Lessons from Benjamin Franklin's civic leadership: the Pennsylvania Hospital story

John Gardner has recently suggested that in a pluralistic society like ours there are many competing groups, each with its own purpose. This leads to fragmentation and conflict as various social systems and institutions interact and collide. We have seen this in health care where competition has eroded traditional provider-insurer-purchaser alliances and, for example, the access problem has grown rapidly. Leaders in such an environment, Gardner (1988) argues, must become involve with building more "mutually workable arrangements with systems external to their own... Leaders unwilling to do so are not serving the long-germ interest of their own constituents... Under the circumstances, all our leader must spend part of their time building community, dealing with polarization, and creating loyalty to the larger venture." Methods for building community in turbulent times are offered by our first health care social entrepreneur, Benjamin Franklin. The following case study presents Franklin's leadership style and the three-phase process of seeking the civic unity that created Franklin's leadership style and the three-phase process of seeking the civic unity that created Pennsylvania Hospital, the nation;s first community hospital. The discussion concludes with a consideration of Franklin's civic leadership in light of five leadership roles suggested by Gardner.