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Article
Publication date: 31 August 2021

Sari Huikko-Tarvainen

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.

Abstract

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.

Details

Leadership in Health Services, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1751-1879

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Article
Publication date: 1 October 2005

John La Puma, Philippe Szapary and Kevin C. Maki

Because patients are more likely to follow advice from healthy weight rather than overweight physicians, seeks to determine whether physician overweight could be predicted…

Abstract

Purpose

Because patients are more likely to follow advice from healthy weight rather than overweight physicians, seeks to determine whether physician overweight could be predicted by self‐reported physician eating behaviors.

Design methodology/approach

An anonymous, written, self‐administered, pre‐tested, confidential survey of practicing physicians in the Midwestern USA was undertaken.

Findings

Most surveyed physicians (394 or 74 per cent) completed the survey. The results indicate that stress at home (OR 2.62, CI 1.35‐5.08) was most significantly and strongly predictive of physician overweight (BMI>25kg/m2), as were particular eating behaviors, including eating food provided at the medical office. Assessment of overall health was significantly and strongly inversely proportionally predictive (OR 0.43, CI 0.30‐0.62) of physician overweight as well.

Research limitations/implications

The research implies that, like patients, practicing US physicians are susceptible to feelings other than hunger which prompt over‐eating and weight gain. Limitations include study of a single, specific sample of physicians, and an exclusive focus on food and nutrition. Future research may wish to include measures of fitness and exercise.

Originality/value

Physicians are susceptible to predictable, particular feelings other than hunger which prompt over‐eating and overweight. Physician ability to respond to these feelings and to ameliorate the stresses and factors associated with them may help improve physician overweight and, in turn, physician ability to facilitate patient weight loss.

Details

Nutrition & Food Science, vol. 35 no. 5
Type: Research Article
ISSN: 0034-6659

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Article
Publication date: 22 May 2009

A.H.J. Klopper‐Kes, N. Meerdink, W.H. van Harten and C.P.M. Wilderom

The purpose of this paper is to apply the image theory to the hospital context in order to add a perspective into the known complex relationship between physicians and…

Abstract

Purpose

The purpose of this paper is to apply the image theory to the hospital context in order to add a perspective into the known complex relationship between physicians and hospital managers. This insight can enrich current intervention schemes used in health care to facilitate organisational change.

Design/methodology/approach

In this paper, the image theory of Alexander et al. on the known complex intergroup context of physicians and hospital managers is applied. The theory is operationalised in relative status, power, and goal incompatibility.

Findings

The data show the three variables are highly relevant and representative. Hospital managers see physicians as higher in professional status and power, and having different goals. Physicians see hospital managers to have higher power, lower status, and different goals. The study validates the applicability of the image theory in the Dutch hospital context. This results in a questionnaire suitable for performing a quick scan on the strength and direction of intergroup stereotyping within hospital organisations.

Originality/value

Data from the questionnaire give the opportunity to have insight in the way physicians and hospital managers perceive each other. This insight helps to focus attention on bottlenecks and possibilities in enhancing the co‐operation between physicians and hospital managers. Research on the relationship between physicians and hospital managers is scarce and mostly of a qualitative nature. This paper is executed in both qualitative and quantitative way, which enables us to empirically and statistically validate the data. The resulting questionnaire is applicable on an organisational intergroup level, while the focus in the extant literature is mostly on the interpersonal or intragroup level.

Details

Journal of Health Organization and Management, vol. 23 no. 2
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 11 September 2007

Pia Jansson von Vultée, Runo Axelsson and Bengt Arnetz

Purpose – The purpose of this research is to show that the Swedish health care system has undergone major changes during the last decades, which have exerted strong…

Abstract

Purpose – The purpose of this research is to show that the Swedish health care system has undergone major changes during the last decades, which have exerted strong influence on the operational freedom of physicians. Design/methodology/approach – This study consisted of 169 physicians in management positions, who answered a questionnaire assessing the relationship between their organizational settings and their perceived wellbeing. The organizational setting was defined as contact with top management, decision‐making influence, well defined organization and whether the physician is acting as a leader. The perceived wellbeing was defined as social climate, work related exhaustion, work satisfaction, influence, development ability and supportive leadership. Findings – According to the results, organizational support improves work satisfaction and mental energy, and decreases work related exhaustion among physicians. This all leads to decreasing turnover rate among physicians. Originality/value – These results point to the importance of maintaining a positive and supportive atmosphere for physicians in their work environment in order to encourage physicians to remain and take on management positions in the health care system. Furthermore enhancing physician influence over decision making processes is important to counteract work‐related exhaustion and it might also contribute to a more efficient organization.

Details

International Journal of Health Care Quality Assurance, vol. 20 no. 6
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 September 2002

Jessie L. Tucker

Physician participation in Medicaid is an important factor in the determination of access to health care for low‐income individuals. This study seeks to provide insight…

Abstract

Physician participation in Medicaid is an important factor in the determination of access to health care for low‐income individuals. This study seeks to provide insight into the factors that affect physicians’ decisions to participate in the Medicaid program. As Medicaid is administered under broad federal guidelines, there is some degree of commonality between the different programs in each state and many physician and market unique factors traverse state lines. On this basis, several propositions are presented. Physician participation in Medicaid is posited to be positively associated with Medicaid reimbursement rates, the percentage of the available patient base in the Medicaid program, physician perceived autonomy and whether the physician is a foreign medical graduate. Alternately, participation decisions are proposed to be negatively associated with practice costs, competition for paying patients, the difference between the marginal revenue derived from paying patients and revenue from Medicaid patients, and board certification. This study seeks to provide a deeper understanding of the effects of changes to the Medicaid program, and suggests their likelihood of success in providing care to vulnerable populations.

Details

International Journal of Social Economics, vol. 29 no. 9
Type: Research Article
ISSN: 0306-8293

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Article
Publication date: 2 May 2008

Joseph S. Guarisco and Stefoni A. Bavin

The purpose of this paper is to provide a case study testing the Primary Provider Theory proposed by Aragon that states that: disproportionate to any other variables…

Abstract

Purpose

The purpose of this paper is to provide a case study testing the Primary Provider Theory proposed by Aragon that states that: disproportionate to any other variables, patient satisfaction is distinctly and primarily linked to physician behaviors and secondarily to waiting times.

Design/methodology/approach

The case study began by creating incentives motivating physicians to reflect and improve behaviors (patient interactions) and practice patterns (workflow efficiency). The Press Ganey Emergency Department Survey was then utilized to track the impact of the incentive programs and to ascertain any relationship between patient satisfaction with the provider and global patient satisfaction with emergency department visits by measuring patient satisfaction over an eight quarter period.

Findings

The findings were two‐fold: firstly, the concept of “pay for performance” as a tool for physician motivation was valid; and secondly, the impact on global patient satisfaction by increases in patient satisfaction with the primary provider was significant and highly correlated, as proposed by Aragon.

Practical implications

These findings can encourage hospitals and physician groups to place a high value on the performance of primary providers of patient care, provide incentives for appropriate provider behaviors through “pay for performance” programs and promote physician understanding of the links between global patient satisfaction with physician behaviors and business growth, malpractice reduction, and other key measures of business success.

Originality/value

There are no other case studies prior to this project validating the Primary Provider Theory in an urban medical center; this project adds to the validity and credibility of the theory in this setting.

Details

Leadership in Health Services, vol. 21 no. 2
Type: Research Article
ISSN: 1751-1879

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Article
Publication date: 1 June 2000

Michael A. Amster, Greg Cogert, Desiree A. Lie and Joseph E. Scherger

This paper examines the attitudes and use of complementary and alternative medicine (CAM) by family physicians. A questionnaire was completed by 234 participants at the…

Abstract

This paper examines the attitudes and use of complementary and alternative medicine (CAM) by family physicians. A questionnaire was completed by 234 participants at the 1998 California Academy of Family Physicians Annual Scientific Assembly to analyze the recommendation, administration, and attitudes towards CAM by family physicians. This study indicates a large percent of California family physicians recommend and administer CAM to their patients. In addition, the results illustrate the importance of incorporating knowledge of CAM into medical education and the essential role family physicians play in the integration of conventional and CAM therapies.

Details

International Journal on Grey Literature, vol. 1 no. 2
Type: Research Article
ISSN: 1466-6189

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Article
Publication date: 1 December 1995

Rajshekhar G. Javalgi, W. Benoy Joseph and William R. Gombeski

Positioning analysis is based traditionally on customerperceptions. However, when a service depends on referrals to attractcustomers, positioning analysis should recognize…

Abstract

Positioning analysis is based traditionally on customer perceptions. However, when a service depends on referrals to attract customers, positioning analysis should recognize the perceptions of the key buying influences who make referrals. Specialized or “tertiary care” hospitals depend on physician referrals to win patients. Focusses on the mapping of referring physicians′ perceptions of leading regional medical centers. Correspondence analysis is employed with data from a survey of more than 1,000 physicians to develop a positioning map from which various hospital positioning strategies and physician marketing implications are drawn.

Details

Journal of Services Marketing, vol. 9 no. 5
Type: Research Article
ISSN: 0887-6045

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Article
Publication date: 27 March 2009

Arttu Saarinen

This article aims to focus on how young physicians in general and different subpopulations, in particular, see the role of the welfare state. The author seeks to compare…

Abstract

Purpose

This article aims to focus on how young physicians in general and different subpopulations, in particular, see the role of the welfare state. The author seeks to compare young physicians' opinions with those of older physicians, a similar age group in the general population and all physicians.

Design/methodology/approach

A random sample was picked from the Finnish Medical Association register (n=1,092). Data were analysed using descriptive statistics and multinomial logistic regression analysis.

Findings

Results show that young physicians – when compared with an overall population of the same age, with physicians overall, or with older physicians – are more critical of the degree of social security currently offered. Young physicians also want to give more responsibility to the private sector than do older physicians. On the other hand, young physicians are not very critical of healthcare system functionality. All in all, young physicians' opinions about the welfare state are not particularly radical. Results indicate that physicians' opinions about the welfare state will not change dramatically in the near future. Views on social security, healthcare system functionality and the role of the private sector correlate best with political orientation.

Originality/value

There are some studies about physicians' attitudes towards the welfare state, but the opinions of young physicians have not been studied in countries with large social security systems. The paper addresses this gap because it is important to study young physicians' opinions because future services will be structured on them.

Details

International Journal of Health Care Quality Assurance, vol. 22 no. 2
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 6 August 2021

Kudret Demirli, Abdulqader Al Kaf, Mecit Can Emre Simsekler, Raja Jayaraman, Mumtaz Jamshed Khan and E. Murat Tuzcu

Increased demand and the pressure to reduce health-care costs have led to longer waiting time for patients to make appointments and during the day of hospital visits. The…

Abstract

Purpose

Increased demand and the pressure to reduce health-care costs have led to longer waiting time for patients to make appointments and during the day of hospital visits. The purpose of this study is to identify opportunities to reduce waiting time using lean techniques and discrete-event simulation (DES).

Design/methodology/approach

A five-step procedure is proposed to facilitate the effective utilization of lean and DES to improve the performance of the Otolaryngology Head and Neck Surgery Outpatient Clinic at Cleveland Clinic Abu Dhabi. While lean techniques were applied to reduce the potential sources of waste by aligning processes, a DES model was developed to validate the proposed solutions and plan patient arrivals under dynamic conditions and different scenarios.

Findings

Aligning processes resulted in an efficient patient flow reducing both waiting times. DES played a complementary role in verifying lean solutions under dynamic conditions, helping to plan the patient arrivals and striking a balance between the waiting times. The proposed solutions offered flexibility to improve the clinic capacity from the current 176 patients up to 479 (without violating the 30 min waiting time policy) or to reduce the patient waiting time during the visit from the current 33 min to 4.5 min (without violating the capacity goal of 333 patients).

Research limitations/implications

Proposing and validating lean solutions require reliable data to be collected from the clinic and such a process could be laborious as data collection require patient and resource tracing without interfering with the regular functions of the clinic.

Practical implications

The work enables health-care managers to conveniently conduct a trade-off analysis and choose a suitable inter-arrival time – for every physician – that would satisfy their objectives between resource utilization (clinic capacity) and average patient waiting time.

Social implications

Successful implementation of lean requires a supportive and cooperative culture from all stakeholders involved.

Originality/value

This study presents an original and detailed application of lean techniques with DES to reduce patient waiting times. The adopted approach in this study could be generalized to other health-care settings with similar objectives.

Details

International Journal of Lean Six Sigma, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2040-4166

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