By Melissa M. Sweetman, OTD, OTR/L

Leadership” and “management” are words that are interchangeable to some, yet represent completely different meaning to others. Do these words mean the same thing, or is there a difference? Take a moment to consider your current and previous supervisors. Would you say they were managers or leaders? What about yourself: do you identify as a manager or leader? Have you ever considered there may be a difference between the two? Many argue is it merely a semantic difference that separates management from leadership, but the experts disagree. This difference, however, does not mean that the two concepts can or should be easily isolated from each other. When used concurrently, management and leadership can be a powerful combination that earns top results.

Consider for a moment the various definitions of management and leadership. According to the dictionary, the term “manage” means “to have under control and direction; to conduct; to guide; to administer; to treat; to handle.”1 The term “lead” means “To guide or conduct in a certain course, or to a certain place or end, by making the way known; to show the way.”2 John C. Maxwell, a well-known leadership expert and author of The 21 Irrefutable Laws of Leadership: Follow Them and People Will Follow You, states, “…the main difference between the two [management and leadership] is that leadership is about influencing people to follow, while management focuses on maintaining systems and processes.”3 John Kotter, best known as an expert about the topics of leadership and change, discussed this topic in a 2013 web publication titled, “Management Is (Still) Not Leadership.”4 In this article, Kotter states, “management is a set of well-known processes, like planning, budgeting, structuring jobs, staffing jobs, measuring performance and problem-solving which help an organization to predictably do what it knows how to do well.”4 He goes on to further define leadership as being “about vision, about people buying in, about empowerment and, most of all, about producing useful change.”4

Recent research examines this topic of management versus leadership. For instance, Algahtani conducted an extensive literature review of 37 peer-reviewed articles that focused on the topic of leadership versus management. He found that most authors separated the two topics based on basic definitions and skill sets. Management definitions and skill sets consistently focused on “doing”—ie, planning, administrating, organizing, controlling, and enforcing rules and regulations.5 Whereas, leadership definitions and skills sets focused on identifying and communicating values, vision, inspiration, empowerment, change, and aligning people. Similarly, Toor conducted a qualitative study in which he interviewed 49 leaders regarding their perceptions about the differences and similarities between management and leadership. Results showed clear differences in these perceptions.

A leader does not simply set a goal and instruct the team to achieve it. Rather, a leader helps the team see how the goal is important and inspires the team to embrace that goal.

A leader does not simply set a goal and instruct the team to achieve it. Rather, a leader helps the team see how the goal is important and inspires the team to embrace that goal.

Study participants associated concepts and words such as “personal, flexible, long-term, principle, change, empower, leading by doing, and personal power” with leadership whereas they identified concepts and words such as “status-quo, subset, short-term, stability and order, impose, position power, managing by asking, and organizational” with management.6 A general theme of the findings was that leadership is more flexible while management is more rigid. Additionally, the concept of power was a predominant theme in this study. Most participants believed that leaders earn power based on the personal relationships they establish with followers, whereas managers earn power based on a titled position or employment rank.

Another perspective to ponder is whether leadership and management can be classified as art or science. Turning back to the dictionary, one finds that the meaning of art is “The systematic application of knowledge or skill in effecting a desired result; the employment of means to accomplish some desired end.”7 Science is defined as “Accumulated and established knowledge, which has been systematized and formulated with reference to the discovery of general truths or the operation of general laws; skill, or expertness, regarded as the result of knowledge of laws and principles.”8 It can be argued that true leadership is the ability to artistically use the science of management. Management is done to a subordinate; leadership is done with followers. Many leadership experts use common words to describe traits of a leader: innovative, inspiring, charismatic, influencing, has vision, facilitates, passionate, proactive, creative, empowering, changing.3,9-13 Similarly, there are common words used to describe traits of a manager: authoritative, controlling, reactive, administering, structured, directing, and maintain. These adjectives used to describe leaders and managers certainly reflect a more artistic connotation for leaders and a more scientific connotation for managers.

Maxwell makes a clear distinction that it is not position that makes one a leader, but his or her ability to influence others.3 Leaders and managers are not always found in formal positions of authority. There are two general forms of leadership: assigned leadership and emergent leadership. Leadership that is based on a titled role of authority within an organization is assigned leadership. Emergent leadership occurs when one is perceived to be a highly influential person within a group regardless of title.14 Managers often achieve a title of manager through assigned leadership. However, leaders can emerge in a variety of settings and situations. For example, therapists lead their clients through the recovery process on a daily basis, yet they may not hold a title of “leader” or “manager.”

While differences do exist between the concepts of management and leadership, they are not mutually exclusive. When used together, these variant approaches can lead to powerful results. Yet, there tends to be a preponderance of managers and a lack of leaders within the rehabilitation field. Just think for a moment about job titles and descriptions. Most often, positions with authority include words that lend toward management: rehab manager, program director, care coordinator, etc. Have you ever seen a job advertisement for a rehab leader, department visionary, or chief influencer? These examples are a bit over the top, but the point remains: the emphasis on hiring is typically slanted toward management.

Management roles are also easier to define, and management skills are easier to teach. While a training program may be advertised as one that teaches leadership or management skills, most often the majority of the subject matter presented revolves around management skills—skills such as planning and budgeting, organizing and staffing, controlling and problem-solving. Management skills tend to be concrete and easily defined. Leadership skills, however, are more abstract—such as establishing direction, creating a vision, aligning people, motivating and inspiring, empowering, and energizing.14 There needs to be an increase in the number of leadership development programs available to managers and clinicians for optimal organizational performance.

Although many organizations do not delineate leadership roles from management roles, it is possible for an individual to rely on both strategies for maximum outcomes. Take, for example, the role of a rehab manager. This is a titled position that automatically instills a sense of power and authority. The person has management responsibilities such as enforcing company policies and procedures, managing revenues and expenses, hiring qualified staff, and ensuring that clinical and financial business drivers are being met. However, these activities can be approached from a leadership perspective. A key characteristic of a strong leader is the ability to create a vision and gain “buy in” from the team. Additionally, a strong leader understands his or her followers (team) and provides the right type and amount of support, guidance, encouragement, and motivation to lead the team toward those organizational (management) goals. A leader does not simply set a goal and instruct the team to achieve it. Rather, a leader helps the team see how the goal is important and inspires the team to embrace that goal.

The leader then works together with the team to facilitate goal attainment. Leaders artistically tailor their style to suit the situation and the particular followers. They use a shared vision to encourage goal accomplishment rather than by using hard data and authority to dictate performance.

Over the course of the last 100 years, the concept of leadership has been widely studied. Scholars have examined the subject from a variety of perspectives and, as a result, a plethora of theories and approaches emerged. Two leadership approaches that are particularly applicable to the rehabilitation setting are authentic leadership and servant leadership. Authentic leadership is a relatively new concept of leadership that can be easily applied whether one is leading a client through recovery or leading a company to financial and clinical success. It is concerned with presenting one’s “true self,” which in turn results in authentic, trusting relationships between the leader and followers.

Research on this topic began to emerge in the late 1990s and early 2000s in response to societal crises and controversies such as 9/11, major corporate scandals, and failure of the banking industry.14 These crises caused people to seek more authentic leaders who they could trust. Because this concept is so new, there is not yet a solidly formed theory of authentic leadership that is widely recognized. Rather, there are many definitions and approaches to describe this phenomenon.

Harter defines an authentic leader as one who owns “one’s personal experiences, be they thoughts, emotions, needs, wants, preferences, or beliefs, processes captured by the injunction to ‘know oneself’?” and one who “acts in accord with the true self, expressing oneself in ways that are consistent with inner thoughts and feelings.”15 Authenticity requires self-awareness and an expression of one’s morals and values. Additionally, the physical manifestation of the leader’s authenticity is critical to this approach. Ladkin and Taylor state, “It is the leader’s body, and the way he or she uses it to express their ‘true self’ which is the seemingly invisible mechanism through which authenticity is conveyed to others.”16

Authentic leaders realize that self-awareness is important and continuously seek to learn more about themselves and their reactions to the world. These individuals are open to feedback about themselves and their actions, and view these situations as opportunities for personal and professional growth.17 Authentic leadership is a valuable approach that can ensure positive, trusting relationships between the leader and the followers that can lead to successful outcomes—a fact that is supported by research. Clapp-Smith, Vogelgesang, and Avey conducted a survey and found that “authentic leadership is related to both performance and trust.”18 López, Alonso, Morales, and León conducted a cross-sectional study that showed a positive relationship between authentic leadership, group cohesion, and group identity.19 Additionally, Ilies, Morgeson, and Nahrgang found that “authentic leaders are able to positively impact the well-being of followers.”20

The concept of servant leadership was established in the 1970s by Robert K. Greenleaf. This theory proposes that leaders put followers and their needs first—above their own—ensuring that the follower feels supported, empowered, and valued. Servant leaders are often considered to be altruistic and humanistic.14 According to this model of leadership, there are 10 characteristics of a servant leader: listening, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, commitment to the growth of people, and building community. Research has demonstrated that this approach to leadership produces positive outcomes related to follower performance and growth, organizational performance, and societal impact.14

A phenomenological study conducted by Savage-Austin and Honeycutt examined the lived experiences of 15 servant leaders and their perceptions of organizational outcomes. Results of this study showed followers of servant leaders felt a greater sense of trust and loyalty toward the organization.21 Additionally, results showed increased productivity, improved morale, and a reduction in employee turnover. A study by Irving and Longbotham proved team effectiveness is highest when performing under a servant leadership approach that focuses on providing accountability, supporting and resourcing, engaging in honest self-evaluation, fostering collaboration, communicating with clarity, and valuing and appreciating.22

Authentic leaders realize that self-awareness is important and continuously seek to learn more about themselves and their reactions to the world. These individuals are open to feedback about themselves and their actions, and view these situations as opportunities for personal and professional growth.

Authentic leaders realize that self-awareness is important and continuously seek to learn more about themselves and their reactions to the world. These individuals are open to feedback about themselves and their actions, and view these situations as opportunities for personal and professional growth.

Return to the original questions: do you believe management and leadership are the same? How would you identify yourself and your supervisors? I hope that by now you can see there is indeed a difference, and that by focusing on strengthening your leadership skills, operational and clinical outcomes can be maximized. The most successful “managers” are not only managers, but they are leaders as well. If a manager is able to look beyond the “black and white” and the “here and now,” and employ vision for future directions and inspiration for goal accomplishment, especially through an authentic or servant leadership approach, a very powerful and successful leader may evolve. RM

Melissa M. Sweetman, OTD, OTR/L, has been an occupational therapist for 20 years. For the majority of her career, she worked as a clinical and operational multi-state regional director in the post-acute and long-term care settings. She currently serves as the co-program director for the Post-Professional Doctor of Occupational Therapy Program at Rocky Mountain University of Health Professions in Provo, Utah. Additionally, she serves as the administration and practice management elective track director within the OTD program. For more information, contact [email protected].


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