First and foremost, physicians: the clinical versus leadership identities of physician leaders

2016 ◽  
Vol 30 (4) ◽  
pp. 711-728 ◽  
Author(s):  
Joann Farrell Quinn ◽  
Sheri Perelli
Keyword(s):  
Health Care ◽  
Skills Training ◽  
Leadership Role ◽  
Organizational Level ◽  
Care Organization ◽  
Full Time ◽  
Clinical Expertise ◽  
Physician Leadership ◽  
Content Type ◽  
Physician Leaders

Purpose – Physicians are commonly promoted into administrative and managerial roles in US hospitals on the basis of clinical expertise and often lack the skills, training or inclination to lead. Several studies have sought to identify factors associated with effective physician leadership, yet we know little about how physician leaders themselves construe their roles. The paper aims to discuss these issues. Design/methodology/approach – Phenomenological interviews were performed with 25 physicians at three organizational levels with physicians affiliated or employed by four hospitals within one health care organization in the USA between August and September 2010. A rigorous comparative methodology of data collection and analysis was employed, including the construction of analytic codes for the data and its categorization based on emergent ideas and themes that are not preconceived and logically deduced hypotheses, which is characteristic of grounded theory. Findings – These interviews reveal differences in how part- vs full-time physician leaders understand and value leadership roles vs clinical roles, claim leadership status, and identify as physician leaders on individual, relational and organizational basis. Research limitations/implications – Although the physicians in the sample were affiliated with four community hospitals, all of them were part of a single not-for-profit health care system in one geographical locale. Practical implications – These findings may be of interest to hospital administrators and boards seeking deeper commitment and higher performance from physician leaders, as well as assist physicians in transitioning into a leadership role. Social implications – This work points to a broader and more fundamental need – a modified mindset about the nature and value of physician leadership. Originality/value – This study is unique in the exploration of the nature of physician leadership from the perspective of the physician on an individual, peer and organizational level in the creation of their own leadership identity.

Can complexity science inform physician leadership development?

2016 ◽  
Vol 29 (3) ◽  
pp. 251-263 ◽  
Author(s):  
Colleen Marie Grady
Keyword(s):  
Complex System ◽  
Health Care ◽  
Leadership Development ◽  
Patient Outcomes ◽  
Health Care Organizations ◽  
Complexity Science ◽  
Primary Role ◽  
Physician Leadership ◽  
Content Type ◽  
Physician Leaders

Purpose The purpose of this paper is to describe research that examined physician leadership development using complexity science principles. Design/methodology/approach Intensive interviewing of 21 participants and document review provided data regarding physician leadership development in health-care organizations using five principles of complexity science (connectivity, interdependence, feedback, exploration-of-the-space-of-possibilities and co-evolution), which were grouped in three areas of inquiry (relationships between agents, patterns of behaviour and enabling functions). Findings Physician leaders are viewed as critical in the transformation of healthcare and in improving patient outcomes, and yet significant challenges exist that limit their development. Leadership in health care continues to be associated with traditional, linear models, which are incongruent with the behaviour of a complex system, such as health care. Physician leadership development remains a low priority for most health-care organizations, although physicians admit to being limited in their capacity to lead. This research was based on five principles of complexity science and used grounded theory methodology to understand how the behaviours of a complex system can provide data regarding leadership development for physicians. The study demonstrated that there is a strong association between physician leadership and patient outcomes and that organizations play a primary role in supporting the development of physician leaders. Findings indicate that a physician’s relationship with their patient and their capacity for innovation can be extended as catalytic behaviours in a complex system. The findings also identified limiting factors that impact physicians who choose to lead, such as reimbursement models that do not place value on leadership and medical education that provides minimal opportunity for leadership skill development. Practical Implications This research provides practical applications for physician leadership development and emphasizes that it is incumbent upon physicians and organizations to focus attention on this to achieve improved patient and organizational outcomes. Originality/value This study pairing complexity science and physician leadership represents a unique way to view the development of physician leaders within the context of the complex system that is health care.

In their own words: describing Canadian physician leadership

2016 ◽  
Vol 29 (3) ◽  
pp. 264-281 ◽  
Author(s):  
Anita J. Snell ◽  
Graham Dickson ◽  
Debrah Wirtzfeld ◽  
John Van Aerde
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Structured Interview ◽  
Baseline Data ◽  
Leadership Roles ◽  
Personal Factors ◽  
Physician Leadership ◽  
Content Type ◽  
Canadian Physician ◽  
Physician Leaders

Purpose This is the first study to compile statistical data to describe the functions and responsibilities of physicians in formal and informal leadership roles in the Canadian health system. This mixed-methods research study offers baseline data relative to this purpose, and also describes physician leaders’ views on fundamental aspects of their leadership responsibility. Design/methodology/approach A survey with both quantitative and qualitative fields yielded 689 valid responses from physician leaders. Data from the survey were utilized in the development of a semi-structured interview guide; 15 physician leaders were interviewed. Findings A profile of Canadian physician leadership has been compiled, including demographics; an outline of roles, responsibilities, time commitments and related compensation; and personal factors that support, engage and deter physicians when considering taking on leadership roles. The role of health-care organizations in encouraging and supporting physician leadership is explicated. Practical implications The baseline data on Canadian physician leaders create the opportunity to determine potential steps for improving the state of physician leadership in Canada; and health-care organizations are provided with a wealth of information on how to encourage and support physician leaders. Using the data as a benchmark, comparisons can also be made with physician leadership as practiced in other nations. Originality/value There are no other research studies available that provide the depth and breadth of detail on Canadian physician leadership, and the embedded recommendations to health-care organizations are informed by this in-depth knowledge.

scholarly journals Just a leader? Leadership work challenges and identity contradiction experienced by Finnish physician leaders

2021 ◽  
Vol 35 (9) ◽  
pp. 195-210
Author(s):  
Sari Huikko-Tarvainen ◽  
Pasi Sajasalo ◽  
Tommi Auvinen
Keyword(s):  
Design Methodology ◽  
Clinical Skills ◽  
Full Time ◽  
Physician Leadership ◽  
Leadership Skill ◽  
Content Type ◽  
Clinical Patient ◽  
Physician Leaders ◽  
Patient Work ◽  
Practical Implications

PurposeThis study seeks to improve the understanding of physician leaders' leadership work challenges.Design/methodology/approachThe subjects of the empirical study were physician leaders (n = 23) in the largest central hospital in Finland.FindingsA total of five largely identity-related, partially paradoxical dilemmas appeared regarding why working as “just a leader” is challenging for physician leaders. First, the dilemma of identity ambiguity between being a physician and a leader. Second, the dilemma of balancing the expected commitment to clinical patient work by various stakeholders and that of physician leadership work. Third, the dilemma of being able to compensate for leadership skill shortcomings by excelling in clinical skills, encouraging physician leaders to commit to patient work. Fourth, the dilemma of “medic discourse”, that is, downplaying leadership work as “non-patient work”, making it inferior to patient work. Fifth, the dilemma of a perceived ethical obligation to commit to patient work even if the physician leadership work would be a full-time job. The first two issues support the findings of earlier research, while the remaining three emerging from the authors’ analysis are novel.Practical implicationsThe authors list some of the practical implications that follow from this study and which could help solve some of the challenges.Originality/valueThis study explores physician leaders' leadership work challenges using authentic physician leader data in a context where no prior empirical research has been carried out.

A strategic and good governance perspective on handling patient complaints

2018 ◽  
Vol 31 (8) ◽  
pp. 923-934
Author(s):  
Sanna Pauliina Ryynänen ◽  
Risto Harisalo
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Good Governance ◽  
Care Organization ◽  
Content Type ◽  
Patient Complaints ◽  
Care Processes ◽  
Patient’S Rights ◽  
Strategic Goals

Purpose The patient complaint is one of the main procedures of exercising patient’s rights in the Finnish health care system. Such complaints typically concern the quality of care and/or patient safety. The purpose of this paper is to examine the types of patient complaints received by a specialized medical care organization and the kinds of responses given by the organization’s personnel. The organization’s strategy and good governance principles provide the framework for understanding the organization’s action. Design/methodology/approach This study’s data comprise patient complaints and the responses from personnel of a specialized medical care organization from the start of 2012 to the end of January 2014. The data were analyzed through qualitative data analysis. Findings The results show many unwanted grievances, but also reveal the procedures employed to improve health care processes. The results are related to patients’ care experiences, provision of information, personnel’s professional skills and the approach to patient complaints handling. The integrative result of the analysis was to find consensus between the patients’ expectations and personnel’s evaluation of patients’ needs. Originality/value Few prior studies have examined patient complaints related to both strategy and good governance. Patient complaints were found to have several confluences with an organization’s strategic goals, objectives and good governance principles. The study recommends further research on personnel procedures for patient complaints handling, with a view to influencing strategic planning and implementation of strategies of organizations.

Workplace-based clinical leadership training increases willingness to lead

2015 ◽  
Vol 28 (2) ◽  
pp. 100-118 ◽  
Author(s):  
Aleece MacPhail ◽  
Carmel Young ◽  
Joseph Elias Ibrahim
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Leadership Training ◽  
Low Cost ◽  
Leadership Role ◽  
Leadership Roles ◽  
Senior Executive ◽  
Clinical Leadership ◽  
Content Type

Purpose – The purpose of this paper is to reflect upon a workplace-based, interdisciplinary clinical leadership training programme (CLP) to increase willingness to take on leadership roles in a large regional health-care centre in Victoria, Australia. Strengthening the leadership capacity of clinical staff is an advocated strategy for improving patient safety and quality of care. An interdisciplinary approach to leadership is increasingly emphasised in the literature; however, externally sourced training programmes are expensive and tend to target a single discipline. Design/methodology/approach – Appraisal of the first two years of CLP using multiple sourced feedback. A structured survey questionnaire with closed-ended questions graded using a five-point Likert scale was completed by participants of the 2012 programme. Participants from the 2011 programme were followed up for 18 months after completion of the programme to identify the uptake of new leadership roles. A reflective session was also completed by a senior executive staff that supported the implementation of the programme. Findings – Workplace-based CLP is a low-cost and multidisciplinary alternative to externally sourced leadership courses. The CLP significantly increased willingness to take on leadership roles. Most participants (93 per cent) reported that they were more willing to take on a leadership role within their team. Fewer were willing to lead at the level of department (79 per cent) or organisation (64 per cent). Five of the 11 participants from the 2011 programme had taken on a new leadership role 18 months later. Senior executive feedback was positive especially around the engagement and building of staff confidence. They considered that the CLP had sufficient merit to support continuation for at least another two years. Originality/value – Integrating health-care professionals into formal and informal leadership roles is essential to implement organisational change as part of the drive to improve the safety and quality of care for patients and service users. This is the first interdisciplinary, workplace-based leadership programme to be described in the literature, and demonstrates that it is possible to deliver low-cost, sustainable and productive training that increases the willingness to take on leadership roles.

Competencies physicians need to lead – a Canadian case

2018 ◽  
Vol 31 (2) ◽  
pp. 195-209 ◽  
Author(s):  
Scott Comber ◽  
Kyle Clayton Crawford ◽  
Lisette Wilson
Keyword(s):  
Financial Literacy ◽  
Design Methodology ◽  
Leadership Skills ◽  
Physician Leadership ◽  
Current Form ◽  
Content Type ◽  
Business Skills ◽  
Canadian Physician ◽  
Physician Leaders ◽  
Systems Transformation

Purpose Emerging evidence correlates increased physician leadership effectiveness with improved patient and healthcare system outcomes. To maximize this benefit, it is critical to understand current physician leadership needs. The purpose of this study is to understand, through physicians’ self-reporting, their own and others’ most effective and weakest leadership skills in relation to the LEADS leadership capabilities framework. Design/methodology/approach The authors surveyed 209 Canadian physician leaders about their perceptions of their own and other physicians’ leadership abilities. Thematic analysis was used, and the results were coded deductively into the five LEADS categories, and new categories emerging from inductive coding were added. Findings The authors found that leaders need more skills in the areas of Engage Others and Lead Self, and an emergent category of Business Skills, which includes financial competency, budgeting, facilitation, etc. Further, Achieve Results, Develop Coalitions and Systems Transformation are skills least reported as needed in both self and others. Originality/value The authors conclude that LEADS, in its current form, has a gap in the competencies prescribed, namely, “Business Skills”. They recommend the development of a more comprehensive LEADS framework that includes such skills as financial literacy/competency, budgeting, facilitation, etc. The authors also found that certain dimensions of LEADS are being overlooked by physicians in terms of importance (Systems Transformation, Achieve Results, Develop Coalitions), and this warrants greater investigation into the reasons why these skills are not as important as the others (Engage Others and Lead Self).

Physician leadership style predicts advanced practice provider job satisfaction

2019 ◽  
Vol 33 (1) ◽  
pp. 56-72
Author(s):  
Robert S. Guevara ◽  
Jared Montoya ◽  
Meghan Carmody-Bubb ◽  
Carol Wheeler
Keyword(s):  
Job Satisfaction ◽  
Health Care ◽  
Transformational Leadership ◽  
Leadership Style ◽  
Advanced Practice ◽  
Years Of Experience ◽  
Physician Leadership ◽  
Provider Type ◽  
Content Type ◽  
The Impact

Purpose This paper aims to examine the relationship between physician leadership style and advanced practice health-care provider job satisfaction. Design/methodology/approach A total of 320 advanced practice providers (nurse practitioners and physician assistants) in Texas rated their supervising/collaborating physicians’ leadership style using the Multifactor Leadership Questionnaire 5X Short (Bass and Avolio, 2000) and assessed their own job satisfaction using the Abridged Job Descriptive Index (Smith, Kendall and Hulin, 1969). Regression models tested the relationships between physician leadership styles and several facets of job satisfaction of advanced practice providers while controlling for advanced practice provider age, gender, ethnicity, years of experience, salary level, clinical practice setting, level of physician supervision/collaboration and advanced practice provider type. Findings The results demonstrated that physician transformational leadership accounted for between 4.4 and 49.1 per cent of the variance in job satisfaction depending on the aspect of job satisfaction. Satisfaction with job supervision and satisfaction with job in general were those in which transformational leadership was found to have the most impact, explaining 49.1 and 15.5%, respectively. Demographic variables such as advanced practice provider type, age, years of experience and number of hours per week of physician collaboration/supervision had small but statistically significant associations with job satisfaction. Practical implications Recommendations for physician leadership development focusing on transformational leadership as a way to increase the satisfaction among other providers on health-care teams are discussed. Originality/value This paper examines the impact of supervising/delegating physician leadership style on other nonphysician members of the health-care team, specifically advanced practice health-care providers.

Modelling of readiness factors for the implementation of Lean Six Sigma in healthcare organizations

2020 ◽  
Vol 11 (4) ◽  
pp. 597-633 ◽  
Author(s):  
V. Vaishnavi ◽  
M. Suresh
Keyword(s):  
Health Care ◽  
Six Sigma ◽  
Health Care Industry ◽  
Lean Six Sigma ◽  
Interaction Matrix ◽  
Successful Implementation ◽  
Care Organization ◽  
Content Type ◽  
Care Industry ◽  
Expert Opinions

Purpose This paper aims to identify, analyze and categorize the major readiness factors for implementing Lean Six Sigma (LSS) in health-care organizations using total interpretive structural modelling technique. The readiness factors are identified would help the managers to recognize the areas that lack and provide importance to the successful implementation of LSS in those areas. The paper further intends to understand the hierarchical interrelationships among the readiness factors identified using dependence and driving power. Design/methodology/approach In total, 16 readiness factors are identified from the literature review and expert opinions are collected from hospitals. The scheduled interview is conducted based on a questionnaire survey in hospitals in the Indian context to identify the relevance of the relations among the readiness factors. The expert opinions are used in the initial reachability matrix and interpretative interaction matrix. Matrix impact cross multiplication applied to classification (MICMAC) analysis uses dependence and driving power to understand the hierarchical relationship among the readiness factors identified. Findings The result indicates that customer-oriented and goal management cultures are the key readiness factors for LSS. The execution technique and training are given according to the current demand of customers and goal change of organization. The manager needs to concentrate more on readiness factors to formulate the execution process of LSS for continuous improvement of the health-care organization. The readiness level helps the manager to identify the target area for LSS execution. Research limitations/implications This research focuses mainly on readiness factors for the implementation of LSS in the health-care industry. Practical implications This study would be useful for researchers and practitioners to understand the readiness factors before starting the implementation process of LSS. Originality/value Many research studies are being done on the success and failure rate of implementation of factors. The present study identifies the readiness factors related to LSS, especially for the health-care industry.

scholarly journals Understanding technology mediation and new service provider roles in health care

2019 ◽  
Vol 33 (2) ◽  
pp. 245-254 ◽  
Author(s):  
Athanasia Daskalopoulou ◽  
Kathy Keeling ◽  
Rowan Pritchard Jones
Keyword(s):  
Health Care ◽  
Service Provider ◽  
Service Providers ◽  
Care Service ◽  
Health Care Service ◽  
Empirical Support ◽  
Organizational Level ◽  
Advance Technology ◽  
Content Type ◽  
Health Care Service Providers

PurposeService research holds that as services become more technology dominated, new service provider roles emerge. On a conceptual level, the potential impact of different roles has been discussed with regard to service provider readiness, job performance and overall experience. However, as yet, there is sparse empirical support for these conceptual interpretations. The purpose of this paper is to provide an understanding of the new service provider roles that emerge due to the increase of technology mediation in services.Design/methodology/approachThis study follows a qualitative methodology. Insights are drawn from in-depth interviews with 32 junior and senior health-care service providers (across 12 specialties) and 5 information governance/management staff.FindingsThis analysis illustrates that new service provider roles include those of the enabler, differentiator, innovator, coordinator and sense-giver. By adopting these roles, health-care service providers reveal that they can encourage, support and advance technology mediation in services across different groups/audiences within their organizations (e.g. service delivery level, peer-to-peer level, organizational level). This paper further shows the relationships between these new service provider roles.Originality/valueThis study contributes to theory in technology-mediated services by illustrating empirically the range of activities that constitute each role. It also complements prior work by identifying that service providers adopt the additional role of sense-giver. Finally, this paper provides an understanding of how by taking on these roles service providers can encourage, support and advance technology mediation in services across different groups/audiences in their organization.

“Stuck in the middle” first-line healthcare managers’ responsibilities and needs of support when applying Lean

2020 ◽  
Vol 12 (2) ◽  
pp. 173-186
Author(s):  
Therese Kahm ◽  
Pernilla Ingelsson
Keyword(s):  
Health Care ◽  
Health Care Organization ◽  
Shared Responsibility ◽  
Care Organization ◽  
First Line ◽  
Line Managers ◽  
Content Type ◽  
Lean Principles ◽  
Organizational Issues ◽  
The Relationship

Purpose The purpose of this paper is to present the supportive conditions that the first-line health-care managers claim that they need from their own managers and what they experience as their own roles and responsibilities in relation to their coworkers when applying Lean principles and practices. Design/methodology/approach A survey with a Web-based questionnaire was designed and used in a Swedish health-care organization two years after the initiation of Lean to investigate the managers’ views on their role, conditions and ability to create change according to Lean. The result from two of the questions will be presented where one focuses on the relationship to the first-line managers’ own manager and the second on the relationship to their coworkers. Findings The results show that to initiate improvement, work based on Lean first-line managers ask for own managers who are assured about Lean, include them in discussions and ask for follow-ups and results about Lean. Concerning first-line managers’ relation to their coworkers they experience themselves as responsible for leading toward creating a culture where problems and mistakes are viewed as possibilities to improve, for encouraging that new work procedures are tested and for creating commitment and inspiration in relation to their coworkers. Originality/value The questions can be used separately or as part of an entire questionnaire before and along the Lean process to highlight organizational issues such as shared responsibility and supportive relations when developing health care.

Sign in / Sign up

Export Citation Format

Share Document