ABSTRACT
Doctors in management are constantly making more individual decisions, some of which may have a major impact of colleagues or the organisation. Doctors are used to making decisions with patients about health, illness and treatment options. If there is a serious lack of alignment with local management, the doctor–manager has to decide whether or not they are able to persuade or otherwise influence other members of the team or whether it is more consistent with their own values and integrity to step down. More senior management roles may be initially for a fixed term or may be on a rolling contract. Even a newly appointed consultant or principal without 'extra' management responsibilities can benefit from being clear about their vision, values and goals for what they want to achieve on the managerial front in their first year or so in post.
