Medical leadership and engagement: no longer an optional extra

Abstract

The purpose of this paper is to analyse the factors that are leading many international health systems to seek new ways of getting doctors to be more engaged in management, leadership and service improvement. The paper draws on the growing research and literature that is demonstrating a strong association between extent of medical engagement and clinical and organisational performance. The current NHS reforms in England place general practitioners very much at the centre of the commissioning process and increasingly consultant medical staff are leading the drive to improve access, quality, safety and new ways of delivering care within hospitals and across health systems. In parallel with political and organisational change, the medical profession has been redefining the characteristics of a good doctor. This includes not only the reinforcement of the need for doctors to be clinical experts but also good managers and leaders. As the custodians of the processes and micro-systems of health care, doctors are ideally placed to lead improvements. The paper argues that there is perhaps congruence between politicians and policy makers for greater medical leadership and engagement with doctors becoming "shareholders" in the running of services, organisations and systems. The paper concludes that perhaps the era of strong general management may be replaced by one where non-clinical managers and clinicians work in partnership to optimise the different expertise, experience and values to achieve high quality, productive and patient-focused care.