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.

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.

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).

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.

Developing physician leaders: why, whether, and how good?

2021 ◽  
Vol 7 (2) ◽  
pp. 85-88
Author(s):  
James K Stoller
Keyword(s):  
Health Care ◽  
Leadership Development ◽  
Clinical Training ◽  
Medical Training ◽  
Leadership Competencies ◽  
Hospital Performance ◽  
Leadership Roles ◽  
Physician Leadership ◽  
Leadership Development Programs ◽  
Physician Leaders

The challenges of providing high-quality, seamless access, and value in health care require great leadership; these needs are compounded by crises like the coronavirus pandemic. In the context that physicians often lead both in titled and informal leadership roles and that evidence associates effective hospital performance with physician leadership, leadership skills are widely needed by doctors. Yet, leadership competencies are not traditionally taught in medical school or during graduate medical training. Furthermore, some aspects of clinical training may conspire against physicians’ developing optimal leadership traits. The tension between need and preparation highlights the imperative to develop physicians’ leadership competencies. Increasingly, physician leadership development programs are being offered, e.g., by some health care organizations, professional societies, business schools, and consulting firms. Still, many unanswered questions beyond the “why” surround such programs: what is the best way to develop physician leaders and are such programs effective? This article considers the rationale for developing physician leaders as well as some leadership handicaps that physicians face by virtue of their clinical training. Attention then turns to considering the evidence regarding the effectiveness of such programs and framing remaining questions for further study.

Who will lead the physicians unwilling to lead? Institutional logics and double-bind situations in health care leadership

2016 ◽  
Vol 37 (3) ◽  
pp. 325-340 ◽  
Author(s):  
Alexander Styhre ◽  
Adam Roth ◽  
Jonas Roth
Keyword(s):  
Health Care ◽  
Health Care Organizations ◽  
Clinical Work ◽  
Institutional Logics ◽  
Leadership Roles ◽  
Organizational Setting ◽  
Leadership Positions ◽  
Case Study Methodology ◽  
Content Type ◽  
Swedish Health Care

Purpose – Health care organizations are increasingly demanded to balance the institutional logic of “medical professionalism” and “business-like health care,” that is, to both recognize physicians’ professional expertise while locating it in a wider social, economic, and political organizational setting. The purpose of this paper is to examine the implications from this shift in terms of leadership work in health care organizations. Design/methodology/approach – Case study methodology including interviews with 15 residents in Swedish health care organizations. Findings – A study of the willingness of residents to take on leadership positions show that leadership roles are treated as what is potentially hindering the acquisition of the know-how, skills, and expertise demanded to excel in the clinical work. Consequently, taking on leadership positions in the future was relatively unattractive for the residents. In order to overcome such perceived conflict between professional skill development and leadership roles, top management of health care organizations must help residents overcome such beliefs, or other professional groups may increasingly populate leadership positions, a scenario not fully endorsed by the community of physicians. Originality/value – The paper demonstrates how complementary or completing institutional logics are influencing debates and identities on the “shop floors” of organizations.

Career path from a dentist to a leader

2018 ◽  
Vol 31 (4) ◽  
pp. 384-397
Author(s):  
Tiina A. Tuononen ◽  
Anna Liisa Suominen ◽  
Johanna Lammintakanen
Keyword(s):  
Health Care ◽  
Goal Orientation ◽  
Career Paths ◽  
Career Path ◽  
Structured Interview ◽  
Personal Factors ◽  
Leadership Positions ◽  
Content Type ◽  
Career Anchor ◽  
Interesting Possibility

Purpose The purpose of this paper was to study the career paths of leaders with a career background as a dentist from basic degree to chief or executive leadership positions and individual factors that influenced their decisions. Design/methodology/approach Semi-structured interview and a questionnaire were used to study 13 leaders using the structure of Edgar Schein’s career anchor interview and career orientation inventory questionnaire. Theory-driven content analysis was used to analyze the data according to themes which included career paths, factors associated with job and career changes and thoughts about future careers. Findings Three different career path types were identified: Progressives (Type A), By chance (Type B), and Enthusiasts (Type C). The main motives were: the Progressives’ goal orientation to proceed to higher leadership positions, the By chance group’s job and even career changing by taking a chance on an interesting possibility that comes their way and the Enthusiasts’ willingness to make a difference and search for possibilities to change things. The most important career anchor was “pure challenge” among the Progressives and By chance groups and “general managerial competence” among the Enthusiasts. Originality/value Studies on personal factors associating with career paths in health care are scarce and similarly leaders with a dentist background are less studied, even though leadership could be an excellent career choice for a dentist. Different individuals can have varied motives and career paths toward executive positions. Because of the multi-professional functions in health care, organizations could benefit from having leaders with different expertise backgrounds.

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.

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.

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