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Article
Publication date: 4 July 2016

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

Erwin Loh, Jennifer Morris, Laura Thomas, Marie Magdaleen Bismark, Grant Phelps and Helen Dickinson

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…

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Abstract

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.

Details

Leadership in Health Services, vol. 29 no. 3
Type: Research Article
DOI: https://doi.org/10.1108/LHS-12-2015-0044
ISSN: 1751-1879

Keywords

  • Doctors
  • Dark side
  • Medical leadership
  • Medical management

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Article
Publication date: 6 October 2015

Doctors as health managers: an oxymoron, or a good idea?

Erwin Loh

The purpose of this paper is to review the current literature and summarises the benefits and limitations of having doctors in health management roles in today’s complex…

Open Access
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Abstract

Purpose

The purpose of this paper is to review the current literature and summarises the benefits and limitations of having doctors in health management roles in today’s complex health environment.

Design/methodology/approach

This paper reviews the current literature on this topic.

Findings

Hospitals have evolved from being professional bureaucracies to being managed professional business with clinical directorates in place that are medically led.

Research limitations/implications

Limitations include the difficulty doctors have balancing clinical duties and management, restricted profession-specific view and the lack of management competencies and/or training.

Practical implications

The benefits of having doctors in health management include bottom-up leadership, specialised knowledge of the profession, expert knowledge of clinical care, greater political influence, effective change champions to have on-side, frontline leadership and management, improved communication between doctors and senior management, advocacy for patient safety and quality, greater credibility with public and peers and the perception that doctors have more power and influence compared to other health professionals can be leveraged.

Originality/value

Overall, there are more benefits than there are limitations to having doctors in health management but there is a need for more management training for doctors.

Details

Journal of Work-Applied Management, vol. 7 no. 1
Type: Research Article
DOI: https://doi.org/10.1108/JWAM-10-2015-005
ISSN: 2205-2062

Keywords

  • Health care
  • Health management
  • Health managers
  • Clinical directorates
  • Hospital management

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Article
Publication date: 15 June 2015

How and why medically-trained managers undertake postgraduate management training: A qualitative study from Victoria, Australia

Erwin Loh

The purpose of this paper is to address the research question using qualitative research methods: how and why medically trained managers choose to undertake postgraduate…

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Abstract

Purpose

The purpose of this paper is to address the research question using qualitative research methods: how and why medically trained managers choose to undertake postgraduate management training?

Design/methodology/approach

This research used two qualitative methods to gather data. Both methods used purposeful sampling to select interviewees with appropriate management expertise, qualifications and experience. The first stage utilised convergent interviews and was exploratory. The five interviewees were managers and academics. The second stage used case research methodology and was confirmatory. The fifteen interviewees were medically qualified chief executives and chief medical officers. In total, 20 in-depth interviews were carried. Rigorous content analysis of data collected showed emergent themes.

Findings

The first theme that emerged was that doctors move into management positions without first undertaking training. The second theme was that doctors undertake such training in the form of a masters-level degree and/or a specialist fellowship. The third theme was that effective postgraduate management training for doctors requires a combination of theory and practice. The fourth theme was that clinical experience alone does not lead to required management competencies. The fifth theme was that doctors choose to undertake training to gain credibility.

Research limitations/implications

This research was exploratory and descriptive in nature and limited to analytical rather than statistical generalisation.

Originality/value

This research has provided insights into the importance of understanding how and why doctors undertake postgraduate management training, and may assist policy makers and training providers in the development of such training for doctors.

Details

Journal of Health Organization and Management, vol. 29 no. 4
Type: Research Article
DOI: https://doi.org/10.1108/JHOM-10-2013-0233
ISSN: 1477-7266

Keywords

  • Clinical leadership
  • Clinician manager
  • Health administration
  • Management training
  • Medical administration
  • Medical management

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Article
Publication date: 6 October 2015

Editorial

Selva Abraham and Jonathan Garnett

Open Access
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Abstract

Details

Journal of Work-Applied Management, vol. 7 no. 1
Type: Research Article
DOI: https://doi.org/10.1108/JWAM-10-2015-007
ISSN: 2205-2062

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Article
Publication date: 4 July 2016

Editorial

Graham Dickson and Karen Owen

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Details

Leadership in Health Services, vol. 29 no. 3
Type: Research Article
DOI: https://doi.org/10.1108/LHS-04-2016-0018
ISSN: 1751-1879

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Article
Publication date: 1 February 1978

MACHINE TRANSLATION AND MACHINE‐AIDED TRANSLATION

W.J. HUTCHINS

The recent report for the Commission of the European Communities on current multilingual activities in the field of scientific and technical information and the 1977…

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Abstract

The recent report for the Commission of the European Communities on current multilingual activities in the field of scientific and technical information and the 1977 conference on the same theme both included substantial sections on operational and experimental machine translation systems, and in its Plan of action the Commission announced its intention to introduce an operational machine translation system into its departments and to support research projects on machine translation. This revival of interest in machine translation may well have surprised many who have tended in recent years to dismiss it as one of the ‘great failures’ of scientific research. What has changed? What grounds are there now for optimism about machine translation? Or is it still a ‘utopian dream’ ? The aim of this review is to give a general picture of present activities which may help readers to reach their own conclusions. After a sketch of the historical background and general aims (section I), it describes operational and experimental machine translation systems of recent years (section II), it continues with descriptions of interactive (man‐machine) systems and machine‐assisted translation (section III), (and it concludes with a general survey of present problems and future possibilities section IV).

Details

Journal of Documentation, vol. 34 no. 2
Type: Research Article
DOI: https://doi.org/10.1108/eb026657
ISSN: 0022-0418

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Article
Publication date: 16 March 2010

Six Sigma quality: a structured review and implications for future research

Mohamed Gamal Aboelmaged

This paper aims to clarify emerging aspects and trends of Six Sigma literature over 17 years, from 1992 to 2008.

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Abstract

Purpose

This paper aims to clarify emerging aspects and trends of Six Sigma literature over 17 years, from 1992 to 2008.

Design/methodology/approach

The literature on Six Sigma from 417 referred journal articles in business and management disciplines, information systems and computer science, engineering, healthcare, etc. were systematically analyzed based on a scheme that consists of four distinct dimensions: publication year and journal, major themes, research type, and application sector (i.e. manufacturing vs service).

Findings

A number of key findings emerged: Six Sigma research is growing rapidly, covering various disciplines and domains with a great focus on Six Sigma tools and techniques; empirical research is dominant with more emphasis on case study approach; and the growing gap between manufacturing‐ and service‐focused articles implies the return of Six Sigma to manufacturing as its initial base. Although a large volume of literature is available on Six Sigma, the topic is still under development and offers potential opportunities for further research and applications.

Originality/value

The paper provides both academics and practitioners with a useful framework for pursuing rigorous Six Sigma research through explaining the chronological growth of Six Sigma, challenging themes of Six Sigma research, dominating research types and application areas in Six Sigma, and the major sources of Six Sigma information.

Details

International Journal of Quality & Reliability Management, vol. 27 no. 3
Type: Research Article
DOI: https://doi.org/10.1108/02656711011023294
ISSN: 0265-671X

Keywords

  • Six Sigma
  • Total quality management
  • Lean production
  • Supply chain management

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Article
Publication date: 6 June 2016

An application of an extended effort-reward imbalance model to police absenteeism behaviour

Amanda Allisey, John Rodwell and Andrew Noblet

Frequent absences from work can be highly disruptive, whilst also potentially indicating problematic working conditions that can lead to increased withdrawal behaviour…

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Abstract

Purpose

Frequent absences from work can be highly disruptive, whilst also potentially indicating problematic working conditions that can lead to increased withdrawal behaviour. The purpose of this paper is to test the predictive capability of an expanded effort-reward imbalance model on employee absenteeism within the context of policing.

Design/methodology/approach

Three separate reward systems are identified by the effort-reward imbalance model. In this study, the authors assessed these individual components for their contribution to officer withdrawal behaviour in the form of absenteeism frequency. Data were gathered from a sample of operational officers (n=553) within a large Australian police agency.

Findings

Findings indicate that there was a strong influence of social rewards such as social support and recognition in the workplace on officer absenteeism rates. Low workload was associated with a higher frequency of absenteeism suggesting a potential underloading effect. There were a number of significant interactions providing support for the effort-reward imbalance mechanism and the separation of the reward construct. Security rewards were particularly influential and significantly moderated the relationship between effort and absenteeism.

Research limitations/implications

Differential effects of occupational rewards were identified in the study, indicating that there are significant opportunities for expansion of the effort-reward imbalance model along with opportunities for HRM practitioners in terms of employee recognition and remuneration programmes. This research was focused on a specific sample of operational officers, therefore should be expanded to include multiple occupational groups.

Originality/value

This paper considers and expanded model of worker strain and contributes a longitudinal assessment of the association between perceived effort and reward systems and worker absenteeism.

Details

Personnel Review, vol. 45 no. 4
Type: Research Article
DOI: https://doi.org/10.1108/PR-06-2014-0125
ISSN: 0048-3486

Keywords

  • Public sector
  • Absenteeism
  • Stress
  • Quantitative
  • Human resource management (HRM)
  • Job characteristics
  • Reward

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