physician leadership
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Cureus ◽  
2021 ◽  
Author(s):  
Emmanuel Tito ◽  
Sarah Black ◽  
Patrick Hilaire ◽  
Joseph Weistroffer ◽  
Cheryl Dickson

2021 ◽  
pp. 1-8
Author(s):  
Rawn Salenger ◽  
William Martin
Keyword(s):  

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sari Huikko-Tarvainen

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.


2021 ◽  
Vol 35 (9) ◽  
pp. 195-210
Author(s):  
Sari Huikko-Tarvainen ◽  
Pasi Sajasalo ◽  
Tommi Auvinen

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.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Keaton A. Fletcher ◽  
Spencer Garcia ◽  
Bhagwan Satiani ◽  
Philip Binkley ◽  
Alan Friedman

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18780-e18780
Author(s):  
Mike Gart ◽  
Hinco J. Gierman ◽  
Daniel P. Petro ◽  
Rushir J. Choksi ◽  
Prateesh Varughese ◽  
...  

e18780 Background:In August 2019 Integra Connect (IC) partnered on a QI with University of Pittsburgh Medical Center (UPMC) to improve outcomes in patients with stage 3 and 4 NSCLC. This report details the findings and interventions in the unresectable stage 3 cohort of the QI. The addition of durvalumab (D) in the PACIFIC trial (Antonia et al. NEJM 2017) after completion of CRT in stage 3 patients who had not progressed showed significant Progression Free Survival and Overall Survival (OS) benefit with Food and Drug Administration approval on 2/16/2018 in this setting. An update (Gray et al. Thoracic Oncol 2020) on 10/14/2019 noted superior OS in patients in whom randomization to D occurred 1-14 days post CRT vs. those with interval 15-42 days (HR 0.43 vs. 0.79). Data suggest that CRT renders tumors more responsive to immunotherapy (McCall et al. Clin Can Res 2018). As part of the QI, we explored the question whether time from CRT to D (TTT) could be shortened. Methods:From the UPMC and IC real-world-data (RWD) databases, we identified 182 patients with Stage 3 unresectable NSCLC treated with CRT between 2/16/18 (D approval) and 11/16/20 for manual chart abstraction. We calculated the TTT from the latest day of radiation or chemotherapy to the first D dose. Time-to-scan (TTS) used a similar methodology. If post-CRT scan data was not found, those patients were excluded from TTS analysis. We captured caregiver perception with surveys and used RWD to determine the proportion of eligible patients treated with D, categorizing the data into 3 successive time periods: Phase 1 (240 days): 2/16/18 approval of D to Gray update 10/14/19, Phase 2 (321 days): 10/15/19 to physician leadership intervention 8/31/20, Phase 3 (76 days): 9/1/20 to 11/16/20. Patients were excluded in phase 3 who started CRT after 11/16/20 to allow for up to 2 months to start D. Our plan included baseline and ongoing monitoring of metrics complemented with physician leadership intervention to address identified gaps in care. Results: Median age of the 182 patients was 68 (range 46-87) with 60% male. Of eligible patients, 121 (66.5%) received at least 1 dose of D. Median TTS improved 16 days from Phase 1 to Phase 3 while TTT concomitantly improved 17 days (Table ). Conclusions: This QI resulted in simultaneous shortening of TTS and TTT following physician intervention with establishment of TTS as a key potential driver of TTT which ultimately may result in improved OS. To do so required overcoming the traditional paradigm of imaging 4-6 weeks post-CRT to capture maximal response with that of early imaging aimed at assuring no progression had occurred. This, as well as proportion treated with D and its resulting duration, plus any subsequent treatments that might indicate relapse, continue to be monitored in a real-time dashboard.[Table: see text]


BMJ Leader ◽  
2021 ◽  
pp. leader-2020-000365
Author(s):  
Ankit Raj

BackgroundIndia has seen a rapid surge in health tech startups that have disrupted many aspects of the healthcare industry. While positive trends have emerged in online pharmacy, telemedicine, and medical education; we are still to see these health tech startups create similar dividends in other aspects of healthcare especially in direct care and treatment. While startups have grown leaps and bounds in multiple industries, health tech startups have not grown to the same extent. There are many existing factors for this supposedly lackluster performance. The author discusses one of these factors contributing to the slow growth of health tech startups in India.ConclusionThe author highlights the lack of intent from the top leadership and executive bodies of these startups to involve physicians at all levels of decision making. A lack of insights from professionals directly involved with the functioning of healthcare and lack of inexperience from outsiders managing these startups may have contributed to this slow growth of health tech startups in India. The author further discusses possible solutions and key factors that can help contribute to better engagement of physicians in decision-making tables of the health tech startups.


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