A theory of expert leadership in psychiatry

The technical competence of leaders, or 'expert knowledge', has been shown in many settings to be associated with better organisational performance. In universities, for example, there is longitudinal evidence that research-focused scholars make the best leaders. Results from a hospital study show that doctors rather than professional managers are most closely associated with the best performing institutions. To explain these patterns, and raise hypotheses, Amanda Goodall developed a theory of expert leadership (TEL). In this paper, the framework for expert leadership is applied to psychiatry.

This study in TEL proposes that psychiatric leaders, as opposed to non-expert managers, improve organisational performance in the following ways:

• their expert knowledge influences organisational strategy;
• having been 'one of them', a psychiatrist understands how to create the optimal work environment for psychiatric teams through appropriate goal-setting, evaluation and support, all factors postively associated with workers' wellbeing and performance;
• exceptional psychiatrist-leaders are likely to set high standards for hiring;
• their credibility extends their influence among core workers, and also signals organisational priorities to stakeholders;
• finally, a necessary prerequisite of TEL is that expert leaders have direct executive power inclusive of budgetary and strategic oversight.

The original theory of expert leadership (TEL) was developed to try to explain empirical regularities that were found in a number of leadership settings (in universities, hospitals, high technology and sports). In that spirit, an ideal-type model for psychiatry is presented in this study. The different channels depicted in the model illustrate how expert leaders - psychiatric-executives - can influence organisational performance. Further research currently in the planning process will uncover fully the strengths and weaknesses of the theory of expert leadership in this important area of medicine.

The full article was published in Australasian Psychiatry in June 2016.