) anything goes” when it comes to leadership styles, and that while it helps to be genetically endowed with such skills, everything can be learned. Or is that even necessary? After all, most everything, from developing a vision and mission to executing our daily work, can be driven by teams, and it can be the total of team members that has the skill set, rather than a single leader who has it all. After all, this is reflected in many academic radiology departments, where the leadership cadre is made up of vice chairs, who bring very specific leadership and subject matter skills to the table.

When I first became curious about a leadership journey in my career, I asked my then section chief and department chair for leadership book recommendations. One recommended Edward Kennedy “Duke” Ellington’s biography. In reading the Duke’s biography through a leadership lens, it became clear to me that he valued the musicians in his orchestra very much. In fact, he wrote music that would showcase the skills of individual musicians. In addition, Ellington was a phenomenal businessman who was committed to delivering music of the highest quality.

The other recommendation was to read Endurance, a book about the explorer Sir Ernest Henry Shackleton and his expedition to Antarctica on the ship Endurance. The book details how the ship got trapped in packed ice and sank, and how Shackleton’s exceptional leadership resulted in the survival and rescue of all crew. In essence, Shackleton never wavered in his vision of survival for the entire crew, which informed all decisions he made along the way. On the other hand, in terms of planning this expedition for all eventualities, Shackleton miserably failed in his leadership.

In my career, I have both employed and lived through a large variety of leadership styles, and I have concluded that more often than not, circumstances inform which leadership style works best.

Authoritarian – Participative – Delegative

While there are undoubtedly negative connotations to being an authoritarian leader in the political world, this leadership style can be very effective when projects need to be completed quickly. A group may prefer this leadership style, when the leader is the most knowledgeable group member. This style does not, however, support the professional skills and advancement of others.

Participative or democratic leadership, on the other hand, is all about welcoming diverse opinions and collaboration. Research finds that this leadership style leads to higher-quality outcomes, but it can take longer to get buy-in from all team members.

Delegative leadership is a laissez-faire style. The leader is removed from the team’s process, but expects a certain outcome. This could be successful when all group members are qualified experts.

Visionary – Coaching – Affiliative – Commanding – Pacesetting

Visionary leadership is often authoritative and can inspire and motivate others. However, a vision only takes the team so far. Having a clear vision to hold on to can help teams that are undergoing dramatic changes within the organization, such as a new practice leader.

Coaching leaders are those who can help team members improve to support the organization’s goals. This requires the ability to give feedback, which can be an artform in itself…

The affiliative leader is relationship-focused and creates harmony among team members. However, if harmony is of the utmost priority, team performance could suffer from lack of constructive feedback.

The commanding leader coerces the team through policies and procedures. As a sole leadership style, this can lead to disengagement of team members. Undoubtedly, though, policies and governance are the necessary foundation for creating accountability and guiding performance assessments.

Pacesetting leaders serve as an example in productivity, performance, and quality. Leaders who create clear requirements for their teams and set deadlines may be very successful, but this style can also result in overworked teams.

Transformational – Transactional

The transformational leader uses coaching and other means to empower teams towards building skills and growing towards a common goal. Meanwhile, the transactional leader drives performance through rewards and punishment. Since external reward/punishment systems work better for achieving short-term goals, this leadership style may not be successful in the long run. I hope this brief overview piques the interest of radiologists who are interested in leadership, but who are unsure if they are cut out for it. A good starting point may be to ponder one’s strengths and find a leadership opportunity in a setting that would benefit from existing skill sets.  

Nadja Kadom, MD
Nadja Kadom, MD


Director for Quality, Department of Radiology, Children’s Healthcare of Atlanta
Interim Director for Quality, Department of Radiology and Imaging Sciences, Emory Healthcare

Professor, Emory University School of Medicine

The opinions expressed on RadTeams are those of the author(s); they do not necessarily reflect the viewpoint or position of the editors, reviewers, or publisher.

2 thoughts on “Anything Goes—Is It True for Leadership Styles?

  1. Interesting definitions and descriptions but where this blog post leaves me wanting is how to effect change or at least be part of meaningful discussions and leadership when the board or chair is a different type of leader than the individual who possesses other traits. Is there a way to coalesce and still be able to have a stake?

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