How we wish to be cited:
Norberg B. The leader game – player and coach [culture]. Rondellen 2003; 14. URL:
http://www.rondellen.net
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Jan Westin was born in Gothenburg 1936, where he in due time became internist, hematologist, and scientist (associate professor). With clinical and scientific training as a basis, Westin has for twenty years been a successful leader of Swedish health care in the university hospitals of Gothenburg and Lund. As an independent adviser, he now has published the concepts behind his career (1). |
A previous paper (2) in this series suggested that present "crisis" in Swedish health care is partly due to leadership failure; in summary too many nurses and doctors in administrative functions, too few professional administrators, and too many administrators. These conclusions appear to be contradictory. Yet, the straight line is the shortest between two points.
The personal interactions of health care cannot be described solely by geometry. The transactional analysis outlined by Berne (3) and Harris (4) applies often to the workers on the shop-floor. European football (soccer) illustrates the interplay between individuals, team, and context factors (5).
As an individual actor at the doctor level in Swedish health care from 1963 and forth, I often could influence my next move (transaction) - barely. The duty system was apt to be over-administrated with five reports in different directions about each new patient. Then I could take a short cut around most of my white-collar work simply by typing the patient chart at once myself; the reports were chart substitutes, until the banded chart was typed next day or next week. However, a first and final chart typed by me reduced my total workload per new patient by 80%.
In Swedish health care, the representatives of the owner have by tradition kept a low profile (cf 2); "health care is best managed by its own professionals, who know their customers, their own organization, and the society around the patients". In such a setting, the training of new leaders from the doctor group is essential. With a conspicuous leader career behind, Westin now addresses the problem of preparing a new generation of physicians for management tasks in health care (1).
It should be emphasized, that the leadership performed and painted by Westin is not a personal power just for own fun, glory, and personal profit. The leader role is more the role of a servant with a defined task from an employer, defined duties toward fellow coworkers at different levels, and defined goals. The leader depicted by Westin is akin to the coach of a football team, "Swedish style". This style of leadership is not new; one such career has been known for about 4000 years (6).
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