Medical leadership in the 21st century

Objective: Psychiatry as a discipline and as a profession stands at the cusp of major challenges in many areas including social, biological and psychological spheres. The practice of psychiatry is affected by ideologically driven policies by politicians, and the continuing long-lasting impact of the global economic downturn along with new developments in health care delivery. Changing biological factors include better understanding of brain structures and functioning and potential developments in psychopharmacogenomics. Social changes facing psychiatry include globalisation and rapid urbanisation. Psychological changes include therapies without therapists and the impact of social media and the information age. The current paper explores these challenges and the opportunities for psychiatrists to provide leadership in a number of settings. Conclusion: Leadership skills are essential skills for psychiatrists, and enable an individual to plan and deliver services, and also help them to lead not only clinical teams but organisations and institutions. Psychiatrists are best placed because of the breadth of the training they undergo and their communication skills. Leadership is markedly different from managerial skills, although there may be a small degree of overlap.