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In the management world, leadership is a quality associated with business leaders, social entrepreneurs and political figures. Doctors are rarely considered as possessing or requiring leadership skills. With doctors, one thinks of skill and knowledge, but for some strange reason, leadership is hardly associated with doctors. This paper aims to highlight the leadership aspects unique to doctors. This study highlights why leadership training is imperative for doctors, outlines current status of leadership training for doctors in India and sets out proposals for effective leadership building.

Methodology is based on a two-pronged explanatory approach – the first is review of current literature in the context of leadership training of doctors, and the second is review of circumstances unique to the line of work undertaken by doctors that shed light on the need for leadership.

This paper highlights the imperative need for leadership training for doctors in India. It recommends leadership training on a continuous basis in their career life cycle as with the other professions. It also calls for involvement of all stakeholders in the medical community to foster leadership training – medical educational institutions, hospitals, medical councils and members of the medical fraternity.

Akin to leadership training programs conducted for IT and management professionals, this paper recommends that similar programs be conducted for doctors.

There are very few studies conducted in the Indian context on leadership training needs for doctors. This paper explains the importance of leadership training for doctors and suggests ways it can be implemented throughout the medical education life cycle of a doctor’s career.

The last decade has seen a significant increase in self-initiated expatriation research across various cohorts; however, limited research exists on the self-initiated expatriation of medical doctors despite their high mobility rates. The purpose of this paper is to investigate the determinants of cross-cultural adjustment among self-initiated medical doctors working and living in a host culture.

A questionnaire was distributed to self-initiated expatriate (SIE) doctors working in Irish hospitals. In total, 193 valid responses were collected. Three linear regression analyses were conducted to explore factors influencing cross-cultural adjustment among SIE medical doctors, along with qualitative insight into their adjustment to working and living in Ireland.

This study found that age, marital status, cultural novelty, previous international work experience, length of time working in the host culture did not influence the cross-cultural adjustment of SIE doctors. However, gender, language ability and perceived fair treatment were found to influence their cross-cultural adjustment in the study. Specifically, female SIE doctors reported higher levels of general adjustment to that of SIE male doctors. SIE doctors' language ability was found to influence their work adjustment, and those who perceived unfair treatment in the host culture reported lower levels of general adjustment.

This paper contributes to the limited knowledge and understanding surrounding the self-initiated expatriation of medical doctors and their cross-cultural adjustment to the host hospital and host culture.

Doctors' labour and medicines are special necessities for human survival and evolution. Since China launched the healthcare reform, the theoretical circles' discussions have not yet clarified the respective special properties of doctors' labour and medicines as goods and the internal relations between doctors' labour and medicines at the level of the theoretical basis.

Health is a prerequisite for people's all-round development, a precondition for economic and social development and the people's common aspiration. The all-round moderately prosperous society could not be achieved without people's all-round health.

The authors believe the socialist relation between doctors' labour and medicines with Chinese characteristics should be one that is people-oriented, and the corporatization of hospitals or the capitalization of doctors' labour should be avoided.

In this paper, the authors explore the particularity of doctors' labour, particularity of medicine production, circulation, consumption and the internal relations between doctors' labour and medicines by using the analytical approach of Marxist political economy while considering the special roles of doctor's labour and medicines in the reproduction of labour power and put forward the theoretical basis for the segregation of doctor's labour and medicines.

Stigmatising attitudes towards persons with mental illness are commonly reported among health professionals. Familiarity with mental illness has been reported to improve these attitudes. Very few studies have compared future medical doctors' attitudes toward types of mental illness, substance use disorders and physical illness. A cross-sectional survey of 5th and 6th year medical students as well as recently graduated medical doctors was conducted in April 2011. The 12-item level of contact report and the Attitude towards Mental Illness Questionnaire were administered. Partici -pants endorsed stigmatising attitudes towards mental illness; with attitudes more adverse for schizophrenia compared to depression. Stigmatising attitudes were similarly endorsed for substance use disorders. Paradoxically, attitudes towards HIV/AIDS were positive and similar to diabetes mellitus. Increasing familiarity with mental illness was weakly associated with better attitudes towards depression and schizophrenia. Stigmatising attitudes towards depression and schizophrenia are common among future doctors. Efforts to combat stigma are urgently needed and should be promoted among medical students and recent medical graduates.

Society is critically dependent on an adequate supply of hospital doctors to ensure optimal health care. Voluntary turnover amongst hospital doctors is, however, an increasing problem for hospitals. The aim of this study was to systematically review the extant academic literature to obtain a comprehensive understanding of the current knowledge base on hospital doctor turnover and retention. In addition to this, we synthesise the most common methodological approaches used before then offering an agenda to guide future research.

Adopting the PRISMA methodology, we conducted a systematic literature search of four databases, namely CINAHL, MEDLINE, PsycINFO and Web of Science.

We identified 51 papers that empirically examined hospital doctor turnover and retention. Most of these papers were quantitative, cross-sectional studies focussed on meso-level predictors of doctor turnover.

Selection criteria concentrated on doctors who worked in hospitals, which limited knowledge of one area of the healthcare environment. The review could disregard relevant articles, such as those that discuss the turnover and retention of doctors in other specialities, including general practitioners. Additionally, being limited to peer-reviewed published journals eliminates grey literature such as dissertations, reports and case studies, which may bring impactful results.

Globally, hospital doctor turnover is a prevalent issue that is influenced by a variety of factors. However, a lack of focus on doctors who remain in their job hinders a comprehensive understanding of the issue. Conducting “stay interviews” with doctors could provide valuable insight into what motivates them to remain and what could be done to enhance their work conditions. In addition, hospital management and recruiters should consider aspects of job embeddedness that occur outside of the workplace, such as facilitating connections outside of work. By resolving these concerns, hospitals can retain physicians more effectively and enhance their overall retention efforts.

Focussing on the reasons why employees remain with an organisation can have significant social repercussions. When organisations invest in gaining an understanding of what motivates their employees to stay in the job, they are better able to establish a positive work environment that likely to promote employee well-being and job satisfaction. This can result in enhanced job performance, increased productivity and higher employee retention rates, all of which are advantageous to the organisation and its employees.

The review concludes that there has been little consideration of the retention, as opposed to the turnover, of hospital doctors. We argue that more expansive methodological approaches would be useful, with more qualitative approaches likely to be particularly useful. We also call on future researchers to consider focussing further on why doctors remain in posts when so many are leaving.

Previous research provides adequate evidence on performance management (PM) for hospitals and healthcare providers; however, less is known about their individual and PM appraisal process. Additionally, there is limited research exploring PM in the Middle Eastern context. This study investigates PM practices in the Middle Eastern healthcare industry.

This study adopts the qualitative research methodology through semi-structured interviews of healthcare professionals in Kingdom of Saudi Arabia and the United Arab Emirates. Thematic analysis was adopted for analyzing this qualitative data.

The main findings have uncovered different facets of appraisal challenges for both the appraiser (i.e. manager) and the appraisee (i.e. employee). These challenges include communication deficits, lack of goal setting standards and regular meeting updates in order to ensure employee satisfaction and motivation in the workplace.

This study has significant implications for policymakers in Middle Eastern hospitals in terms of implementing PM for their staff. Moreover, future studies can conduct in-depth analysis and provide comparison between public and private sectors in the Gulf countries.

This study is one of the first to portray challenges involved in conducting PM in the Middle East healthcare sector specifically in the UAE and Kingdom of Saudi Arabia (KSA), both from the perspectives of the appraiser and appraisee.

The purposes of this paper are two-fold: first, to introduce a new concept of primary care consultation system at a mainland Chinese hospital in response to healthcare reform; and second, to explore the factors associated with change resistance and acceptance from both patients’ and medical staff’s perspectives.

A survey design study, with two questionnaires developed and distributed to patients and medical staff. Convenience and stratified random sampling methods were applied to patient and medical staff samples.

A 5-dimension, 21-item patient questionnaire and a 4-dimension, 16-item staff questionnaire were identified and confirmed, with 1020 patients (91.07 percent) and 202 staff (90.18 percent) as effective survey participants. The results revealed that patient resistance mainly stems from a lack of personal experiences with visiting general practice (GP) and being educated or having lived overseas; while staff resistance came from occupation, education, GP training certificate, and knowledge and experience with specialists. Living in overseas and knowledge of GP concepts, gender and education are associated with resistance of accepting the new practice model for both patients and staff.

There are few Chinese studies on process reengineering in the medical sector; this is the first study to adopt this medical consultation model and change in patients’ consultation culture in Mainland China. Applying organizational change and process reengineering theories to medical and healthcare services not only extends and expands hospital management theory but also allows investigation of modern hospital management practice. The experience from this study can serve as a reference to promote this new consultation model in Chinese healthcare reform.

The purpose of this study had two aims: (1) to extend insight regarding the challenges of implementing standardised work, via care pathways, in a healthcare setting by considering interactions with other operational (i.e. resource sharing, portfolio alignment) and professional (i.e. autonomous expertise) dependencies and (2) to develop novel insights regarding a specific flow mechanism, the stroke nurse practitioner, a form of flow “pilo” or guide.

This was a longitudinal case study of implementing the acute stroke care pathway in a National Health Service hospital in England based on 185 hours of non-participant observations and 68 semi-structured interviews. Archival documents were also analysed.

The combined flow, operational and professional dependency lens extends operations management understanding of the challenge of implementing standardised work in healthcare. One observed practice, the process pilot role, may be particularly valuable in dealing with these dependencies but it requires specific design and continuous support, for which the authors provide some initial guidance.

The research was a single case study and was focussed on a single care pathway. The findings require replication and extension but offer a novel set of insights into the implications of standardised work in healthcare.

In addition to confirming that a multidependency lens adds conceptual and practical insight to the challenges of implementing standardised work in a healthcare setting, the findings and recommendations regarding flow “pilots” are novel. The authors' analysis of this role reveals new insights regarding the need for continued improvisation in standardised work.

This study aims to examine the impact of workplace safety (WPS) on employee retention (ER) in the health-care sector in Azad Jammu and Kashmir (AJ&K), Pakistan. At the same time, a mediation relationship through job satisfaction (JS) and employee loyalty (EL) was also tested.

Structured questionnaires were used to collect the data from 300 doctors, using purposive sampling technique analysed using partial least squares (Smart-PLS 3).

This study’s findings supported all hypotheses, such as WPS has a significant positive relationship with ER. In addition, a mediation relationship between JS and EL was also confirmed. Furthermore, a serial mediation effect of JS and EL between WPS and ER was also confirmed in this study.

This study might not fit organisations from other regions due to regional norms. In the future, this study’s model may be tested on other regions and segments of the health-care sector, such as nurses, management staff and support staff.

The present study is unique because it is based on a newly formulated framework, WPS → JS → EL → ER, under the social exchange theory, which has not been tested before.

In a safe environment, doctors will feel relaxed, stay longer and provide better services; resultantly, patients will get better treatment.

This study tested the sequential mediation effect through JS and EL for the first time in ER, which was missing previously, to the best of the authors’ knowledge. This will add more insights to the safety-retention literature in health-care settings. Furthermore, this study is also the first attempt to explore the relationship between WPS and ER in the health-care sector in AJ&K.

In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries favor a combination of professional regulatory boards and clinical governance frameworks that feature paramedics taking lead clinician roles. The purpose of this paper is to bring together the evidence for medical direction and clinical governance in paramedic services through the prism of paramedic self-regulation.

This narrative synthesis critically examines the long-established North American Emergency Medical Services medical direction model and makes some comparisons with the UK inspired clinical governance approaches that are used to monitor and manage the quality and safety in several other Anglo-American paramedic services. The databases searched were CINAHL and Medline, with Google Scholar used to capture further publications.

Synthesis of the peer-reviewed literature found little high quality evidence supporting the effectiveness of medical direction. The literature on clinical governance within paramedic services described a systems approach with shared responsibility for quality and safety. Contemporary paramedic clinical leadership papers in developed countries focus on paramedic professionalization and the self-regulation of paramedics.

The lack of strong evidence supporting medical direction of the paramedic profession in developed countries challenges the North American model of paramedics practicing as a companion profession to medicine under delegated practice model. This model is inconsistent with the international vision of paramedicine as an autonomous, self-regulated health profession.