Leadership in anesthesiology: not just a one man show

Anesthesiology had been one of highly skilled professional specialty with diversity of training but with a structured model of leadership culture. The culture which could be drawn back since medical training to become a medical doctor. School of medicine had already established a standard model of teaching and training. The tutoring method is implemented mostly based on classroom meetings in traditional basic lesson, bedside teaching for clerkship and internship and lately adopted method of case-based discussion.1 Professional teaching is definitely different than regular and traditional teaching method. Bachelor degree is not the only main goal but good attitude, work ethics and communication as part of character building hold some key points too. Mentoring system not only based on teachers, professors, counselors, seniors who put themselves as trailblazers but also need to establish new foundations for pupils, juniors, and successors to become future leaders. Our predecessor, Ki Hadjar Dewantara had already synthesized a leadership Javanese-rootedphilosophy but could be accustomed to Indonesian culture as a whole country. “Ing ngarso sung tulodo, ing madya mangun karso, tut wuri handayani” was a deep philosophy that could build a strong value of leadership in every needs. These strong words also could be internalized in every anesthesiologist, starting from junior residents and high profile professors and consultants. All of us would start as fresh and highly fascinated residents, embracing knowledge, sharpening our skills, make our way up to become a professional anesthesiologist. Without personal confidence and conscience awakening of the leadership value, our journey to become an anesthesiologist would only be filled with disputes, breakdowns, and restraints. As the old sayings, we need to become servants to others in order to become true leaders. According to published research from Florida Society of Anesthesiologists, about 60% US citizens did not know about anesthesiologist, what were their job and competencies, and even did not know that anesthesiologists are also a trained medical doctor. United States of America employs nurse anesthetists that could provide anesthesia service in accordance with their competency level who become rivalries with anesthesiologist in anesthesia service. This evolving matter would make anesthesiologists need to find a way to level up their services and competencies in order to get higher marks and reputation. One of true competencies that future anesthesiologist should have to overcome others is leadership. The true leadership not only lies on commanding others but also managing ourselves and coworkers into a solid team to improve performances.2 Theory of Leadership had been evolving in time. Not all of theories could be applied to special healthcare working team who faced exceptional challenges. The team needs to provide consistent high-quality patient care and at the same time train and develop each team member especially the novice members. Their tasks would be uncertain, unpredictable, urgent and complex. A special team that really need a good team leader to build, guide, and coordinate its member to overcome challenges. Those theories especially which could be practiced on a special trained unit and perfectly derived and compared with anesthesiologist way of leadership are already in research field of Katherine J. Klein and her colleagues (2006). Klein and team had drawn four leadership perspectives of particular relevance to extreme action teams of the Trauma Resuscitation Unit (TRU). They are contingent leadership, functional leadership, shared team leadership, and flexible leadership.3-5 Contingent leadership theory emphasized that leaders must be matched to, or must match their style to characteristics of the situation. Leaders urged to provide directive leadership when subordinates are inexperienced and their tasks are unstructured and complex. Leaders are advised to allow subordinates more influence in decision making if the subordinates share, rather than oppose, organizational goals. The theory suggests leaders of extreme action teams may adapt their behaviors to the changing nature of their teams` tasks.3-5 Functional leadership theory describe the broad functions a leader may serve for his or her team. Some key leadership functions identified in this theories include monitoring team performance an 1,2Anesthesiologist, Regional Anesthesia Consultant, Anesthesiology and Intensive Care Department, Udayana University 3Anesthesiologist, Anesthesiology and Intensive Care Department, Udayana University