Followership sounds unattractive to many people. Eighty percent of the personnel are followers, and every leader has been a follower at some point. Followers have their own minds and abilities – so, it would make sense to learn more about followership. Until I came across this review article on followership by Caleb Leung and colleagues, I had no idea that there is research on this topic. It turns out that there is one published article on followership for every sixty articles on leadership, which is both sad and not surprising. There is a disproportionate focus on leadership styles and leadership training in healthcare, and we do not spend enough time understanding followership. We just assume that if we have good leadership, followership happens automatically.

Robert E. Kelley describes a followership matrix describing five types of followers depending on the degree of engagement from passive to active, and the degree of independence and critical thinking from low to high. It gives us a framework to think about different team members, and address individual abilities and contributions and how to bring out the best in each team member. Passive followers follow along without thinking or being engaged. Conformists have high motivation and initiative but depend on the leader for direction because they do not have the ability to think critically. Alienated followers are capable and think critically, but they are not engaged. Effective followers are those who are both highly engaged and capable of thinking critically and independently. They have the courage to both support the leader and challenge the leader. Pragmatists are “fence-sitters” who are middle of the road. On the whole, a good relationship between the leader and follower is associated with greater productivity and work satisfaction for both the leader and the follower.

Actively Engaged?Thinking Critically and Independently?Follower Type

Follower styles with higher levels of engagement and critical thinking are associated with greater personal satisfaction and organizational performance. In addition to level of engagement and critical thinking, expectations of followers from the leader as well as the group itself may influence the followers negatively or positively per implicit followership theories. An overall positive follower prototype has attributes such as industry, good citizen, and enthusiasm. An overall negative follower prototype has incompetence, insubordination, and conformity. Expectations play a big role in out-grouping and in-grouping among followers, and those who violate prototypical norms can be ostracized by the group. Some followers may scale back effort and productivity to stay in the group. There is a perceived fear among many that women and diverse leaders may not be able to command adequate followership. Several implicit biases work against them as well. As unattractive as it may be, understanding followership is important.

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