From leader to leadership: clinician managers and where to next?

Abstract

Individual clinician leadership is at the forefront of health reforms in Australia as well as overseas with many programs run by health departments (and hospitals) generally focus on the development of individual leaders. This paper argues, along with others, that leadership in the clinician management context cannot be understood from an individualistic approach alone. Clinician managers, especially in the ranks of doctors, are usually described as 'hybrid-professional managers' as well as reluctant leaders for whom most leadership theories do not easily apply. Their experiences of leadership development programs run by health departments both in Australia and internationally are likely to be based on an individual leader-focussed approach that is driving health care reforms. These approaches work from three key assumptions: (1) study and fix the person; (2) give them a position or title; and (3) make them responsible for results. Some would argue that the combination of these three approaches equates to heroic and transformational leadership. Several alternative approaches to leadership development are presented to illustrate how reforms in healthcare, and notably in hospitals, must incorporate alternative approaches, such as those based on collective and relational forms of leadership. This does not mean eschewing individual approaches to leadership but rather, thinking of them differently and making them more relevant to the daily experiences of clinician managers. We conclude by highlighting several significant challenges facing leadership development for clinician managers that arise from these considerations.

From the clinical to the managerial domain: the lived experience of role transition from radiographer to radiology manager in South‐East Queensland

“…Using the domain theory, Forbes and Prime proposed a new domain of ‘clinical manager' that ‘straddles the two worlds of the service domain and the managerial domain’ . In the Australian healthcare system, a hybrid clinician manager has also been described: a person who is managing professional colleagues and other staff part time while remaining in clinical practice . This requires professionals to wear and balance two hats, regarding both roles as equal, even though the individual may not be nearly as qualified to wear the managerial ‘hat’…”

Clinicians’ experiences of becoming a clinical manager: a qualitative study

“…In Irish hospitals, the integration of clinicians into managerial roles has been recognized “as a key determinant of operational effectiveness” [12]. The focus on clinicians in management is not limited to Europe, but is seen internationally, including in countries such as Australia [5] and New Zealand [13]. …”

Service delivery in Kenyan district hospitals – what can we learn from literature on mid-level managers?

“…For the purposes of this review, we adopt a broad definition of an MLM in a hospital as a manager who is directly involved in planning and coordinating the production of services that are specific to their own units, bridging the gap between senior-level management and front-line workers. Definitions within the reviewed studies lean more towards those managers who hold primary administrative responsibilities of heading department or units, as well as being in charge of clinical services, closer to clinical hybrid managers [40,41]. In many cases, however, the managers under study had no personal role in service provision.…”