What is the best way to manage a less than perfect leader? Here, Malcolm Lowe-Lauri offers some suggestions

'I am fully and consistently supportive of the executive directors and others who report to me. I take a keen interest in their personal and professional development. I behave consistently in my relationship with them. They can rely on me in any type of situation. We work together as an outstanding team that is the envy of other foundation trusts.'

And that, your honour, concludes the defence's case.

The prosecution would, however, pick some holes in this, while my ego takes comfort in an oft-remembered quote that 'only the mediocre are at their best all the time'.

The reality is rather mixed. Like many well-intentioned people there is, as organisational behaviour expert Chris Argyris would say, 'the difference between espoused theory and theory in use'. The problem is mine but the consequences often sit with those who work for me. What strategies can we use for handling a less than perfect boss?

To start with, how do you get the boss's attention? I recall a pharmacy director saying that his peers in other hospitals could not get their chief executives to listen because 'they're all too busy flying round the lampshades'. I took this to mean the rigours of performance pressures were generating a little anxiety and this was overriding their listening function.

But there is a bit of a clue here. There is no substitute for bringing forward ideas for current issues, provided they are more credible than the Baldrick approach: 'I have a cunning plan.' Once you are in the conversation you have the opportunity to develop interest in your projects.

If you want to see this done successfully, go no further than a clinician emphasising how a new gizmo will save loads of money and bring in many more patients.

In my mind's ear I can hear hundreds of them. On the other hand the chief may be an arch strategist with limited interest in operational details (though I would be surprised at that these days). In that case your idea could be an enabler for their big idea.

You may do this alone, you may work with groups of colleagues, but do whatever connects with the boss's style.

Style is one thing, ego quite another. Some bosses are happy to endorse the ideas of their subordinates and give credit where it is due. Others need to think it was their idea all the time.

I remember a director colleague telling me some years ago of a chief executive who told her he was never wrong. I subsequently met the person concerned who described something as having occurred as he had foreseen it would. I remembered the same quote as coming almost verbatim from the bad guy Emperor in one of the Star Wars films.

Our frailties and foibles need careful handling. One of the few certainties is that we will be wrong some of the time.

Doing our preparation with trusted colleagues, rather than holding a battle of wills, is probably the best way forward - although I am the first to say I learned this the hard way. But even well-balanced individuals can be unhinged by unusual circumstances and sometimes it does not take much.

I once made the error of ordering sandwiches rather than a finger buffet for an important occasion. My boss of the time responded by coming within several inches of my face and telling me with a remarkable combination of halitosis and hatred that he wanted to string me up.

More seriously, the most rational-empirical types can get unusually excited when a 'major incident' kicks off. The stress of the occasion tempts many (myself included) into wanting to do something, either by ourselves or in response to others. These are times when the boss and others have to make it clear that we are to do exactly what it says on the tin - that is, what it says in the procedure document. Other members of the team must have licence to put the boss back in their box if necessary. A small ego wound is preferable to a catastrophe.

The good news is there is plenty of help around these days. 'Managing the boss' is not an unusual title on development courses or master's programmes, though it may be part of wider modules on group dynamics or leadership modules.

It is good subject material for mentors. The best of these can guide us through the tricky boss territory. The key is to find a mentor with as much wisdom as knowledge. Why is the combination important?

I am indebted to outgoing Department of Health deputy chief medical officer Martin Marshall for an explanation: 'Knowledge is knowing that a tomato is a fruit, not a vegetable. Wisdom is not putting it in your fruit salad.' Chief executives have made a few organisational fruit salads with tomatoes in their time.

When asked about mentors I usually refer people to the likes of chiefs David Astley at St George's and Julian Nettel at St Mary's. They don't come much wiser or with better values.

The mentor or coach will sometimes steer us towards managing ourselves as much as the boss. I don't doubt some of my own quirks have made it difficult at times. But I have at least avoided public rows and impulsive resignations.

In fact there is quite a lot of learning to be had from working for a quirky superior, provided the handling strategy is right. On his Endurance expedition Ernest Shackleton described the need to 'put the footstep of courage into stirrups of patience'. There are rewards to be had from playing a long but determined game. The same man who wanted to string me up enthusiastically opened a number of career doors for me.

Hanging on to your motivation and values is important. So is a sense of humour. Organisational life involves some tragedy but a fair bit of comedy too.