Health Management Leadership essay

Health Management Leadership 4

Transformational Leadership Theory in the HealthSector



Word Count: 2259

All over the world, leadership is regarded as an essential featurefor the future success of institutions.1 West et al.2suggest that system changes, setting targets and competition increaseare still inadequate measure for change within an organization. Thehealth care sector is one of the organizations that critically need achange of culture in management for the continual improvement ofquality health care provision. To have a realized change of culturein a health organization, influence from leadership is needed. One ofthe leadership theories that has gained recognition and muchattention is the transformational leadership.1 Theleadership style was first put across by James Burns in 1978 andfurther research into the model was quickly researched by otherindividuals.1 This paper will, therefore, evaluate theleadership style in detail, noting the various dimensions articulatedfor the model as well its characteristics. Presently, the paper willevaluate the positive and negative aspects of the leadership approachwhile stating its contribution to knowledge. An application of thetheory will also be included which involves an internship programthat was undertaken in an international pharmaceutical company.Finally, the paper will end with a personal reflection of the modeland a conclusion after that.

The reason for choosing this topic under evaluation was…..

Matthews3 points out that a transformational leaderusually seeks to satisfy the higher needs of the followers whileengaging their full potential. These leaders go beyond satisfactionof social material but go deeper into satisfying psychological needssuch as competence and affection.1 Consequently, theirattention and attendance to the psychological needs of followersstrengthen further efforts and commitment of the followers towardsthe organization’s goal.1 Transformational leadershipcontains four critical dimensions. They include inspirationmotivation, idealized influence, individualised consideration andintellectual stimulation.1,2,3

Inspiration Motivation

This dimension refers to the way the leader views the followers’future with optimism by selling a vision to them while influencingtheir commitment to the vision by communicating the achievability ofthe set goals. The leader stresses on ambitious goals and offers aprojection of the vision to the followers.

Idealised Influence

It involves engaging in charismatic behaviour which is admirable tothe followers. The leader puts across high expectations of the futurethrough his beliefs, values and sense of mission which earn respectand trust to the leader.

Individualised Consideration

This dimension focuses on the individual needs of the followers byaddressing their aspirations and strengths. The head showsself-awareness of the individual needs of the followers and attemptto satisfy each individual’s needs. The satisfaction may come inthe form of advice, paying attention to the needs, and supporting thefollowers so that they can self-actualize and further develop.

Intellectual Stimulation

The leader stimulates the intellectual ability of the followers bychallenging their decision-making skills through incorporation intoproblem-solving mechanisms. Followers can also be encouraged tochallenge existing frameworks and assumptions to provide logicalsolutions for the various institutional functions.

Transformational Leadership and the Satisfaction of PsychologicalNeeds

As indicated earlier, transformational leadership is embedded in fourkey dimensions which conceptualize the leadership framework thusmaking it effective.1 Kovjanic et al.1 suggeststhat the self-determination theory provides a key framework for theeffectiveness of the transformational leadership model. They pointout the theory’s postulation of three psychological needs which areessential preconditions for human development and blossoming.1(p1033)these three human needs are autonomy, competence, and relatedness.1Autonomy means the need for self-organizing a feeling ofself-choices and not through external influence. Competence is thefeeling and ability to be effective through mastery of capabilities.It involves the provision of opportunities which will further enhancethe mastery of these skills and abilities. Relatedness is the feelingof connectedness to the others including other followers and leader.Below is a linkage between transformational leadership and itsfulfilment of the three human psychological needs.

Need for autonomy

Followers need the feeling of self-organizing without externalinfluence. Transformational leaders use idealised influence dimensionby being portraying charismatic behaviours which are easily admiredby the followers. The leaders then use the opportunity to extendtasks that are value encumbered. The leaders also view the futureexpectations of the followers and provide a vision for them which arefollowed by an influenced commitment on the side of the followers.1Consequently, the followers take up these attractive goals from theleader and perceive them as theirs. Not only do the transformationalleaders provide followers with goals which seem autonomous tofollowers but also provide them with the opportunity to challengeframeworks and give out solutions to problems (intellectualstimulation).

Need for Competence

As noted in the dimensions of transformational leadership, the leadergives adequate attention to the development of follower skills,knowledge and abilities (Individualised consideration). Theseleaders, therefore, endeavour to provide training to theirfollowers.1 Similarly, transformational leaders areregarded as coaches as they provide adequate feedback and anexcellent environment that fosters mutual respect and trust amongfollowers.1 The leaders also build employee confidence asthey engage in idealised influence while articulating to them thatthe goals are achievable through inspirational motivation. Finally,transformational leaders satisfy the competence need of theirfollowers through role modelling. The leaders act as points ofreference to the employees as they learn. The great exhibition ofconfidence and optimism about the future is easily emulated to thefollowers. As a result, these leaders offer an environment thatcontains challenges, support, and responsive feedback, which arecrucial for the enhancement of competence.

Need for Relatedness

Transformational leaders strive to create a sense of connection amongthe employees.1 The connection is twofold between theleader and the employee and among the several employees. Throughidealised influence, the leader can create a high ethicalconsideration standard that ought to be met by followers. Through theemployees’ fervour towards the shared goal, the team is pushed toacting in a self-sacrificial manner placing the team’s aspirationsbefore theirs subsequently earning respect among themselves.Transformational leaders are also familiar with motivating the teaminto accepting the set goals and mission.4(p265) Theyconnect the aspirations with the employees thus connecting thefollowers to a common aspect. Social identification is a factoridentified by Kovjanic et al.1(p1035) whereby the leadercompares and separates the team from all other teams through thearticulation of past achievements.

All the three psychological needs are, therefore, addressed by thetransformational leader through the four dimensions oftransformational leadership framework.

Leadership structures usually contain both positive and negativeaspects. Similarly, the transformational leadership model has bothpositive and negative factors. Most of the advantages of theleadership model are connected to the four dimensions oftransformational leadership approach.

Positive Aspects of the Transformational Leadership Framework

Builds Trust

Using the idealised dimension, the leader can gradually gainconfidence from the followers. The charismatic behaviour exhibited bythe leader builds trust among the followers and over time the leaderlearns to trust the employees.3 the idealised influenceelement of the leadership model allows for trust development as theleader continues to act and behave as the followers’ role model.

Influence Employees to be Leaders

As the leader demonstrates the charismatic behaviour and the optimismheld of the future, the employees are left with a large admirationover their leader.1 The high level of risk engaged by theleader coupled with a set of core values and principles make theleader greatly admired pushing employees into seeking leadershipopportunities in future. The leadership model can, therefore, beargued to foster leadership and cultivate leaders in the workenvironment.

Build Communication Skills

In the description of this leadership model, the leader identifiesindividual needs among the followers and searches for appropriatemotivation that suits each follower.1,2,3,4 Motivating thefollowers while maintaining high charisma takes a lot ofcommunication skills. Similarly, the leader often needs vigour, senseof authority, precision, and power to effectively communicate thevision to the followers. The leader also develops optimism for thefuture which is communicated to the rest of the team. Over time, theleader develops a high communication skill standard as frequentexposure to different circumstances calls for proper communicationthat will easily be received.

Creativity and Innovation

Transformational leadership always place employees in challengingsituations.3 The leaders frequently challenge theemployees on various institutional approaches and, in turn, theirdecision-making skills are enhanced. Through the leaders’ valuationof employee autonomy, their creativity and innovation skills areenhanced. Transformational leaders also help employees discoverproblems within frameworks and stimulate them into providingsolutions for the problems without criticism. The leader helps thefollowers to view problems deeply by selling the vision which makesthem view the bigger picture of a problem. As a result, employeesacquire their full potential which improves the overall performanceof the organization.2


Role modelling is a key aspect of the transformational leadershipframework. The leader is a leading example to the followers. Asdiscussed earlier, the leader displays a set of values and positivebehaviour that are beneficial. The transformational leader usuallymust identify every follower’s motivation through observation orlistening in people’s conversations. Through that, the leader thenoffers customized training to each follower addressing to individualneeds.1 These pieces of training allow attainment of fullpotential and growth among followers. Similarly, the relatednessamong followers as well as between the leader and followers makes thegrowth process more involving for newer members or veteran employees.


Apart from developing the skills and fulfilling the needs of thefollowers, the leader also has a vision for the organization’sfuture.3 The vision could involve a change in businessplan or change departmental structures. The leader has ideas that themanagement would gladly receive as they would be beneficial for theoverall growth of the institution.

Employee Retention

The focus of a transformational leader is to develop followers andmake them realise their full potential.1 the leader oftenengages in communication with individual employees and discuss waysof developing their careers. Therefore, the leader creates a strongbond with the followers which reduces employee turnover. Theemployees feel a corporate fit as they can easily report anything totheir leader. In turn, the organization avoids costs arising fromtraining and hiring of new employees.

Negative Aspects of the Transformational Leadership Framework

Tourish presented a book titled The Dark Side of TransformationalLeadership where he scorned the transformational leadershipframework.

Coercive Control

Tourish5 argues that transformational leaders use coercivemeans to assert their power and authority. Tourish comparestransformational leaders with captors who use mechanisms such as rolemodelling to use force as a mechanism.1(p40) Similarly,the leaders use manipulation into showing employees they are highlyvalued only to be expecting performance in return.

Authoritarian Form of Organization

The leader advocates for a strict obedience to rules in theorganization. Tourish5(p37) suggests that the leader hasall the power in the organizational environment leaving the followerswith none. The followers are left with no choice of opposition totheir leaders as their behaviours assert an authoritarian rule.

Use of Ideology to Enhance Power

Transformational leaders use different ideas to spread values totheir followers. Tourish5(p59) puts across one ideology ofspirituality which is used by leaders to enhance their powers.

The Framework Stifles Dissent

Transformational leaders support feedback from followers. However,this feedback always has barriers hence no feedback is made. Tourishdescribes how the model suppresses any opposing expressions from theleaders. The leader is the role model for the team and going againstany decision made earlier will be perceived as rebellious.

Application of the Transformational Leadership Theory

In the assessment of how the theory of transformational leadership isapplied to the health care sector, the paper considered ….

Personal reflection

While conducting this study, I ….


Transformational leadership is a leadership framework with globalrecognition for its focus on the needs of the employees whilestriving to develop their competence. The model identifies the leaderas a role model to the followers who emulate values and behaviourfrom. As a result, there exists interconnectedness among theemployees and between the leader and the employees. This leadershipmodel builds trust among employees while ensuring the gradual growthof employees. Therefore, the company can reduce employee turnover asthey acquire a sense of belonging. However, some postulates arguethat this leadership model uses coercive mechanisms to manageemployees.5 Nevertheless this leadership model holds thekey to organizational success as it focuses on employee growth anddevelopment to reach full potentials. This is evident in England’sNational Health System (NHS) which continues to be successful due toits embrace of transformational leadership model.6 However, NHS has problems with maintaining these leaders as they are soonreplaced once they get into difficulty. NHS needs to support itsleaders and give priority to developing more collective leadershipwithin local systems of care.


  1. Kovjanic S, Schuh SC, Jonas K, Quaquebeke NV, Dick R. How do transformational leaders foster positive employee outcomes? A self‐determination‐based analysis of employees` needs as mediating links. Journal of Organizational Behavior. 2012 Nov 133(8):1031-52.

  2. West M, Armit K, Loewenthal L, Eckert R, West T, Lee A. Leadership and leadership development in healthcare: the evidence base. London: The Kings Fund. 2015.

  3. Mathews J. Leadership and Motivation: Developing an Effective Climate. University College Dublin 2016.

  4. Antonakis J, Avolio BJ, Sivasubramaniam N. Context and leadership: An examination of the nine-factor full-range leadership theory using the Multifactor Leadership Questionnaire. The leadership quarterly. 2003 Jun 3014(3):261-95.

  5. Tourish D. The dark side of transformational leadership: A critical perspective. Routledge 2013 Mar 4.

  6. Rughani A. Transformational leadership is for everyone. Education for Primary Care. 2015 Sep 326(5):286-8.