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Introduction
Physicians have long assumed leadership roles in hospitals, often as full-time administrators or as full-time clinicians with part-time leadership duties (Reinertsen, 1998; Schwartz and Pogge, 2000). While some have argued that industry challenges demand more physician leadership (Stoller et al., 2006), others have observed that physicians, are often promoted into administrative roles on the basis of clinical expertise but lacking qualities necessary for effective organizational leadership (Lobas, 2006; Stoller, 2008; Taylor et al., 2008; Weston et al., 2008), and many “have not been great leaders” (Porter, 2007, p. 1). It is more apparent than ever and now even a topic of public discourse that doctors need to be competent managers and leaders at all stages of their careers (Clark et al., 2008).
With an ongoing need for effective physician leaders, as well as an increasing focus on physician leadership development within health care organizations, a greater understanding of the unique nature of physician leadership is needed before physicians can be selected and trained for leadership roles. While several studies in recent years have sought to identify factors that promote effective physician leadership (Lane and Ross, 1998; Lobas, 2006; Chaudry et al., 2008; Stoller, 2008; Taylor et al., 2008), there has been limited focus on understanding how physician leaders themselves construe their roles. This paper offers a model that suggest that the physician leaders are unique in their leadership to their colleagues and patients in terms of quality of care and patient outcomes, yet there is a disconnect in how they view organizational leadership roles.
The objective of this study was to understand the nature of physician leadership. To address this gap, a qualitative study was undertaken. Semi-structured interviews with 25 physicians in four hospitals within a single health care organization in the southeastern USA were conducted to understand how physicians in leadership roles understand and enact them. Participants included full-time physician executives and part-time physician leaders. Our findings suggest that identity, at individual, relational and organizational levels is an important factor in how physicians understand and enact leadership roles, and specifically that acceptance of a dual identity may be advantageous for success as a physician leader. Our results may be useful to decision makers in hospitals and other...