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The purpose of this study is to better understand social media (SM) factors that physician leaders need to consider, as they adapt their cross-boundary practices to engage with colleagues and patients. Firstly, this study explores why SM is being used by physicians to cross horizontal (physician to physician) and stakeholder (physician to patient) boundaries prior to COVID-19. Secondly, based on the studies reviewed, this study provides insights on the practical SM implications for physician leaders working in the COVID-19 environment to actively enhance their practices, reduce public confusion and improve patient care, thus informing health-care practices.

A systematic literature review was used to conduct a structured transparent overview of peer reviewed articles that describe physicians’ use of cross-boundary SM across several disciplines (e.g. health, information science). As a baseline assessment prior to COVID-19, the review synthesized 47 articles, identified and selected from six databases and Novanet. This study used NVivo 12 to thematical code the articles, leading to the emergence of four broad factors that influence SM use.

A key reason noted in the literature for physicians use of SM to cross horizontal boundaries is to share knowledge. Regarding stakeholder boundaries, the most cited reasons are to improve patient’s health and encourage behavioural changes. Insights garnered on the practical SM implications include the need for physicians to be stronger leaders in presenting trustworthy and consistent facts about health information to the public and fellow peers. As role models for the effective use of SM tools, physician leaders can mentor and coach their colleagues and counterparts.

As this was a literature review, the authors did not collect primary data to further explore this rapidly changing and dynamic SM world. Next steps could include a survey to determine firstly, how physicians currently use SM in this COVID-19 environment, and secondly, how they could leverage it for their work. Findings from this survey will help us better understand the role of physician leaders as health-care influencers and how they could better create trust and inform the Canadian public in the health information that is being conveyed.

Physician leaders can play a key role in positively influencing institutional support for ethical and safe SM use and engagement practices. Physicians need to participate in developing regulations and guidelines that are fundamentally to physician leader’s SM use. Central to this research would be the need to understand how physicians cross-boundary practices have changed during and potentially post COVID-19. Physician leaders also need to monitor information sources for credibility and ensure that these sources are protected. As role models for the effective use of SM tools, physician leaders can mentor and coach their colleagues and counterparts in this area.

Although there have been studies of how physicians use SM, fewer studies explore why physician leaders’ cross boundaries (horizontal and stakeholder) using SM. Important insights are gained in physician leaders practical use of SM. Key themes that emerged included: organizational and individual, information, professional and regulations and guideline factors. These factors strengthen physician leaders understanding of areas of foci to enhance their cross-boundary interactions. There is an urgency to study the complexity of SM and the effectiveness of regulations and guidelines for physicians, who are being required, at an accelerated rate, to strengthen and increase their cross-boundary practices.

This study seeks to improve the understanding of physician leaders' leadership work challenges.

The subjects of the empirical study were physician leaders (n = 23) in the largest central hospital in Finland.

A 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.

The authors list some of the practical implications that follow from this study and which could help solve some of the challenges.

This study explores physician leaders' leadership work challenges using authentic physician leader data in a context where no prior empirical research has been carried out.

The purpose of this paper is to determine the particular competencies demonstrated by effective physician leaders. Changing organizational and environmental dynamics present unique challenges to leaders in the field of healthcare. An accelerated emphasis on increasing the quality of health care delivery, containing costs, and restructuring the delivery of health care itself are redefining the very nature of healthcare and the roles of physicians as leaders. Given this context, the authors propose to identify the essential competencies for twenty-first century physician leadership.

In all, 53 critical incident interviews from 28 physicians identified as emerging leaders at the Cleveland Clinic, a top-rated US academic healthcare institution, were examined in two ways: an existing leadership competency model was applied to each critical incident and inductively derived themes were identified through thematic analysis of the incidents.

The predominant distinguishing leadership competencies demonstrated by the physician leaders included: Empathy, Initiative, Emotional Self-Awareness and Organizational Awareness. Communicating deliberately, getting buy-in from colleagues, focussing on the mission of the organization and showing respect for others were also discovered through thematic analysis to be essential practices of these effective physician leaders. Over 90 percent of the critical incident stories dealt with colleague-to-colleague interactions.

The research was conducted in one academic healthcare organization, thus limiting the generalizability of the results. Additional research testing these results in a variety of healthcare institutions is warranted.

This study identified specific competencies that distinguish effective physician leaders. These leaders actively sought to work with colleagues to obtain their input and consensus in order to enact organizational change and improve health care delivery in their institution. Importantly, their intentions were neither self-focussed nor self-promoting but strongly mission driven. The identification of physician leader competencies will assist incumbent and emerging physician leaders in their ability to be effective leaders, as well as inform the design of training and development programs for physicians.

The purpose of this paper is to provide a systematic review of the current state of physician leadership. Theory of expert leadership (TEL) was applied to explore the effects of physician inherent knowledge, industry experience and leadership capabilities on leader behaviors and outcomes.

This review (August 2011–February 2022) applied the preferred reporting items for systematic review and meta-analysis strategy. Our search began with 3,537 studies and a final sample of 12 articles.

The findings offer a number of studies that note the relationship between physician leadership and the three dimensions of TEL. How influential these are on leadership behaviors and health-related outcomes varies. We also found a number of studies that described general physician leadership behaviors that were not directly linked to factors of TEL, as well as two additional themes: leader identity and trust.

To the best of the authors’ knowledge, this is the first systematic review that has applied a highly cited theory (i.e. TEL) to the data and the first that has focused solely on a U.S. population. These findings offer healthcare organizations insight into the potential strengths and challenges of physician leadership.

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.

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.

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.

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.

Motivation is a widely explored topic and numerous studies have been done to determine motivation importance and implementation. However, no studies have been identified that investigate what motivators are most important to physicians and if physician leaders agree with the importance physicians place on specific motivational aspects. The purpose of this paper is to investigate this missed management learning opportunity.

A fully inclusive sampling of all (n=2,547) public-practice physicians and physician leaders (clinic and hospital employed, non-private practice) in Minneapolis and St. Paul Minnesota was conducted in the summer and fall of 2013. The surveys were sent in a link via a web survey software program by the study researchers. The surveys were anonymous and minimally intrusive, asking only for perspectives regarding the most important motivational elements by physicians and physician leaders.

Generally, the responses were surprisingly similar between physicians and physician leaders. The two statistically different motivators – interesting work and job security – were ranked as more important by physicians than the physician leaders. This suggests that leaders should be more attentive to ensuring variety, challenge, and engagement is an active part of the physicians’ work. This also suggests that managers should emphasize and reinforce the fact that – if it is the case – jobs are secure and that staffing stability is a key goal for management. As Kovach (1987) suggests, as employees’ income increases, money becomes less of a motivator and as employees get older, interesting work becomes more of a motivator.

Conclusions and generalizations can be made about the population sampled.

The two statistically different motivators – interesting work and job security – were ranked as more important by physicians than the physician leaders. This suggests that leaders should be more attentive to ensuring variety, challenge, and engagement is an active part of the physicians’ work. This also suggests that managers should emphasize and reinforce the fact that – if it is the case – jobs are secure and that staffing stability is a key goal for management.

As this study reveals, physicians have clear preferences when it comes to workplace motivation. It is not unreasonable then to determine that the more satisfied the employee, the better he or she will perform. Accordingly, the environment that managers create for their employees must be one that is constructive to positive energy. If employees feel happy when they are working, then they will be naturally encouraged to work, thus producing improved quality healthcare for patients.

What are the most important motivators for physicians and do physician leaders understand what motivators are to enhance physician productivity, well-being, and morale? Answers to this question may be beneficial to designing leadership education that enhances the understanding of the impact effectively identified and effectively applied motivation techniques may have on employee behavior and attitudes. Insights will also benefit the design of motivational structures and methods in the healthcare workplace.

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.

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.

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.

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.

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.

This work points to a broader and more fundamental need – a modified mindset about the nature and value of physician leadership.

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.

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.

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.

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.

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.

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.

The purpose of this paper is: first, to present a qualitative descriptive case study of the Mayo Clinic leadership and organization development philosophy and approach; second, to summarize a strategy for using intentional organization design as a foundation for culturally aligned physician leadership development and third, to describe the Mayo Clinic Leadership Model.

This manuscript is a qualitative descriptive case study of the Mayo Clinic leadership development philosophy and approach. The authors reviewed the organization design and leadership development programs of a leading healthcare institution. In the systematic appraisal, the authors sought to understand the key features and elements of team-based leadership development and the supporting organizational characteristics that guide development with the use of a customized institutional leadership model.

The authors identified four intentional characteristics of the multi-specialty group practice structure and culture that organically facilitate the development of leaders with the qualities required for the mission. The four characteristics are: patient-centered organizational design, collaborative leadership structure, egalitarian leader selection process and team-based development system. The authors conclude that organization culture and design are important foundations of leadership development. Leadership development cannot be separated from the context and culture of organizational design. Mayo Clinic’s organizational and governance systems are designed to develop culturally aligned leaders, build social capital, grow employee engagement, foster collaboration, nurture collegiality and engender trust. Effective organization design aligns the form and functions of the organization with leadership development and its mission.

This qualitative descriptive case study presentation and analysis offers a unique perspective on physician leadership and organization development in healthcare.

This paper aims to present the argument that effective physician leadership is needed to improve the quality and efficiency of healthcare delivery in the USA and around the world.

This paper is based on an in-depth literature review, interviews with physician leaders and a study of the competencies required for physicians to successfully lead healthcare organizations.

The paper finds that a clear need exists for training to improve specific leadership competencies among physicians, regardless of their career stage or career path.

Limited research has been conducted on the value of physician leadership and its impact on quality outcomes and patient safety.

This paper establishes the need for physician leadership in healthcare organizations.

This paper will influence public attitudes within the healthcare sphere on the value that physician leaders can bring to healthcare.

This paper fulfils a need for more study on the impact that physician leadership brings to quality and patient care, and establishes the need for physician leaders to obtain specific leadership competencies.