ABSTRACT
The concept that leadership is for everybody and for all doctors and it is not just 'another competency', defined by a competency framework is further supported by Rughani and Lees, indicating that development of such skills later in postgraduate training may well be too late to allow the talented leaders in waiting to flourish. Development in both leadership and management is needed for all doctors, and it is now recognised that it is not 'an optional extra'. The changing external context of healthcare requires primary and secondary care doctors to operate in a vastly different environment which will require a different form of organisational leadership. The changing of the doctor's role from clinician to 'clinician/manager' in the United States in the 1990s led to commentators suggesting there is a need for doctors to influence rather than to control, to develop a more external than internal focus, with the physician leading by listening, influencing and supporting others.
