Strategic decision‐making in the healthcare industry: the effects of physician executives on decision outcomes

Parayitam, Satyanarayana; Phelps, Lonnie D.; Olson, Bradley J.

doi:10.1108/01409170710736329

Cited by 12 publications

(7 citation statements)

References 48 publications

(42 reference statements)

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“…Two studies reported on doctors’ involvement in strategic decision-making. 37 38 Parayitam et al 37 examined the self-reported outcomes of decisions when physician executives were involved in strategic decision-making processes in 109 USA hospitals. Hypotheses were that increased numbers of doctors involved in strategic decision-making teams would be associated with better decisions, greater understanding of the rationale of decisions and more commitment to decisions.…”

Section: Resultsmentioning

confidence: 99%

Medical leadership, a systematic narrative review: do hospitals and healthcare organisations perform better when led by doctors?

et al. 2017

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IntroductionDespite common assumptions that doctors are well placed to lead hospitals and healthcare organisations, the peer-reviewed literature contains little evidence on the performance of doctors in leadership roles in comparison with that of non-medical managers.ObjectivesTo determine whether there is an association between the leader’s medical background and management performance in terms of organisational performance or patient outcomes.MethodsWe searched for peer-reviewed, English language studies using Medline, Embase and Emerald Management between 2005 and 2017. We included quantitative, qualitative and mixed method empirical studies on the performance of senior healthcare managers where participants were described as doctors or leaders and where comparative performance data were provided on non-medical leaders. Studies without full text available, or no organisational, leadership behaviour or patient measures, were excluded.ResultsThe search, conducted in Medline (n=3395), Embase (n=1913) and Emerald Management (n=454) databases, yielded 3926 entries. After the application of inclusion and exclusion criteria, 16 studies remained. Twelve studies found that there were positive differences between medical and non-medical leaders, and eight studies correlated those findings with hospital performance or patient outcomes. Six studies examined the composition of boards of directors; otherwise, there were few common areas of investigation. Five inter-related themes emerged from a narrative analysis: the impact of medical leadership on outcomes; doctors on boards; contribution of qualifications and experience; the medical leader as an individual or part of a team and doctors transitioning into the medical leadership role.Discussion and conclusionA modest body of evidence supports the importance of including doctors on organisational governing boards. Despite many published articles on the topic of whether hospitals and healthcare organisations perform better when led by doctors, there were few empirical studies that directly compared the performance of medical and non-medical managers. This is an under-researched area that requires further funding and focus.

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Section: Resultsmentioning

confidence: 99%

Medical leadership, a systematic narrative review: do hospitals and healthcare organisations perform better when led by doctors?

et al. 2017

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“…fulltime versus part-time) was positively associated with an increase in staff-to-patient ratios (nurse and physician) (Kuntz and Scholtes, 2013). Parayitam et al (2007) found that physician leadership participation was associated with higher-quality decision-making (e.g. with regard to coverage of a range of relevant issues, structured decision rationale, and securing commitment to decision implementation).…”

Section: Work Demands and Rewardsmentioning

confidence: 99%

The state-of-play in physician health systems leadership research

Onyura

Crann

Freeman

et al. 2019

LHS

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Purpose This paper aims to review a decade of evidence on physician participation in health system leadership with the view to better understand the current state of scholarship on physician leadership activity in health systems. This includes examining the available evidence on both physicians’ experiences of health systems leadership (HSL) and the impact of physician leadership on health system reform. Design/methodology/approach A state-of-the-art review of studies (between 2007 and 2017); 51 papers were identified, analyzed thematically and synthesized narratively. Findings Six main themes were identified in the literature as follows: (De)motivation for leadership, leadership readiness and career development, work demands and rewards, identity matters: acceptance of self (and other) as leader, leadership processes and relationships across health systems and leadership in relation to health system outcomes. There were seemingly contradictory findings across some studies, pointing to the influence of regional and cultural contextual variation on leadership practices as well entrenched paradoxical tensions in health system organizations. Research limitations/implications Future research should examine the influence of varying structural and psychological empowerment on physician leadership practices. Empirical attention to paradoxical tensions (e.g. between empowerment and control) in HSL is needed, with specific attention to questions on how such tensions influence leaders’ decision-making about system reform. Originality/value This review provides a broad synthesis of diverse papers about physician participation in health system leadership. Thus, it offers a comprehensive empirical synthesis of contemporary concerns and identifies important avenues for future research.

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“…There is a vital need for increased involvement of physicians in: (a) policy -especially in the areas of quality and clinical innovation, payment policy and medical education and training (Laugesen and Rice 2003); and (b) strategic and higher-order operational decisions in healthcare systems, as it affects commitment and the decision quality (Parayitam et al 2007). This requires that strong, value-based and assertive physician leaders become key partners with other healthcare leaders (Zismer and Brueggemann 2010).…”

Section: Affirming Versus Enabling Leadershipmentioning

confidence: 99%

Towards Reconciliation of Several Dualities in Physician Leadership

Saxena¹,

Walker²,

Kraines³

2015

hcpol

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Leadership has a renewed focus in healthcare, and physicians are being increasingly involved in a range of leadership roles. The aim of this paper is to discuss several dualities that exert tensions at the systems and individual levels. Although oppositional, the common dualities of physician leadership are not mutually exclusive but represent a complex, dynamic and interdependent relationship, often coexisting with each other and exerting tensions in multiple dimensions. The authors contend that a dialectic understanding -instead of either/or or finding a middle ground -of the opposite poles of these dualities allows for generating meaningful leadership perspectives and choices. RésuméLe leadership est au centre de l' attention dans les services de santé et les médecins s'impliquent de plus en plus dans une vaste gamme de rôles liés au leadership. L' objectif de cet article est d' aborder diverses dualités qui exercent des tensions aux niveaux des systèmes et des personnes. Bien qu' elles soient opposées, les dualités habituelles du leadership des médecins ne s' excluent pas l'une l' autre, mais représentent plutôt une relation d'interdépendance complexe et dynamique; elles coïncident souvent l'une avec l' autre et exercent des tensions sous plusieurs dimensions. Les auteurs affirment qu'une compréhension dialectique des pôles qui s' opposent dans ces dualités -plutôt que de choisir un des deux ou de trouver le juste milieu -permet d' obtenir un point de vue appréciable sur le leadership ainsi que sur les choix présents.

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Strategic decision‐making in the healthcare industry: the effects of physician executives on decision outcomes

Cited by 12 publications

References 48 publications

Medical leadership, a systematic narrative review: do hospitals and healthcare organisations perform better when led by doctors?

Medical leadership, a systematic narrative review: do hospitals and healthcare organisations perform better when led by doctors?

The state-of-play in physician health systems leadership research

Towards Reconciliation of Several Dualities in Physician Leadership

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