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The difference between a leader, a manager, and an innovator

Arlen Meyers, MD, MBA
Physician
October 7, 2025
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The gimmick of the day is to make -preneur the suffix of the year. Solopreneurs. Doctorpreneurs. Digipreneurs. Trumpreneurs. It should come as no surprise then, that leaderpreneur has appeared in your latest Google search. What is a leaderpreneur, anyway, and why should anyone care? Recognizing that there are as many definitions of leadership, entrepreneurship, and innovation as there are practitioners of those arts, here is my take:

Entrepreneurship is the pursuit of opportunity with scarce resources with the goal of creating user-defined value through the deployment of innovation using a VAST business model to achieve the sextuple aims.

Leadership is about creating social influence by communicating vision, direction, and inspiration. The fundamentals are:

  • Uniting people around an exciting, aspirational vision.
  • Building a strategy for achieving the vision by making choices about what to do and what not to do;
  • Attracting and developing the best possible talent to implement the strategy;
  • Relentlessly focusing on results in the context of the strategy;
  • Creating ongoing innovation that will help reinvent the vision and strategy; and
  • “Leading yourself”: knowing and growing yourself so that you can most effectively lead others and carry out these practices.

Here are eight essential skills and how to practice them.

Leaderpreneurs create the future by leading innovators. Unlike managers, they lead and develop innovators, they do not manage innovation.

Managers and leaders may have different job roles, but they share a lot of common roles and responsibilities. Shifting your focus to your team and championing the corporate culture will help develop your leadership abilities and make you an effective manager. This includes developing the ability to see the larger picture while zooming in to address issues further down the company’s hierarchy.

Here are some leaderpreneur traps. As you transition to a leadership role, your relationship to power changes: You gain more of it, and people start acting differently around you due to your authority. How can you avoid the hidden traps of gaining power, which shapes you in ways you may not realize? These authors outline five key traps leaders can fall into (the savior trap, the complacency trap, the avoidance trap, the friend trap, and the stress trap) and offer ways to counteract each.

Innovators are people who create something that is new or use something old in a new way that creates significant user-defined multiples of value compared to the status quo of the competition. Managers are tasked with optimizing efficiency and efficacy with existing resources. Each of these roles requires different skills and, in many instances, are overlapping depending on the situation or the goal.

Coaches help people reach their full potential.

Former Cisco CEO John Chambers, in his book, Connecting the Dots, points to several leaderpreneurship skills:

  • Vision
  • Direction
  • Inspiration
  • Communication
  • Culture
  • Results
  • Resilience

Innovators, for example, exhibit questioning, associating, observing/connecting, networking and experimenting. Leaders make decisions quickly; they are relentlessly reliable; they excel at managing relationships; and they adapt swiftly to changing circumstances.

In their book, Blue Ocean Strategy, Kim and Mauborgne identify the key organizational barriers to executing a transformational organizational strategy:

  • Problem: Creating a sense of urgency that wakes up employees to the need for a strategic shift.
  • Solution: The solution is to come face-to-face with the worst problems and talk to the most disgruntled customers.
  • Problem: Limited resources.
  • Solution: Leverage activities that create the most value, eliminate wasteful ones that create little value, and barter for resources within your organization.
  • Problem: Motivating people to change.
  • Solutions: The solutions are to find and support champions, showcase their accomplishments, and break down their accomplishments into little pieces. Swing to put people on base, not for the fences.
  • Problem: Opposition to change from vested interests.
  • Solutions: Find the right sponsors and consigliere to run cover and build your political power.

The distinctions are important since, at least in biomedicine and sick care, we have to raise the bar if we are to innovate ourselves out of the mess. Doing so will call for educating and training a new breed of health care pioneers and leaderpreneurs who have what it takes to lead the revolution. In academia, research, teaching and patient care are being replaced by the new triple threat: innovator, entrepreneur, and leaderpreneur.

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Doctors are still trying to understand how they should evolve from technicians, to managers to leaders to leaderpreneurs. The current state of leadership training in medical student and residency training is limited and nonuniform. These data align with descriptions of leadership training in other surgical residencies which are reported as heterogenous and lacking in effectiveness. This review highlights the need for standardized leadership training for OHNS residents. The high-quality leadership development initiatives within graduate medical education are reviewed to inform future directions for effective curriculum development and assessment.

It will take a while, but if nothing else, a sense of urgency will get them off the dime so they can, indeed, create the future of medicine for patients by leading innovators. That is why defining leaderpreneurship is important.

Arlen Meyers is a physician executive.

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