Toward a renewed leadership Gestalt.

Charismatic leaders inspire us: The words of Winston Churchill, Franklin Roosevelt, and Martin Luther King, Jr., have galvanized millions. Yet their power is as much a product of a profoundly basic human need as it is image and rhetoric. From Plato's Republic to Machiavelli's The Prince, to James MacGregor Burns' Leadership, the testimony to our fascination with the successful leader is made again and again. "One of the most universal cravings of our time," according to Burns (1978), the hunger suggested by this insatiable concern is timeless through human history. Bruce Vladeck's article is evidence of this powerful interest as it affects health care organzations. Vladeck must be commended for his stimulating and persuasive message concerning the need to elevate standards for institutional health care leaders. For hospital CEOs in particular, the imperatives for balanced responses to organizational and community interests cannot be overstated. Unfortunately, at a time of upheaval in health care accentuated by unprecedented competition and economic uncertainty, attaining excellence on both fronts seems to be within reach of only a segment of the hospital sector. This often provocative piece brings into sharp focus the fundamental concern in this balancing act: The leader must be accountable to all stakeholder groups and act on carefully delineated responsibilities. Primarily, Vladeck explores the value-driven issues that confront institutional leaders who must be ready to respond quickly to a multitude of internal and external economic, social, and political exigencies. THE LITERATURE ON LEADERSHIP Vladeck is on target in his characterization of the literature on leadership as "bottomless and heterogeneous. In recent years we have witnessed a cascade of publications on leadership from both the "real" and academic worlds. From slender collections of aphorisms by famous personalities to more substantial, thought-provoking dissertations, the production of literature continues at a brisk pace. In 1974, when the first edition of Stogdill's definitive Handbook of Leadership was published, some 3,000 studies of leadership were cited; the 1990 edition, updated by Bernard Bass, boasts over 7,500 entries and is the most comprehensive review of the literature to date (Bass 1990). Leadership seems to be more art than science. Although it may possess the nuts-and-bolts pragmatism of management, its core is also compounded of vision and inspiration. Like the 50-odd terms for "snow" in the language of the Eskimo, the shades of meaning for leadership seem to be as varied as the leaders themselves. In the view of one academic, "there are almost as many definitions of leadership as there are persons who have attempted to define the concept" (Bass 1990). On the one hand, we have General George Patton (Blumenson 1974) defining leadership as "the thing that wins battles. I have it, but I'm damned if I know what it is." On the other hand, we have academic Bernard Bass (1990) presenting it in a much different way: "When the goal of one member, A, is that of changing another member, B; or when B's change in behavior will reward A, or reinforce A's behavior, A's effort to obtain the goal is leadership." Understandably, much of the empirical work is not very useful to the practicing executive. Approaching the concept of leadership, one may wonder that empirical efforts can be applied to a term that has eluded precise definition for so long. For example, kinds of leaders may extend from organizational to public, to intellectual leaders; types may range from autocratic to laissez faire; and the tasks of leadership may overlap with those of management to such a degree that any distinction between the two terms is lost. Any comprehensive study of leadership must address a host of elements, including the "jungle" of leadership theories, the personality and characteristics of leaders and followers, motivations of leaders, as well as communication and interpersonal dynamics. …