Search results

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.

The purpose of this paper is to describe research that examined physician leadership development using complexity science principles.

Intensive interviewing of 21 participants and document review provided data regarding physician leadership development in health-care organizations using five principles of complexity science (connectivity, interdependence, feedback, exploration-of-the-space-of-possibilities and co-evolution), which were grouped in three areas of inquiry (relationships between agents, patterns of behaviour and enabling functions).

Physician leaders are viewed as critical in the transformation of healthcare and in improving patient outcomes, and yet significant challenges exist that limit their development. Leadership in health care continues to be associated with traditional, linear models, which are incongruent with the behaviour of a complex system, such as health care. Physician leadership development remains a low priority for most health-care organizations, although physicians admit to being limited in their capacity to lead. This research was based on five principles of complexity science and used grounded theory methodology to understand how the behaviours of a complex system can provide data regarding leadership development for physicians. The study demonstrated that there is a strong association between physician leadership and patient outcomes and that organizations play a primary role in supporting the development of physician leaders. Findings indicate that a physician’s relationship with their patient and their capacity for innovation can be extended as catalytic behaviours in a complex system. The findings also identified limiting factors that impact physicians who choose to lead, such as reimbursement models that do not place value on leadership and medical education that provides minimal opportunity for leadership skill development.

This research provides practical applications for physician leadership development and emphasizes that it is incumbent upon physicians and organizations to focus attention on this to achieve improved patient and organizational outcomes.

This study pairing complexity science and physician leadership represents a unique way to view the development of physician leaders within the context of the complex system that is health care.

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.

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.

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.

This paper aims to examine the relationship between physician leadership style and advanced practice health-care provider job satisfaction.

A total of 320 advanced practice providers (nurse practitioners and physician assistants) in Texas rated their supervising/collaborating physicians’ leadership style using the Multifactor Leadership Questionnaire 5X Short (Bass and Avolio, 2000) and assessed their own job satisfaction using the Abridged Job Descriptive Index (Smith, Kendall and Hulin, 1969). Regression models tested the relationships between physician leadership styles and several facets of job satisfaction of advanced practice providers while controlling for advanced practice provider age, gender, ethnicity, years of experience, salary level, clinical practice setting, level of physician supervision/collaboration and advanced practice provider type.

The results demonstrated that physician transformational leadership accounted for between 4.4 and 49.1 per cent of the variance in job satisfaction depending on the aspect of job satisfaction. Satisfaction with job supervision and satisfaction with job in general were those in which transformational leadership was found to have the most impact, explaining 49.1 and 15.5%, respectively. Demographic variables such as advanced practice provider type, age, years of experience and number of hours per week of physician collaboration/supervision had small but statistically significant associations with job satisfaction.

Recommendations for physician leadership development focusing on transformational leadership as a way to increase the satisfaction among other providers on health-care teams are discussed.

This paper examines the impact of supervising/delegating physician leadership style on other nonphysician members of the health-care team, specifically advanced practice health-care providers.

The purpose of this paper is to seek clarity on the factors that increase acceptance of a leadership identity and influence a physician leader to participate in the leader role at a higher level.

To explore the direct and mediating effects of positive psychological climate (PPC) and role endorsement (RE) on physician professional participation (PP) in leadership, a survey was disseminated to members of the American Association of Physician Leadership.

Findings show that positive relationships support the individual in acceptance of a second identity as a leader, therefore, to a higher level of PP. The double mediation with PPC and RE found in this model warrants additional meaning toward the cultivation of positive relationships.

A broader understanding of physician leadership may benefit from a more comprehensive collection procedure other than self-reported data, including one in which data is collected in a 360-degree feedback format.

Role endorsement serves as a mediating mechanism to PP (citizenship behaviors) for both PPC and social intelligence competencies. These data indicate that the presence of role endorsement for physicians changes their degree of participation and impacts their own role identity. This immediately helps to direct development efforts for physicians during their transition from physician to physician leader.

This study confirms the mediating relationship of REupon the PP of physician leaders, with both implications for practice and a broader understanding of the nature of physician leadership.

Emerging evidence correlates increased physician leadership effectiveness with improved patient and healthcare system outcomes. To maximize this benefit, it is critical to understand current physician leadership needs. The purpose of this study is to understand, through physicians’ self-reporting, their own and others’ most effective and weakest leadership skills in relation to the LEADS leadership capabilities framework.

The authors surveyed 209 Canadian physician leaders about their perceptions of their own and other physicians’ leadership abilities. Thematic analysis was used, and the results were coded deductively into the five LEADS categories, and new categories emerging from inductive coding were added.

The authors found that leaders need more skills in the areas of Engage Others and Lead Self, and an emergent category of Business Skills, which includes financial competency, budgeting, facilitation, etc. Further, Achieve Results, Develop Coalitions and Systems Transformation are skills least reported as needed in both self and others.

The authors conclude that LEADS, in its current form, has a gap in the competencies prescribed, namely, “Business Skills”. They recommend the development of a more comprehensive LEADS framework that includes such skills as financial literacy/competency, budgeting, facilitation, etc. The authors also found that certain dimensions of LEADS are being overlooked by physicians in terms of importance (Systems Transformation, Achieve Results, Develop Coalitions), and this warrants greater investigation into the reasons why these skills are not as important as the others (Engage Others and Lead Self).

This paper examines the effect of job satisfaction on job performance among physicians in Iraq's public hospitals. It also determines the mediating role of job satisfaction on the relationship between emotional intelligence and job performance. It further unveils the mediating role of job satisfaction on the nexus between transformational leadership and job performance. As physicians form the bulk of health-care professionals, their performance at work is crucial in determining patient satisfaction regarding care quality.

A quantitative approach with structural equation modelling via partial least squares (PLS-SEM) and bootstrapping estimation was used to test the hypotheses developed. A total of 157 responses were utilized in the data analysis.

Evidence from the study indicates that job satisfaction has a positive relationship with job performance. The study also provides evidence that job satisfaction plays a positive mediating role in the relationship between emotional intelligence and job performance. Similarly, job satisfaction has a positive mediating effect on the nexus between transformational leadership and job performance among physicians in Iraq's public hospitals.

To the best of the authors' knowledge, this is the first study to investigate the relationship between physician job satisfaction and job performance in Iraqi public hospitals. Studies using Eastern samples are scarce, so the findings of this study will add to the body of knowledge from a cross-cultural standpoint.

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.