Towards Reconciliation of Several Dualities in Physician Leadership

Saxena, Anurag; Walker, Keith; Kraines, Gerry

doi:10.12927/hcpol.2015.24172

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…37,38 Early engagement of local physicians is essential as DME implementation temporarily disrupts social cohesiveness. 18 Reconciling competing goals by a dialectic approach 39 or working towards a superordinate goal 40 requires effective collaboration. Local pride and status in communities attributed to unique learning experiences tailored to the local context 38 with an attendant desire for autonomy needs to be balanced with central oversight for ensuring quality and accountability.…”

Section: Discussionmentioning

confidence: 99%

Challenges, success factors and pitfalls: implementation of distributed medical education

et al. 2018

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Objectives There are only a few descriptive reports on the implementation of distributed medical education (DME) and these provide accounts of successful implementation from the senior leadership perspective. In Saskatchewan, over a period of 4 years (2010–2014), four family medicine residency sites were established and two additional sites could not be developed. The aim of this study was to identify challenges, success factors and pitfalls in DME implementation based upon experiences of multiple stakeholders with both successful and unsuccessful outcomes. Methods Data were obtained through document analysis (n = 64, spanning 2009–2016; perspectives of government, senior leadership, management and learners), focus groups of management and operations personnel (n = 10) and interviews of senior leaders (n = 4). Challenges and success factors were ascertained through categorisation. Iterative coding guided by three sensitising frameworks was used to determine themes in organisational dynamics. Results Both challenges and success factors included contextual variables, governance, inter‐ and intra‐organisational relationships (most common success factor), resources (most common challenge), the learning environment and pedagogy. Management and operations were only a challenge. Organisational themes affecting the outcome and the pitfalls included the pace of development across multiple sites, collaborative governance, continuity in senior leadership, operations alignment and reconciliation of competing goals. Conclusions Emerging opportunities for DME can be leveraged through collaborative governance, aligned operations and resolution of competing goals, even in constrained contexts, to translate political will into success; however, there are pitfalls that need to be avoided. Our findings based upon multi‐stakeholder perspectives add to the body of knowledge on deployment, carefully considering the conditions for success and associated pitfalls.

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Section: Discussionmentioning

confidence: 99%

Challenges, success factors and pitfalls: implementation of distributed medical education

et al. 2018

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“…Our earlier work had highlighted a dialectic approach to reconcile dualities and simultaneously uphold multiple truths for effective healthcare leadership. 38 However, shared leadership requires the incorporation of new information into the existing mental framework 39 and changing mental models takes time. 40 Although not specifically highlighted in our study, the importance of a "growth mindset" 41 appears intuitively integral as it focuses on continuous learning.…”

Section: Mindset and Attitudesmentioning

confidence: 99%

Challenges and success strategies for dyad leadership model in healthcare

Saxena

2020

Healthc Manage Forum

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The use of a dyad leadership model involving a physician co-leader and a co-leader with a different background, the dyad co-leader, is gradually increasing in Healthcare Organizations (HCOs). There is a paucity of empirical studies on various aspects of this model. This study’s aim was to identify challenges and strategies for success in the dyad leadership model in healthcare. Through a mixed-methods approach utilizing focus groups, surveys, and semi-structured interviews, perceptions of 37 leaders in one HCO at different hierarchical levels were analysed based on their lived experiences. The challenges and success strategies spanned personal, interpersonal, and organizational domains. The areas requiring attention included mindsets, competencies, interpersonal relationship, support, time, communication, and collaboration. In addition, the importance of organizational context addressing its structure, strategy, operations, and culture was highlighted. The findings from this study may be used for praxis, development, and implementation of dyad leadership.

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“…There needs to be an emphasis that the professional duty for PLs extends beyond their clinical practice and constituents and that their accountabilities lie in a superordinate identity (Coates, 2001). The duality articulated in the accountability conundrum can also be reconciled through a dialectic approach (Saxena et al, 2015).…”

Section: Lhs 312mentioning

confidence: 99%

Structure of health-care dyad leadership: an organization’s experience

Saxena

Davies

Philippon

2018

LHS

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Purpose This study aims to explore the structural aspects (roles, responsibilities and reporting) of dyad leadership in one health-care organization (HCO). Design/methodology/approach The perceptions of 32 leaders (17 physician leaders and 15 dyad co-leaders) in formal leadership positions (six first-level with formal authority limited to teams or divisions, 23 middle-level with wider departmental or program responsibility and three senior-level with institution-wide authority) were obtained through focus groups and surveys. In addition, five senior leaders were interviewed. Descriptive statistics was used for quantitative data, and qualitative data were analyzed for themes by coding and categorization. Findings There are a large number of shared responsibilities in the hybrid model, as most activities in HCOs bridge administrative and professional spheres. These span the leadership (e.g. global performance and quality improvement) and management (e.g. human resources, budgets and education delivery) domains. The individual responsibilities, except for staff and physician engagement are in the management domain (e.g. operations and patient care). Both partners are responsible for joint decision-making, projecting a united front and joint reporting through a quadrat format. The mutual relationship and joint accountability are key characteristics and are critical to addressing potential conflicts and contradictions and achieving coherence. Practical implications Clarity of role will assist development of standardized job descriptions and required competencies, recruitment and leadership development. Originality/value This is an original empirical study presenting an integrated view of dyad leaders and senior leadership, meaningful expansion of shared responsibilities including academic functions and developing mutual relationship and emphasizing the central role of stability generating management functions.

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Towards Reconciliation of Several Dualities in Physician Leadership

Cited by 3 publications

References 16 publications

Challenges, success factors and pitfalls: implementation of distributed medical education

Challenges, success factors and pitfalls: implementation of distributed medical education

Challenges and success strategies for dyad leadership model in healthcare

Structure of health-care dyad leadership: an organization’s experience

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