Objective: Leaders’ technical competence – ‘expert knowledge’ – has been shown in many settings to be associated with better organizational performance. In universities, for example, there is longitudinal evidence that research-focused scholars make the best leaders; results from a hospital study show that doctors instead of professional managers are most closely associated with the best performing institutions. To explain these patterns, and raise hypotheses, a theory of expert leadership (TEL) has been developed that might explain these patterns. In this paper the framework for expert leadership is applied to psychiatry. Conclusions: The TEL proposes that psychiatric leaders, as opposed to non-expert managers, improve organizational performance through several channels. First, experts’ knowledge influences organizational strategy. Second, having been ‘one of them’, a psychiatrist understands how to create the optimal work environment for psychiatric teams, through appropriate goal-setting, evaluation and support. These factors are positively associated with worke
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