scholarly journals Elements of perceived good physician leadership and their relation to leadership theory

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sari Huikko-Tarvainen
Keyword(s):  
Leadership Theory ◽  
Leadership Roles ◽  
Physician Leadership ◽  
Leadership Theories ◽  
Content Type ◽  
Medical Expertise ◽  
Hierarchical Levels ◽  
Physician Leaders ◽  
Interpretative Approach ◽  
Medical Leadership

Purpose This research paper aims to discover the elements of good physician leadership as perceived by physicians and to find out how the findings connect to the leadership theory. Design/methodology/approach The subjects (n = 50) of this qualitative study are physicians from four hierarchical levels (residents/specialising physicians, specialists, heads of departments and chief physicians). Content analysis with a constructivist-interpretative approach by thematisation was the chosen method, and it was also analysed how major leadership theories relate to good physician leadership. Findings Physician leaders are expected to possess the professional skills of physicians, understand how the work affects physicians’ lives and be competent in applying suitable leadership approaches following different situations and people. Trust, fairness, empathy, social skills, two-way communication skills, regular feedback, collegial respect and emotional intelligence are expected. As medical expertise connects leaders and followers, success in medical leadership comes from credibility in medical expertise, making medical leadership an inseparable part of good physician leadership. Subordinates are physician colleagues, who have their informal leadership roles on their hierarchical levels, making physician leadership a multidimensional leadership setting wherein formal leaders lead informal leaders, which blurs the traditional leader–follower boundary. In summary, good physician leadership is leadership through medical expertise combined with good manners, collegiality and traits from different kinds of leadership theories. Originality/value This study discovers elements of good physician leadership in a Finnish health-care context in which no similar prior empirical research has been carried out.

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.

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.

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).

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.

Resilient leadership: a transformational-transactional leadership mix

2015 ◽  
Vol 6 (1) ◽  
pp. 99-112 ◽  
Author(s):  
Kwasi Dartey-Baah
Keyword(s):  
Transactional Leadership ◽  
Design Methodology ◽  
Strategic Thinking ◽  
Leadership Theory ◽  
Learning Performance ◽  
Leadership Theories ◽  
Content Type ◽  
Performance Orientation ◽  
Resilient Leadership ◽  
Conceptual Link

Purpose – This paper aims to bring to bear the resemblance between the current resilient leadership theory and the transformational–transactional leadership theories. It does this with the view of re-focusing discussions of leadership on an effective mix of the transformational–transactional leadership theories to achieve the desired organisational performance, rather than a new look at leadership from the resilient leadership perspective – which is quite the same. Design/methodology/approach – It achieves this purpose by reviewing literature on the three leadership styles; and further goes on to draw a conceptual link among them to buttress the point that resilient leadership is a repetition of the ideas underlying the two already existing theories – transformational and transactional. Findings – A review of the three leadership theories in literature showed that qualities such as strategic thinking, emotional intelligence, adaptation/change orientation, learning, performance orientation and collective leadership as captured under the resilient leadership theory are already considered under the transformational–transactional leadership theories, and thus, constitutes a repetition not needed in the search for the best leadership approach. Originality/value – The current volatile, uncertain, complex and ambiguous environment calls for a new leadership thinking/approach – one that is known and empirically tested to yield best results. In this regard, the present study advocates for a consideration of the transformational–transactional approaches, which have been proven to yield best results, to focus the discussion on leadership.

Shining the light on the dark side of medical leadership – a qualitative study in Australia

2016 ◽  
Vol 29 (3) ◽  
pp. 313-330 ◽  
Author(s):  
Erwin Loh ◽  
Jennifer Morris ◽  
Laura Thomas ◽  
Marie Magdaleen Bismark ◽  
Grant Phelps ◽  
...  
Keyword(s):  
Research Question ◽  
Professional Associations ◽  
Public Hospitals ◽  
Dark Side ◽  
Future Research ◽  
Leadership Roles ◽  
Health Departments ◽  
Negative Perception ◽  
Content Type ◽  
Medical Leadership

Purpose The paper aims to explore the beliefs of doctors in leadership roles of the concept of “the dark side”, using data collected from interviews carried out with 45 doctors in medical leadership roles across Australia. The paper looks at the beliefs from the perspectives of doctors who are already in leadership roles themselves; to identify potential barriers they might have encountered and to arrive at better-informed strategies to engage more doctors in the leadership of the Australian health system. The research question is: “What are the beliefs of medical leaders that form the key themes or dimensions of the negative perception of the ‘dark side’?”. Design/methodology/approach The paper analysed data from two similar qualitative studies examining medical leadership and engagement in Australia by the same author, in collaboration with other researchers, which used in-depth semi-structured interviews with 45 purposively sampled senior medical leaders in leadership roles across Australia in health services, private and public hospitals, professional associations and health departments. The data were analysed using deductive and inductive approaches through a coding framework based on the interview data and literature review, with all sections of coded data grouped into themes. Findings Medical leaders had four key beliefs about the “dark side” as perceived through the eyes of their own past clinical experience and/or their clinical colleagues. These four beliefs or dimensions of the negative perception colloquially known as “the dark side” are the belief that they lack both managerial and clinical credibility, they have confused identities, they may be in conflict with clinicians, their clinical colleagues lack insight into the complexities of medical leadership and, as a result, doctors are actively discouraged from making the transition from clinical practice to medical leadership roles in the first place. Research limitations/implications This research was conducted within the Western developed-nation setting of Australia and only involved interviews with doctors in medical leadership roles. The findings are therefore limited to the doctors’ own perceptions of themselves based on their past experiences and beliefs. Future research involving doctors who have not chosen to transition to leadership roles, or other health practitioners in other settings, may provide a broader perspective. Also, this research was exploratory and descriptive in nature using qualitative methods, and quantitative research can be carried out in the future to extend this research for statistical generalisation. Practical implications The paper includes implications for health organisations, training providers, medical employers and health departments and describes a multi-prong strategy to address this important issue. Originality/value This paper fulfils an identified need to study the concept of “moving to the dark side” as a negative perception of medical leadership and contributes to the evidence in this under-researched area. This paper has used data from two similar studies, combined together for the first time, with new analysis and coding, looking at the concept of the “dark side” to discover new emergent findings.

Explaining incongruities between leadership theory and practice: integrating theories of resonance, communication and systems

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Brent D. Ruben ◽  
Ralph A. Gigliotti
Keyword(s):  
Social Influence ◽  
Leadership Theory ◽  
Theory And Practice ◽  
Traditional Values ◽  
Resonance Theory ◽  
Leadership Theories ◽  
Content Type ◽  
Single Moment ◽  
Subject Matter Expertise ◽  
Leadership Study

PurposeLeadership scholars, practitioners and educators find themselves at a very opportune time, when their subject matter-expertise is of increasing interest across sectors, settings and levels of analysis, as leadership is hailed as both a pressing problem and a promising solution. It is also a challenging time for leadership study—a point in time when incongruities between leadership theories and the observed dynamics and outcomes of leadership in practice have been difficult to ignore. In this article we identify and discuss several problematic incongruities, explore possible reasons for these gaps and outline an integrated view of theories of resonance, communication and systems to address these discontinuities and advance our understanding of leadership theory and practice.Design/methodology/approachBuilding upon the intersection of theories of resonance, communication and systems in this conceptual article, we advance a line of renewed macro-level thinking on the topic of leadership as social influence, resulting in what we describe as leadership resonance theory.FindingsThis article advances an explanation of leadership as a phenomenon that is co-constructed through the communicative connections established between leaders and followers. These connections are mutually-defining, mutually-reinforcing and mutually-causal. Resonance, activation and cultivation are central concepts in the proposed framework, introduced to help explain dynamics and outcomes that seem unpredictable or unexplainable when focusing attention solely on a leader or followers in isolation of one another at a single moment in time.Originality/valueThis framework offers an original, nuanced and integrated way of thinking about leadership in terms of communication, social influence and systems theory, and it helps to explain gaps between the guidance provided by leadership theory and observed leadership outcomes in practice. The proposed framework can help to explain observed leader–follower behaviors, dynamics and outcomes, irrespective of whether they are seen as desirable or comfortable, whether they are necessarily aligned with extant theories or guidance on preferred practices and whether or not they align with traditional values in a personal, organizational or societal context.

scholarly journals Self-determining medical leadership needs of occupational health physicians

2017 ◽  
Vol 30 (4) ◽  
pp. 394-410 ◽  
Author(s):  
Prosenjit Giri ◽  
Jill Aylott ◽  
Karen Kilner
Keyword(s):  
Health Care ◽  
Leadership Development ◽  
Leadership Roles ◽  
Leadership Qualities ◽  
Leadership Academy ◽  
Self Assessment ◽  
Leadership And Management ◽  
Content Type ◽  
Management Experience ◽  
Medical Leadership

Purpose The purpose of this study was to explore which factors motivate doctors to engage in leadership roles and to frame an inquiry of self-assessment within Self-Determination Theory (SDT) to identify the extent to which a group of occupational health physicians (OHPs) was able to self-determine their leadership needs, using a National Health Service (NHS) England competency approach promoted by the NHS England Leadership Academy as a self-assessment leadership diagnostic. Medical leadership is seen as crucial to the transformation of health-care services, yet leadership programmes are often designed with a top-down and centrally commissioned “one-size-fits-all” approach. In the UK, the Smith Review (2015) concluded that more decentralised and locally designed leadership development programmes were needed to meet the health-care challenges of the future. However, there is an absence of empirical research to inform the design of effective strategies that will engage and motivate doctors to take up leadership roles, while at the same time, health-care organisations continue to develop formal leadership roles as a way to secure medical leadership engagement. The problem is further compounded by a lack of validated leadership qualities assessment instruments which support researching this problem. Design/Methodology/approach The analysis draws on a sample of about 25 per cent of the total population size of the Faculty of Occupational Medicine (n = 1,000). The questionnaire used was the Leadership Qualities Framework tool as a form of online self-assessment (NHS Leadership Academy, 2012). The data were analysed using descriptive statistics and simple inferential methods. Findings OHPs are open about reporting their leadership strengths and leadership development needs and recognise leadership learning as an ongoing development need regardless of their level of personal competence. This study found that the single most important factor to affect a doctor’s confidence in leadership is their experience in a management role. In multivariate regression, management experience accounted for the usefulness of leadership training, suggesting that doctors learn best through applied “leadership learning” as opposed to theory-driven programmes. Drawing on SDT (Deci and Ryan, 1985; 2000; Ryan and Deci, 2000), this article provides a theoretical framework that helps to understand those doctors who are likely to engage in leadership and management activities in the organisation. More choice and self-determination of medical leadership programmes are likely to result in more relevant leadership learning that builds on doctors’ previous experience in this area. Research limitations/implications While this study benefitted from a large sample size, it was limited to the use of purely quantitative methods. Future studies would benefit from the application of a mixed methodology to combine quantitative data with one-to-one interviews or a focus group. Practical implications This study suggests that doctors are able to determine their own learning needs reliably and that they are more likely to increase their confidence in leadership and management if they are exposed to leadership and management experience. Originality/value This is the first large-scale study of this kind with a large sample within a single medical specialty. The study is considered as insider research, as the first author is an OHP with knowledge of how to engage OHPs in this work.

Evaluating a physician leadership development program – a mixed methods approach

2016 ◽  
Vol 30 (3) ◽  
pp. 390-407 ◽  
Author(s):  
Cheryl Throgmorton ◽  
Trey Mitchell ◽  
Tom Morley ◽  
Marijo Snyder
Keyword(s):  
Leadership Development ◽  
Leadership Programs ◽  
Physician Leadership ◽  
Program Outcomes ◽  
Content Type ◽  
Evaluation Strategy ◽  
Physician Leaders ◽  
Four Levels Of Evaluation ◽  
Four Levels ◽  
Levels Of Evaluation

Purpose – With the extent of change in healthcare today, organizations need strong physician leaders. To compensate for the lack of physician leadership education, many organizations are sending physicians to external leadership programs or developing in-house leadership programs targeted specifically to physicians. The purpose of this paper is to outline the evaluation strategy and outcomes of the inaugural year of a Physician Leadership Academy (PLA) developed and implemented at a Michigan-based regional healthcare system. Design/methodology/approach – The authors applied the theoretical framework of Kirkpatrick’s four levels of evaluation and used surveys, observations, activity tracking, and interviews to evaluate the program outcomes. The authors applied grounded theory techniques to the interview data. Findings – The program met targeted outcomes across all four levels of evaluation. Interview themes focused on the significance of increasing self-awareness, building relationships, applying new skills, and building confidence. Research limitations/implications – While only one example, this study illustrates the importance of developing the evaluation strategy as part of the program design. Qualitative research methods, often lacking from learning evaluation design, uncover rich themes of impact. The study supports how a PLA program can enhance physician learning, engagement, and relationship building throughout and after the program. Physician leaders’ partnership with organization development and learning professionals yield results with impact to individuals, groups, and the organization. Originality/value – Few studies provide an in-depth review of evaluation methods and outcomes of physician leadership development programs. Healthcare organizations seeking to develop similar in-house programs may benefit applying the evaluation strategy outlined in this study.

Developing Canadian physician: the quest for leadership effectiveness

2016 ◽  
Vol 29 (3) ◽  
pp. 282-299 ◽  
Author(s):  
Scott Comber ◽  
Lisette Wilson ◽  
Kyle C. Crawford
Keyword(s):  
Leadership Effectiveness ◽  
Leadership Roles ◽  
Physician Leadership ◽  
Skill Levels ◽  
Content Type ◽  
Four Dimensions ◽  
Political Skills ◽  
Future Design ◽  
Networking Ability ◽  
Canadian Physician

Purpose The purpose of this study is to discern the physicians’ perception of leadership effectiveness in their clinical and non-clinical roles (leadership) by identifying their political skill levels. Design/methodology/approach A sample of 209 Canadian physicians was surveyed using the Political Skills Inventory (PSI) during the period 2012-2014. The PSI was chosen because it assesses leadership effectiveness on four dimensions: social astuteness, interpersonal influence, networking ability and apparent authenticity. Findings Physicians in clinical roles’ PSI scores were significantly lower in all four PSI dimensions when compared to all other physicians in non-clinical roles, with the principal difference being in their networking abilities. Practical implications More emphasis is needed on educating and training physicians, specifically in the areas of political skills, in current clinical roles if they are to assume leadership roles and be effective. Originality/value Although this study is located in Canada, the study design and associated findings may have implications to other areas and countries wanting to increase physician leadership effectiveness. Further, replication of this study in other settings may provide insight into the future design of physician leadership training curriculum.

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