LEADERSHIP DEVELOPMENT


Name Author Abstract Publication/Date Link
Training the Next Generation of Physician– Executives: An Innovative Residency Pathway in Management and Leadership D. Clay Ackerly, MD, MSc The rapidly changing field of medicine demands that future physician–leaders excel not only in clinical medicine but also in the management of complex health care enterprises. However, many physicians have become leaders “by accident,” and the active cultivation of future leaders is required. Addressing this need will require multiple approaches, targeting trainees at various stages of their careers, such as degree-granting programs, residency and fellowship training, and career and leadership development programs Acad Med 2011 May

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http://tinyurl.com/q3nd8zm
Crafting Strategy Henry Mintzberg The crafting image better captures the process by which effective strategies come to be. The planning image, long popular in the literature, distrots these processes and thereby misguides organizations that embrace it unreservedly. Harvard Business Review, July-August 1987

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http://tinyurl.com/ns74l8m
Developing Physician Leaders Today Using the 70/20/10 Rule Tracy Duberman, PhD Health care delivery today requires a fundamentally different approach--and a new breed of physician leaders who can rally around new requirements resulting from changes in health care financing, physician reporting requirements, standards for accountable care organizations, clinical process improvements and team-based care.Today, physician leaders are being measured by the results they achieve, the value or efficiency with which they achieve good outcomes, and improvements in performance resulting from a focus on teamwork through superior coordination, information sharing, and teaming across disciplines.Chief medical officers, department chairs, vice presidents of medical affairs, and other physician leaders must rally around these new requirements and bring teams of clinical and administrative leaders together. PEJ Sept-Oct, 2011

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http://www.tldgroupinc.com/uploads/DevelopingPhysicianLeaders70.20.10.pdf
Educating Physicians to Lead Hospitals Richard Gunderman, MD, PhD, The percentage of hospitals that arephysician led has been steadily decliningand now stands at or near an all-time low. What price do the health care system and the people it serves pay for this decline in physician leadership? What might health care look like if medical educators devoted more time and attention to developing future physicians as organizational leaders? What changes would medical schools need to make to prepare medical students to play such a role? What advantages might accrue for patients, communities, and physicians themselves if more hospitals were physician led? Because hospitals are a vital resource in caring for the sick, promoting health, and addressing the challenges facing the U.S. health care system, it is now more important than ever before to explore how medical education can complement its traditional focus on the molecular, cellular, and organismal levels of health and disease with insight into the organizational dimensions of patient care. The authors believe the time is ripe to rethink medical education’s role in preparing tomorrow’s physicians as leaders. Acad Med. 2009 Oct

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http://tinyurl.com/pjd3gu7
Failure of Senior Leadership- Is this a problem in Your Hospital? Eugene E. Fibuch, M,D CHCQM Many articles and books have been written about successful leadership, but perhaps organizations should also be taking a look at the reasons behind failed leadership Physician Exec. 2011 Mar-Apr

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http://tinyurl.com/oy959na
Physician-leaders and hospital performance: Is there an association? Amanda H. Goodall Although it has long been conjectured that having physicians in leadership positions is valuable for hospital performance, there is no published empirical work on the hypothesis. This cross-sectional study reports the first evidence. Data were collected on the top-100 U.S. hospitals in 2009, as identified by a widely-used media-generated ranking of quality, in three specialties: Cancer, Digestive Disorders, and Heart and Heart Surgery. The personal histories of the 300 chief executive officers of these hospitals were then traced by hand. The CEOs are classified into physicians and non-physician managers. The paper finds a strong positive association between the ranked quality of a hospital and whether the CEO is a physician or not (p < 0.001). This kind of cross-sectional evidence does not establish that physicianleaders outperform professional managers, but it is consistent with such claims and suggests that this area is now an important one for systematic future research IZA DP July 2011

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http://ftp.iza.org/dp5830.pdf
Doctors who become chief executives in the NHS: from keen amateurs to skilled professionals Chris Ham Doctors who become chief executives are self-styled 'keen amateurs' and there is a need to provide more structures support to enable them to become skilled professionals. The new faculty of medical leadership and managament could have an important role in this process. J R Soc Med. 2011 Mar

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http://jrs.sagepub.com/content/104/3/113.full.pdf+html
Case Study of Physician Leaders in Quality and Patient Safety, and the Development of a Physician Leadership Network Chris Hayes There is increasing recognition of the need for physician leadership in quality and patient safety, and emerging evidence that physician leadership contributes to improved care. Hospitals are beginning to establish physician leader positions; however, there is little guidance on how to define these roles and the strategies physician leaders can use toward improving care. This case study examines the roles of four physician leaders, describes their contribution to the design and implementation of hospital quality and patient safety agendas and discusses the creation of a physician network to support these activities. The positions were established between July 2006 and April 2009. All are corporate roles with varying reporting and accountability structures. The physician leads are involved in strategic planning, identifying and leading quality and safety initiatives, physician engagement and culture change. All have significantly contributed to the implementation of hospital improvement activities and are seen as influential among their peers as resources and mentors for local project success. Despite their accomplishments, these physician leads have been challenged by ambiguous role descriptions and difficulty identifying effective improvement strategies. As such, an expanding physician network was created with the goal of sharing approaches and tools and creating new strategies. Physician leaders are an important factor in the improvement of safety and quality within hospitals. This case study provides a template for the creation of such positions and highlights the importance of networking as an effective strategy for improving local care and advancing professional development of physician leaders in quality and patient safety. Healthcare Quarterly, 13 (Sp) October 2010

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http://tinyurl.com/qzprnm4
What Physician Leaders Say and Do Matters- The Spirit of Mudita James S. Hernandez, MD, MS Physician leaders may not realize that what they say and what they do is being watched all the time. In such a tightly coupled and social system like health care, our actions have a profound effect on what gets rewarded, whether we intend to have that effect or not. Our non-verbal actions may have an even greater effect. Communication experts have found that what makes people respond well to us is due to our body language, 55 percent; our voice, 38 percent; and our words, only 7 percent. In other words, people may listen to our words, but they are watching for the non-verbal clues that they perceive as our real intention PEJ Nov-Dec, 2011

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http://www3.acpe.org:8082/docs/default-source/pej-archives-2011/what-physician-leaders-say-and-do-matters.pdf?sfvrsn=4
Physician Executives Share Insights on Ways to Influence People Ronald P. Hudak, JD, PhD, FACHE AMERICAN HEALTH CARE continues to grapple with revolutionary changes transforming the organization, delivery and financing of health services. Massive industry restructuring is changing the nature and roles of health professionals, dislocating the structure of health care organizations and altering the demands placed on their leaders. In this environment of increasing patient, provider, payer and public disenchantment, it is increasingly clear that physicians and physician executives must find effective ways to reassert authority and influence in their organizations. Physician Executive, July 2002

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http://www.thefreelibrary.com/Physician+executives+share+insights+on+ways+to+influence+people....-a090317131
Turning Doctors into Leaders Thomas H. Lee The problem with health care is people like me—doctors (mostly men) in our fifties and beyond, who learned medicine when it was more art and less finance. We were taught to go to the hospital before dawn, stay until our patients were stable, focus on the needs of each patient before us, and not worry about costs. We were taught to review every test result with our own eyes—to depend on no one. The only way to ensure quality was to adopt high personal standards for ourselves and then meet them. Now, at many health care institutions and practices, we are in charge. And that’s a problem, because health care today needs a fundamentally different approach—and a new breed of leaders. Harvard Business Review, From the April 2010 Issue

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https://hbr.org/2010/04/turning-doctors-into-leaders
Developing Effective Physician Leaders: Changing Cultures and Transforming Organizations Ann Scheck McAlearney In this article, the authors discuss the problematic issue of transformational change in the face of cultural conflict between the worlds of clinical care and organizational leadership, and describe a case study of organizational cultural change facilitated through a physician leadership development program. A locally developed physician leadership program can be extremely effective at both improving physicians' leadership skills and increasing understanding of the strategic goals and direction of the organization. The transformational change required for physicians to develop and appreciate business and leadership skills can be supported and encouraged in a leadership development program that includes the components of careful curriculum design, program monitoring, and opportunities to apply new skills in practice. For Columbus Children's Hospital, Columbus, Ohio, this organizational transformational change effort was successfully achieved when a new medical leadership development program helped academic and community physicians to become involved in organizational leadership. The authors describe the background and development of this program and provide results of their evaluation of the program, with discussion of future extensions to the program. Hospital Topics, March 2005

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http://www.helse-midt.no/Upload/Topplederprogrammet/Litteratur/4.4%20Developing%20Effective%20Physician%20Leaders.pdf
Developing High-Performance Leaders Mara Melum Although there is widespread recognition that strong leadership is key in these challenging times, many companies provide only the tip of the iceberg of leadership development support. This article is a resource for high-powered leadership development systems that will have an impact on performance. Four topics are discussed: (1) models, (2) investment and results, (3) critical success factors, and (4) case studies of how the 3M Company and HealthPartners develop high-performance leaders. Studies that quantify the effect of leadership development on performance are noted. Five critical success factors are described, and examples from leadership development benchmark organizations such as General Electric and Reell Precision Manufacturing are discussed 2002 Lippincott Williams & Wilkins Inc.

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http://www.library.armstrong.edu/eres/docs/eres/MHSA7650-1_CROSBY/7650_week5_leadership_development.pdf
Physician Leaders and Their Bases of Power: Common and Disparate Elements Stewart Gabel, MD Physicians hold numerous types of leadership positions in academic, executive, and/or clinical environments. To be successful, physician leaders must exert power, or social influence, as power is conceptualized in social psychology. The power of leaders accrues through their positions, expertise, or other factors, such as communication abilities or their ability to influence others to identify with the vision they espouse. This article discusses the types of leadership roles that physicians play and the power types they must apply in these roles. Crossing all leadership roles are a series of necessary personal characteristics and interpersonal competencies that result in what has been called "referent power," a more subtle form of social influence that is crucial for success regardless of position. Leadership training that includes practice in cultivating these personal characteristics and interpersonal competencies should be an essential component of medical and graduate medical education. Studying the types and nature of power also would be a valuable contribution to courses on professionalism in medical practice. Examples are provided of the types and uses of power that may be applied in the various leadership roles that physicians hold. Acad Med. 2012 Feb

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http://tinyurl.com/ouep6qk
The professional responsibility model of physician leadership Frank A. Chervenak, MD The challenges physician leaders confront today call to mind Odysseus' challenge to steer his fragile ship successfully between Scylla and Charybdis. The modern Scylla takes the form of ever-increasing pressures to provide more resources for professional liability, compliance, patient satisfaction, central administration, and a host of other demands. The modern Charybdis takes the form of ever-increasing pressures to procure resources when fewer are available and competition is continuously increasing the need for resources, including managed care, hospital administration, payers, employers, patients who are uninsured or underinsured, research funding, and philanthropy. This publication provides physician leaders with guidance for identifying and managing common leadership challenges on the basis of the professional responsibility model of physician leadership. This model is based on Plato's concept of leadership as a life of service and the professional medical ethics of Drs John Gregory and Thomas Percival. Four professional virtues should guide physician leaders: self-effacement, self-sacrifice, compassion, and integrity. These professional virtues direct physician leaders to treat colleagues as ends in themselves, to provide justice-based resource management, to use power constrained by medical professionalism, and to prevent and respond effectively to organizational dysfunction. The professional responsibility model guides physician leaders by proving an explicit "tool kit" to complement managerial skills. Department of Obstetrics andGynecology, Weill Medical College of CornellUniversity, New York, NY 2012

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http://www.ajustnhs.com/wp-content/uploads/2012/06/physician-leadership-chervanak-2012.pdf
Tell it like it is Duncan G. Sinclair … failing to tell it like it is, is a bad habi. It misleads the media and public, reinforces complacency and thus throws up yet another unwelcome obstable in the path of creating a real system to provide us with the full range of health and sickness services Canadian need to optimize their health Healthcare Quarterly, Vol. 14 2011

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https://www.longwoods.com/product/download/code/22148
Squeezing out the doctorThe role of physicians at the centre of health care is underpressure Bangalore and Framingham- The Economist ...demand for health care looks unlikely to be met by doctors in the way the past century's was. For one thing, to treat the 21st century's problems with a 20th-century approach to health care would require an impossible number of doctors. For another, caring for chronic conditions is not what doctors are best at. For both these reasons doctors look set to become much less central to health care—a process which, in some places, has already started. The Economist, July 2012

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http://www.economist.com/node/21556227
The new clinical leader Kim Oates, Sydney Medical School, University of Sydney and Clinical Excellence Commission, Sydney, Australia The complexity and cost of health care, along with a greater need for accountability calls for a new style of clinical leadership. The new clinical leader will lead reform by putting the needs of the patient first and foremost, looking at current and planned services from the patient's point of view as well as the clinician's. Excellent clinical skills will remain essential but will be supplemented by a focus on team work and mentoring, patient safety, clear communication and reduction in waste and inefficiency, leading to better financial outcomes. The new clinical leaders will understand the importance of consulting widely and engaging colleagues in creating change to improve patient care. They will develop trusting and mutually respectful relationships with health service management and be able to negotiate the delicate balance between clinical judgement, resource constraints and personal loyalties by keeping the best outcome for the patient at the forefront of their thinking. Journal of Paediatrics and Healthcare, 2012

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https://www.deepdyve.com/lp/wiley/the-new-clinical-leader-JBXbG63mr2
Managing Your Impact on Others Bill Tiffan Principal at T2 Management Consultants, Sarasota, Fl The article discusses how one can manage the impact of his/her attitude or behavior on others. The author state that he finds that managers often ignore the importance of impact and assume what they must do is get along with others. He suggests that one should increase self-awareness by using a 360-degree feedback process to have a good working environment. He stresses the need of leaders to learn the skills of paraphrasing, summarizing, and probing to keep conversations on track. PEJ Nov-Dec, 2011

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http://www3.acpe.org:8082/docs/default-source/pej-archives-2011/managing-your-impact-on-others.pdf?sfvrsn=5
Building physician capacity for transformational leadership Mark A. Vimr, RN, MScN, CHE In 2001, St. Joseph's Health Centre reported on its efforts to design and deliver a physician leadership program. The program was launched in Fall 2010 and has just completed its second cohort with a total of 29 physicians participating. The results and associated learning have been very encouraging. Healthcare Management Forum April 2011

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http://www.irisgroup.ca/usercontent/articles/Building-physician-capacity-for-transformational-leadership.pdf