How to Be a Leader When You Are Not “the” Leader


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You can grow your influence and help your organization succeed by applying this one leadership concept.

Fam Pract Manag. 2015 Nov-Dec;22(6):10-12.

Author disclosure: no relevant financial affiliations disclosed.

It's 10 a.m. on a Thursday. You are running 45 minutes behind in seeing patients, you have a mountain of paperwork on your desk, and your staff is on edge because patients are complaining about the wait time. At your performance review yesterday, you felt unfairly assessed because of lower than expected patient satisfaction scores, and physician leadership is now saying you need to improve your quality metrics. Your morale, like staff morale, is not the highest, and you feel something needs to change. Frustration is setting in as it seems there is never enough time to do everything expected. You feel you are doing the best you can, and it's not your fault all of these things are happening. What more can you possibly do?

We've all been here at some point in our professional life as an employed physician. Whether you're now employed because you left private practice or your employed career started straight out of residency, you are probably not “the boss.” You're paid to meet or exceed expectations set forth by your organization's leaders.

Although your influence and decision-making may appear to be limited because you are not in charge, you can be a powerful catalyst for change in your organization.

A concept that has been helpful to me in my practice is “servant leadership.” In 1977, Robert Greenleaf described servant leadership as a “natural feeling that one wants to serve first. Then conscious choice brings one to aspire to lead.”1,2,3 The servant leader inspires others to grow as persons, thus making the organization better.

How can you be a servant leader?

About the Author

Dr. Cuenca is a board-certified family medicine and sports medicine physician. He serves as the site physician lead for OptumCare Medical Group, doing business as Ross Medical Associates, in Ladera Ranch, Calif. He is also a member of the FPM Editorial Advisory Board.

Author disclosure: no relevant financial affiliations disclosed.


1. Greenleaf RK. Greenleaf Servant Leadership: A Journey Into the Nature of Legitimate Power and Greatness. Mahwah, NJ: Paulist Press; 1977.

2. Frick DM. Robert K. Greenleaf: A Life of Servant Leadership. San Francisco: Berrett-Koehler; 2004.

3. Valeri DP. The Origins of Servant Leadership. Dissertation. St. Louis, MO: Greenleaf University; February 2007. http://www.greenleaf.edu/pdf/donald_valeri.pdf.


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