Health care leadership vs. health care administration: What's the difference?

What’s the difference between health care leadership and health care administration — and what does it take to develop the skills to lead in today’s complex health care environment? Sandi Ferretti, program director of Brown University’s master's in healthcare leadership, explores the distinction between managing health care systems and leading people, teams and change.

Four coworkers collaborate around a conference table with laptops in a bright office.

For at least 50 years, the Master of Healthcare Administration, formerly the Master of Hospital Administration, or “MHA”, has been the gold standard of management training in health care. Many leaders in health care, including myself, earned an MHA and benefited enormously from the knowledge, frameworks and opportunities it provided.

And then we entered the real world.

We quickly discovered that knowing how a health care organization works does not necessarily prepare you to lead the people, teams and projects within it. It can be a bit of a “dive in, then sink or swim” experience.

That experience raises an important question for anyone considering graduate education in health care: What makes the difference between a program that gives you knowledge and one that helps you develop the skills to act on that knowledge?

Administration and leadership are not the same thing

Health care administration and health care leadership are closely connected, but they are not interchangeable.

Health care administration focuses on understanding and managing the systems that make health care organizations function. Finance, operations, policy, quality, strategy, workforce management and regulatory requirements are all essential areas of expertise for health care administrators.

Leadership involves a different set of questions.

“ How do you bring people together around a difficult problem? How do you influence change when you don't have formal authority? How do you navigate competing priorities and perspectives? How do you make decisions when there is no obvious right answer? And perhaps most importantly, how do you turn an idea into action? ”

Effective health care leaders need administrative knowledge. But they also need opportunities to practice using that knowledge in situations that resemble the complexity of real health care environments.

From knowledge to leadership

Leadership is often discussed as though it were a set of personal characteristics: confidence, vision, decisiveness, communication. But leadership is not simply something people have. It is something they practice.

That means leadership education needs to create opportunities for students to do more than learn about leadership. They need opportunities to make decisions, navigate complexity, work through competing interests, receive feedback and see the consequences of their choices.

This is one of the principles underlying Brown's master of science in healthcare leadership (MHL). The program is designed to go beyond knowledge and provide opportunities for applied practice and skill building.

Three themes run across the curriculum.

  • Leadership in specific health care disciplines. As students engage in the course curriculum, each class addresses the leadership and decision-making requirements of that particular area of study. A great example is health care policy. Students learn the nuances and complexities of health care systems as they exist today in the U.S. and internationally. The focus though, is on how policy gets made and the mechanisms to drive policy change. An assignment might be for the student to assume a leadership role, such as a State Governor, and develop a comprehensive action plan to address the opioid crisis. Emphasis is placed on planning and decision making in real-world scenarios.
  • Leadership in practice. Our capstone requirement, the Critical Challenge Project, requires students to synthesize their learning and skills practice into an applied project that is meaningful to them. This provides real world practice in leading a large project with systemic impact. Students go on to implement their project, publish articles and start companies. Our student results speak for themselves.
  • Leading and developing yourself. The MHL program also includes a specific leadership development curriculum that students participate in throughout the program. Students receive an evaluation, leadership coaching, develop their own leadership development plan and participate in hands-on activities that practice skills.

The question for today's health care leaders

The health care environment is unlikely to become less complicated.

Organizations are navigating workforce challenges, changing models of care, technological disruption, evolving policy, financial pressures and growing expectations from patients and communities. Leaders are increasingly expected to work across organizational boundaries and bring people together around problems that no single department or discipline can solve.

In that environment, technical and administrative knowledge remain essential. But knowledge alone is not enough.

The more useful question may be: Can we turn what we know into effective action and can we bring other people with us? That is the space where health care administration and health care leadership intersect.

An MHA can provide a strong foundation in the management of health care organizations. Leadership education complements that foundation by focusing deliberately on the human, relational and practical work of leading change.

For health care professionals considering graduate education, the distinction is therefore less about choosing between administration and leadership than understanding what capabilities they need to develop next.

Health care needs leaders who understand the system.

It also needs leaders who know how to move within that system, work with others, make difficult decisions and turn ideas into action.

The future of health care will require both.

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