Editor's summary

Dentists need leaders. That's what this BDJ qualitative research asserts. The profession needs transformational leaders who lead with a style that embraces teamwork. But why? What does all this leadership jargon mean? What can leaders actually do for us? How can an effective leader help in this time of change?

Perplexed by these questions, I looked to one of the world's most famous 'transformational leaders' Barak Obama for inspiration. Obama suggests: 'Change will not come if we wait for some other person or some other time. We are the ones we've been waiting for. We are the change that we seek.' On direction Obama argues: 'Focusing your life solely on making a buck shows a certain poverty of ambition. It asks too little of yourself. Because it's only when you hitch your wagon to something larger than yourself that you realise your true potential.' That's inspiring isn't it? I'm certainly motivated to make myself a better person! But I can't phone Obama when I feel a dip in motivation. I can't call on him for advice when I lose sight of the team's vision. We need our own leaders in the profession for this.

This study provides a window into the minds of current key dental leaders and their views on the type of leaders dentists need. It also concludes that shaping of new leaders will be crucial to helping the profession negotiate changes in policy, practice and patient expectations.

The article also inspired me to think about other leaders in the world and to investigate different leadership styles. I discovered an excellent slant on leadership from the not-so-obvious leader, Albert Einstein. He said: 'setting an example is not the main means of influencing another, it is the only means.' That is the way that leadership in the dental profession needs to happen. A transformational leader leads by motivating their followers. They have a clear, shared vision and use enthusiasm to inspire others. This is very different to vertical leadership, for example, where the leader is in charge and tells people what to do. The profession is facing continuing change and uncertainty – is this because there is a lack of leadership or due to external forces? Perhaps a bit of both? One thing is certain, the development of effective leaders is essential for dentistry right now.

I finish with one last leadership quote, again from an American President, Dwight D. Eisenhower. Eisenhower provides a good reason for us to turn to transformational leadership rather than pursuing vertical leadership: 'You do not lead by hitting people over the head', he claimed, 'that's assault, not leadership.'

The full paper can be accessed from the BDJ website ( www.bdj.co.uk ), under 'Research' in the table of contents for Volume 214 issue 1.

Ruth Doherty

Managing Editor

Author questions and answers

1. Why did you undertake this research?

This research emerged from an initial exploration of the role of team working in shaping dental professionals of the future. Leadership and education for leadership emerged as integral components in empowering dental professionals to move forward and adapt to change. The research identified the significant potential in undergraduate education and the need for this to be fully developed. Indeed, education at all levels was identified in being instrumental to adaptability. The research also provided the opportunity to speak to leaders about their role and their vision for the future. This was seen as vitally important in giving validity to the emergent ideas.

2. What would you like to do next in this area to follow on from this work?

This paper opens up a much needed debate about the role of leadership in the dental profession. One area of particular interest is in the potential impact of the introduction of a management and leadership domain in the undergraduate curricula for all dental and dental care professionals. There is the potential for research into the development of programmes which encourage and nurture leadership skills. There is also longitudinally, the potential to explore the impact these changes have on dental leaders of the future. Additionally, there is the opportunity to examine how the dental profession continues to respond to the demands for change imposed by external forces and the role current leaders take in control the future of the profession as they go forward.

Commentary

This study is a timely empirical contribution to developing leadership for dentists, an area where there is comparatively little research to date. Leadership is of topical interest across the clinical professions, particularly given the challenges to working practices emanating from recent reforms and changes to undergraduate and postgraduate dental training curriculum.

The aim of this study was to explore dental leaders' perceptions of the current position of leadership, using interviews with a small sample (13) of leaders within the dental services. Three broad themes are highlighted: the characteristics and behaviours of dental leaders; challenges for dental leaders; and education and training for dental leadership. The study offers a range of different characteristics and behaviours believed to be associated with good leadership. Of particular note, was the value attached to shared leadership. This is a topical theme in both leadership theory and practice in the NHS.

With regard to challenges, the obvious one is the challenge of structural change and lack of funding in healthcare. The study rightly points out these changes have made leadership in dentistry difficult. It is necessary to face up to these challenges by developing new leaders for the profession. The failure to develop new leaders has been a problem for other professions. The study also reports that education and training for leadership are considered important but that not enough has been provided to date and those courses currently provided are not always appropriate.

I agree with the authors that leadership in dentistry is complex and multi-faceted, with an overriding need for the development of a collaborative style of leadership. Of particular interest is the authors' notion of developing a leadership cycle for effective leadership involving teamwork, communication and education. The key context is the dental team.

The study correctly shows, albeit from a limited sample, that there is a growing awareness of the importance of leadership and team working in dentistry and dental leaders are aware of the way forward, which to a large extent is to provide appropriate, dental-specific education and training at undergraduate and postgraduate levels. A similar need has been identified in medicine.