Leadership in Academic Medicine: Capabilities and Conditions for Organizational Success

Developing Physician-Leaders: A Call to Action

“…Because of the strong reflex for deficit-based thinking, physician-leaders must learn to switch nimbly between different reasoning and thinking processes-one that is "deficit-based," narrowly focused, and well-adapted for clinical practice and another that is more divergent or "appreciative" for thinking about organizational or system issues and challenges. 11,16 Furthermore, interviews of ten academic internal medicine chairs identified several critical leadership success factors, 17 including mastery of visioning, communication, change management, "emotional intelligence" (EI), [18][19] team building, business skills, personnel management, and systems thinking. Emphasizing the importance of EI, which consists of competencies regarding self-awareness, self-management, social awareness, and relationship management, [18][19] these chairs "stated that this ability was fundamental to their success and its absence the cause of their failures."…”

“…Emphasizing the importance of EI, which consists of competencies regarding self-awareness, self-management, social awareness, and relationship management, [18][19] these chairs "stated that this ability was fundamental to their success and its absence the cause of their failures." 17 To the extent that the current selection of academic leaders may place greater priority on traditional academic and clinical success than on leadership readiness or skill, a gap and opportunity are identified. As one chair stated, "The fact is that the majority of chairs are chosen for skill sets that have little to do with the skill sets they are going to need to use."…”

“…In this gap between current practice and actual need lies the rationale and energy to develop physician-leaders. Though the evidence that great physician-leadership confers clinical and organizational benefit is sparse and demands greater study, 17 early findings support the value of excellent leadership. For example, Xirasagar et al 20 have reported that physician-leaders' "transformational leadership"-which reflects four elements (idealized influence, inspirational motivation, intellectual stimulation of those led, and individualized communication)-was significantly associated with perceived leadership effectiveness (R 2 = 0.687, p < 0.0001) and, in a sample of community health centers, with the achievement of clinical goals (e.g., hemoglobin A1C levels in diabetics, functional status scores in geriatric patients, etc.).…”

“…Also, at what point in one's training are the competencies best developed (e.g., in medical school, during training, 28 or after further clinical maturation)? As pointed out by Lobas,17 developing answers to these questions should prompt enthusiasm and funding for research regarding organizational development in health care, a novel but important area for study. In the end, those institutions that develop the answers and implement the solutions to these questions will design the future of health care.…”

The Influence of Mentorship and Role Modeling on Developing Physician–Leaders: Views of Aspiring and Established Physician–Leaders

“…As more physicians become leaders in healthcare institutions, the question of how best to prepare them for their future roles commands interest. A survey of academic chairs of internal medicine indicated that promotion to leadership positions has more to do with research skills or clinical expertise than to any background or training in important leadership competencies 1 . At the same time, the need for training of physician-leaders has led some healthcare institutions to offer leadership training.…”