i agree with you Freaky v.2. She is the best at what she does...medical stuff, not the drinking stuff, cuz shes an alcoholic. but being good at medical jutsus, does that make a great leader? Well it depends. i dont think it hurts her, but to be a good leader in you have to be decisive, and honorable. What she is doing for the ninjas is a perfect example. she gave up her chakra to the little slugs, maybe to a point where she becomes old or even dies, for konoha. True, that is expected of a leader but where does it say that a leader has to have many jutsus and be great a fighting?
The main point in the manga is that youre supposed to believe in yourself and in others. Tsunade might not be able to handle Pain directly, but she can handle the wounded and dying, and believes that naruto can take Pain on. I guess kish is saying big boobed people are people too.