Effective Physician Leadership Research Articles

Emotional Intelligence: Three Pivotal Points for Effective Physician Leadership

In today’s demanding healthcare environment, physician leaders must learn to make well-formed decisions and avoid being misled by their emotions. Research has shown the significant effect of emotional intelligence (EI) on the job satisfaction, influence, and leadership potential of physicians. Although emotional intelligence is not solely an innate trait, it is a skill that can be cultivated through intentional practice.

Physician Perceptions of Administrative Leadership Development Post-COVID-19

Effective physician leadership has become more critical as our healthcare system grapples with the worsening workforce attrition associated with the COVID-19 pandemic. A study explored physician leaders’ perspectives of their preparation for administrative leadership. Overall, this study revealed that physicians need training beyond traditional undergraduate and postgraduate medical education to prepare for administrative leadership as they and healthcare institutions navigate the post-COVID-19 landscape. It is essential to understand their specific needs so that leadership development opportunities can be developed and tailored to positively impact burnout and support today’s healthcare workforce.

Exploring medical students’ perspectives of physician leadership

BackgroundLeadership has been recognized as an important competency in medicine. Nevertheless, leadership curricula for Canadian medical students lacks standardization and may not be informed by medical students’ perspectives of physician leadership. The purpose of this study was to elicit these perspectives on physician leadership.MethodsThe present study utilized semi-structured interviews to ascertain the views of medical student participants, including students in their first, second and third years of medical school, on physician leadership. Interview questions were based on ‘the 3-C model’ of physician leadership, which includes three aspects of leadership, namely character, competence and commitment. The interviews were audio-recorded, transcribed and then coded using thematic analysis.ResultsThe medical students of this study provided rich examples of resident and staff physicians demonstrating effective and ineffective leadership. The participants identified the importance of character to effective physician leadership, but some participants also described a feeling of disconnect with the relevance of character at their stage of training. When discussing physician competence, medical students described the importance of both medical expertise and transferable skills. Lastly, the leadership aspect of commitment was identified as being relevant, but medical students cautioned against the potential for physician burnout. The medical student participants’ suggestions for improved leadership development included increased experiences with examples of physician leadership, opportunities to engage in leadership and participation in reflection exercises.ConclusionsOverall, the study participants demonstrated an appreciation for three aspects of leadership; character, competence and commitment. Furthermore, they also provided recommendations for the future design of medical leadership curricula.

Perspectives on physician leadership: The role of character-based leadership in medicine.

Physician leadership is multifaceted, but leadership training in medicine often is not. Leadership education and training for physicians are rarely grounded in conceptual leadership frameworks and suffer from a primary focus on cognitive leadership domains. Character-based leadership is a conceptual leadership framework that moves beyond cognitive competencies and articulates dimensions of character that promote effective leadership. The purpose of this study was to explore the relevance of character-based leadership in the medical context. This qualitative descriptive study used semi-structured interviews to explore health care professionals' perceptions of character in relation to effective leadership in medicine. All interviews were audiorecorded and transcribed. Consistent with descriptive qualitative inquiry, a qualitative latent content analysis was used. Simultaneous data collection and analysis incorporating character-based leadership as a theoretical framework was used to help organise the analysis of the data. The researchers met regularly to clarify coding structures and categorise codes until sufficiency was reached. Twenty-six individuals (12 doctors, 5 nurses, 2 social workers, 2 directors and a pharmacist, dietician, coordinator, administrator and unit clerk) participated. Character-based leadership resonated with participants; they deemed character essential for effective physician leadership. Participants reflected on different character dimensions they attributed to an effective physician leader, in particular, collaboration, humility and humanity. They shared examples of working in interdisciplinary health care teams to illustrate these in practice. Moreover, participants believed that effective physician leaders need not be in a positional leadership role and asserted that physicians who demonstrate character stand out as leaders regardless of their career stage. Our findings suggest a role for a character-based leadership framework in medical education. Participants recognised the execution of character in everyday practice, associated character with effective leadership and understood leadership in dispositional rather than positional terms. These findings provide important insights for expanding and enhancing existing leadership training interventions.

Learning to Lead: An Exploration of Leadership Development in Obstetrics and Gynaecology

Physicians’ leadership skills are essential to their ability to achieve high quality patient care and establish well-functioning, cost-effective healthcare systems. Research shows that effective physician leadership can improve clinical outcomes, including decreasing mortality rates and length of hospital stay. Despite its clear value, leadership training in residency and beyond is predominantly informal, and there is limited research regarding how leadership skills develop from training into independent practice.

Community Medical Leadership Workshop: An Introduction to Physician Leadership for Resident Physicians.

ObjectiveThe Community Medical Leadership Workshop (CMLW) aims to prepare residents to become effective physician leaders through medical leadership lectures and case scenario discussions. By the end of the CMLW, participants will be able to define leadership in medicine, employ strategies to manage conflict and differences of opinions in the workplace, demonstrate effective communication skills while working with others, and describe the role of power in effective leadership.MethodsA total of 32 resident physicians participated in our workshop that is based on the leadership practice inventory (LPI) and the Medical Leadership Competency Framework (MLCF). Our evaluation assessed communication strength, conflict resolution, time management, negotiation, delegation, teamwork, and community service.ResultsMost participants were satisfied with the course. They rated the workshop's contents the highest. In addition, over 90% of learners would recommend this workshop to others. We found a statistically significant increase in learners’ ability to provide opportunities to include patients in quality improvements.ConclusionOur workshop was designed and tailored for resident physicians to introduce them to physician leadership. The workshop was well received and could serve as a model to promote qualities in residents that define effective physician leaders.

Service on student-run free clinic executive board improves leadership skills of medical students in the underserved medical system

PurposeAs the need for effective physician leaders caring for underserved populations grows, it is important to initiate interventions for medical professionals early in their education. Board experience on a student-run free clinic serving vulnerable populations within the community has the potential to educate medical students in a hands-on environment. This paper aims to determine if serving as a leader of a student-run free clinic impacts leadership skills and future leadership goals of medical students.Design/methodology/approachMedical students leading a student-run free clinic completed an anonymous electronic survey to determine how this experience affected their teamwork skills, interprofessional leadership skills and future leadership career goals. The survey consisted of 12 items to which students responded with how closely they agreed via a five-point Likert scale with 1 = strongly disagree and 5 = strongly agree. Descriptive statistics are reported.FindingsFrom the 46 students (42.2% response rate) responding to the survey, 95.45% had a previous leadership experience and 89.2% expressed previous interest in a leadership position. Students scored on average 4.36 (out of 5) for improvement in teamwork skills, 4.34 (out of 5) for improvement in interprofessional skills and 3.88 (out of 5) for impact on future leadership career goals.Originality/valueThis study suggests that service on a student-run free clinic improves teamwork and interprofessional leadership skills as well as future leadership plans of medical students in an underserved vulnerable population environment. Other institutions could use student-run free clinics for early development of effective leaders in medical health care for the vulnerable population.

Implementing a Radiology Residency Quality Curriculum to Develop Physician Leaders and Increase Value for Patients.

Diagnostic and interventional radiology residency programs must educate trainees on quality and patient safety topics to meet board requirements and prepare residents to become effective physician leaders. A quality curriculum should encompass process improvement methodology as well as instruction about crucial patient safety subjects. The authors have developed a standardized and structured approach to fulfill this need using didactic and experiential learning. The educational format includes short lectures, peer-to-peer instruction, and self-study, with the value of presented information reinforced by physician leaders and process improvement specialists. Equally important is a structured experience in departmental quality improvement wherein trainees learn the collaborative nature of effective durable process change in areas of interest to them. This curriculum is implemented during the 3rd year of radiology residency to leverage residents' knowledge and experience with radiology workflows and proximity to the American Board of Radiology Core Exam. Feedback from educators and trainees as well as objective examination data support this approach. This article shares guidance and lessons learned from the authors' radiology residency educational efforts and offers a framework for successful implementation of a comprehensive quality curriculum at any residency training program. This curriculum serves the dual purpose of developing skilled future physician leaders and promoting value for patients. ©RSNA, 2020.

Effective physician leaders: an appreciative inquiry into their qualities, capabilities and learning approaches

PurposeThe aim of this study was to explore the qualities and capabilities effective physician leaders attribute to their success in leading change and how they developed these.MethodThe authors interviewed 20...

The Affordable Care Act and Its Effects on Physician Leadership: A Qualitative Systematic Review.

The Affordable Care Act (ACA) shifted the focus in medical care from quantity to quality. This qualitative systematic review aimed to determine the key skills necessary for effective physician leaders after the implementation of the ACA, and to compare them with key skills identified prior to its implementation. A qualitative systematic review was conducted. A systematic literature search on leadership skills for physicians returned 26 articles published between 2009 and 2016. Thematic analysis was used to categorize the data presented in each article. The results from the thematic analysis were then compared with a similar article published before the implementation of the ACA. Teamwork and team-building, communication, and self-awareness skills were mentioned most often. The percentage of articles mentioning teamwork and team-building skills (61.5%) was significantly greater than the percentage (25%) reported before the implementation of the ACA (P ≤ .04). With the shift toward quality of patient care, health care workers at all levels should strive to work as a team to provide the best quality of care at all stages of patient care.

First and foremost, physicians: the clinical versus leadership identities of physician leaders.

Purpose - 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. Design/methodology/approach - 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. Findings - 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. Research limitations/implications - 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. Practical implications - 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. Social implications - This work points to a broader and more fundamental need - a modified mindset about the nature and value of physician leadership. Originality/value - 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.

Physician leadership development at Cleveland Clinic: a brief review

We aim to describe the rationale for and spectrum of leadership development programs, highlighting experience at a large healthcare institution (Cleveland Clinic, Cleveland, Ohio, USA). Developing leaders is a universal priority to sustain organizational success. In health care, significant challenges of ensuring quality and access and making care affordable are widely shared internationally and demand effective physician leadership. Yet, leadership competencies differ from clinical and scientific competencies and features of selecting and training physicians-who have been called "heroic lone healers" -often conspire against physicians being effective leaders or followers. Thus, developing leadership competencies in physicians is critical.Leadership development programs have been signature features of successful organizations and various Australian organizations offer such training (e.g. The Australian Leadership Foundation and the University of South Australia), but relatively few health care organizations have adopted the practice of offering such training, both in Australia and elsewhere. As a United States example of one such integrated program, the Cleveland Clinic, a large, closed-staff physician-led group practice in Cleveland, Ohio has offered physician leadership training for over 15 years. This paper describes the rationale, structure, and some of the observed impacts associated with this program.

Fellowship Directors’ Program: Higher Ground—Helping Our HPM Fellowships Continue to Grow and Thrive in an Era of Rapid Change (P04)

performance and behavior at work. Effective physician leadership is instrumental to improved patient satisfaction, reduced length of stay, and better integration of clinical care across service lines. To be effective, physician leaders must master multiple clinical and leadership competencies, including interpersonal skills. When leaders learn to use interpersonal skills, they are able to apply them in a wide variety of specific activities, including leading teams, coaching, and managing conflict. This preconference program is offered in partnership with the American Association for Physician Leadership. This session applies to all physician leaders and practice settings looking to increase their effectiveness as a team leader. Primary leadership competencies addressed in this program include interpersonal skills, communication skills, and the ability to convey a clear, compelling vision.

Physicians Lead the Way in Transforming Healthcare

AN ERA OF AWAKENING began in 1999 with the publication of the Institute of Medicine's report To Err Is Human. The report turned the nation's attention to the urgent need to reduce harm in healthcare institutions. Although the report was met initially with disbelief and distrust of the data-which signaled an alarming level of harm-16 years later, healthcare generally believe that preventable harm continues to occur at unacceptable levels. For this reason, some have committed to achieving zero harm by improving their organization's safety culture, as well as by using improvement science and change management to generate sustainable gains.Across the thousands of US hospitals accredited by The Joint Commission, one observation is consistent: Effective physician leadership is a vital characteristic of high-performing healthcare organizations. Exhibit 1 shows physician engagement along the quality and safety continuum. In high-performing healthcare organizations, physicians lead, collaborate on interdisciplinary teams, and take ownership of improvement activities and outcomes. Conversely, organizations that struggle in their improvement efforts typically lack engaged physicians and effective physician leaders. In these organizations, the physicians-and at times even the physician leaders-are unable to articulate their organization's quality-improvement activities and goals (Nelson et al. 2014; Taitz, Lee, and Sequist 2012).EFFECTIVE LEADERSHIP IMPROVES QUALITY AND SAFETYEffective physician leadership is essential for transforming an organization from one that accepts harm as inevitable and makes only modest improvements each year to one that aims for zero harm and is on a path to becoming a high-reliability organization (HRO). HROs rarely, if ever, have significant accidents. These organizations manage safety hazards well, despite facing dynamic tasks, time constraints, and complex environments. In the pursuit of excellence, they constantly look for lessons in errors and close calls to reduce the risk of harm. A key to becoming an HRO is to learn from the organization's mistakes (Reason 1997; Weick and Sutcliffe 2007).The Joint Commission sets high standards for leaders. For example, according to standard LD.03.01.01 of the Comprehensive Accreditation Manual for Hospitals, leaders create and maintain a culture of safety and quality throughout the hospital (Joint Commission 2015). Standard LD 03.05.01 directs to implement changes in existing processes to improve the performance of the (Joint Commission 2015). The Joint Commission also encourages hospitals and health systems to become learning organizations, which requires a special type of leadership-one that encourages all staff to discuss safety issues openly and provides opportunities for all to participate in safety and quality initiatives. These are just a few of The Joint Commission's expectations of who intend to transform their organization into one that is highly reliable.Although improving quality and patient safety is of critical importance, it is only one of many areas in which effective physician leadership is vital. The increasing integration and growth of health systems, population health management, new payment systems, and competitive market trends are other forces that contribute to the unprecedented demand for physician leadership and physician engagement. Unfortunately, the need far exceeds the nation's supply of physician who have the critical skills required to face today's challenges.Palomar Health in Escondido, California, and ProMedica in Toledo, Ohio, are two excellent examples of healthcare organizations that are responding to this gap. These organizations represent a national movement in which healthcare organizations are taking on the responsibility of developing physician leadership programs or virtual leadership academies. Each recognized the need to improve and transform, developed a customized approach to its curriculum, and aligned physicians with the organization's goals. …

Distinguishing competencies of effective physician leaders

Purpose– 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.Design/methodology/approach– 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.Findings– 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.Research limitations/implications– 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.Originality/value– 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 affect of vision and compassion upon role factors in physician leadership.

The career path for many professionals is often into a leadership role, yet many professionals do not have the competencies or inclination to lead. This study explores physician leaders as a representative group of professionals. While there have been many efforts at understanding the characteristics of effective physician leaders, a greater understanding is needed on the nature of physician leadership. The largest healthcare organization for physician leaders in the United States was surveyed to gain a greater understanding of the nature of leadership. Partial Lease Squares (PLS) was used to analyze results from 677 online surveys to understand the causal relationship of role conflict and role endorsement to participation. The findings reveal the mediating influence that positivity exerts upon participation, and offers health care leaders an opportunity to increase understanding of the social identification process that leads a higher level of professional participation, which may increase effectiveness for physicians in leadership.

A Model for Physician Leadership Development and Succession Planning.

Although the presence of physicians in formal leadership positions has often been limited to roles of department chiefs, MAC chairs, etc., a growing number of organizations are recruiting physicians to other leadership positions (e.g., VP, CEO) where their involvement is being genuinely sought and valued. While physicians have traditionally risen to leadership positions based on clinical excellence or on a rotational basis, truly effective physician leadership that includes competencies such as strategic planning, budgeting, mentoring, network development, etc., is essential to support organizational goals, improve performance and overall efficiency as well as ensuring the quality of care. In this context, the authors have developed a physician leader development and succession planning matrix and supporting toolkit to assist hospitals in identifying and nurturing the next generation of physician leaders.

Unique benefits of physician leadership – an American perspective

Purpose – 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. Design/methodology/approach – 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. Findings – 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. Research limitations/implications – Limited research has been conducted on the value of physician leadership and its impact on quality outcomes and patient safety. Practical implications – This paper establishes the need for physician leadership in healthcare organizations. Social implications – This paper will influence public attitudes within the healthcare sphere on the value that physician leaders can bring to healthcare. Originality/value – 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.

Distinguishing Behaviors and Competencies of Effective Physician Leaders

Changing organizational and environmental dynamics present unique challenges to leaders in the field of health care. An accelerated emphasis on increasing the quality of health care delivery, conta...

Key Elements of Clinical Physician Leadership at an Academic Medical Center

A considerable body of literature in the management sciences has defined leadership and how leadership skills can be attained. There is considerably less literature about leadership within medical settings. Physicians-in-training are frequently placed in leadership positions ranging from running a clinical team or overseeing a resuscitation effort. However, physicians-in-training rarely receive such training. The objective of this study was to discover characteristics associated with effective physician leadership at an academic medical center for future development of such training. We conducted focus groups with medical professionals (attending physicians, residents, and nurses) at an academic medical center. The focus group discussion script was designed to elicit participants' perceptions of qualities necessary for physician leadership. The lead question asked participants to imagine a scenario in which they either acted as or observed a physician leader. Two independent reviewers reviewed transcripts to identify key domains of physician leadership. Although the context was not specified, the focus group participants discussed leadership in the context of a clinical team. They identified 4 important themes: management of the team, establishing a vision, communication, and personal attributes. Physician leadership exists in clinical settings. This study highlights the elements essential to that leadership. Understanding the physician attributes and behaviors that result in effective leadership and teamwork can lay the groundwork for more formal leadership education for physicians-in-training.