Leadership in Medicine: who will answer the call of duty?

Sir

With the Health Service under continued pressure, the Medical profession needs strong leadership now more than ever. Inspiring leaders are essential to the success of any endeavour as they help us to achieve our goals by translating a vision into reality1. However, one has to wonder how leaders are created; who nurtures the skill-set necessary to guide change and how can we ensure a supply of future leaders? Over the last decade, we have seen a greater appreciation for the role of leadership within Medicine and how crucial it is to the success of the healthcare system. Modern day medicine is collaborative where physicians practice as part of multidisciplinary teams. This has thrust many doctors into leadership roles, which they may not be suited to and/or trained for. A recent study on the impact of organisational leadership on physician satisfaction and burnout revealed that the leadership qualities of physician supervisors significantly impacts on the well-being of physicians working in a health care organisation2. This highlights the importance of selecting leaders carefully and ensuring they receive adequate training.

Furthermore, it’s essential that leadership qualities are fostered at an undergraduate level so that doctors can develop clinical skills in tandem with their leadership skills. Undergraduate leadership development programs would allow students to understand their own leadership style, to be aware of the barriers faced by leaders, to appreciate how relationships are built with others and to help them become mentors to other doctors. There is an ever increasing need for our colleagues to be innovative, visionary and to manage change in an effective way. A recent systematic review of faculty development initiatives designed to promote leadership in medical education showed that participants consistently found leadership programs to be useful on both a personal and professional level4. Many of these initiatives involved seminars, workshops or mentoring programs and addressed vital topics such as team building, time management, conflict resolution and strategic planning. Interestingly, it has also been shown that leader inclusiveness enhances inter-professional team performance through an increase in shared team identity and a reduction in perceived status differences3. As future doctors will be working with people from different cultures due to the globalisation of medicine and health professionals from Generation Y and mature graduates alike, it’s essential that mutual respect and sharing of knowledge across professional borders is encouraged as early as possible4.

In recent years, the paradigm of healthcare delivery has evolved whereby it is now viewed as a commercial enterprise, with all the associated challenges of surviving in a harsh competitive environment. The changing nature of medical practice demands that we function like a private company, where flexibility and a rapid response to changes in the operational environment are essential. Lessons can be learned from the business arena where strategic planning can be used as a conduit through which the best aspects of the Irish health service can be preserved and incorporated into a framework for superior future performance. Strategic leadership will help us navigate through the challenging times we are in and to embrace change. Maximising human capital, encouraging accountability and a sense of belonging will be central to this process, which in turn will inspire official and unofficial leadership at all levels. 

H Ferris1, ME Collins2

1Public Health SpR, HSE South, Cork

2Institute of Leadership, RCSI, 123 St Stephen’s Green, Dublin 2

Email: ferrish@tcd.ie 

References 

  1. Bennis W. (2009). On becoming a leader. Basic Books, Fourth Edition.
  2. Shanafelt T, Gorringe E, Menaker R, Storz KA, Reeves D, Buskirk SJ, Sloan JA, Swensen SJ. (2015). Impact of organisational leadership on physician burnout and satisfaction. Mayo Clinic Proceedings, Apr 2015; 90, 4.
  3. Mitchell R, Boyle B, Parker V, Giles M, Chiang V, Joyce P. (2015). Managing inclusiveness and diversity in teams: how leader inclusiveness affects performance through status and team identy. HR Management 2015: 54: 2 pp217-239
  4. Ferlie E, Fitzgerald L, Wood M, Hawkins C. (2005). The non-spread of innovation: the mediating role of professionals. Academy of Management Journal 48: 1: 117-134

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