“Making clinicians organisational leaders is a huge and costly task. Is it worth it, especially given the many competing demands on clinicians’ time?”
Making senior clinicians as organisational leaders after years of their clinical &
practical skills, time investment, financial cost to something which they were not
trained from the medical school and higher specialty training is definitely a huge and
Traditional view of doctors and nurses are trained to look after the sick and suffering
patients while managers plan strategically for finance and development is not a healthy
model in the modern healthcare industry. Making clinicians as organizational leaders
is worth every penny – as evidence from all over the world suggest that health care
systems led by doctors are offering a fantastic quality of service and value for
money. Classic examples for this doctor leading organisations – Kaiser Permanente,
Veterans Health Administrations, Mayo clinic (USA) and Apollo hospitals (India).
Health care systems across the world are facing their toughest challenge of providing safe
and quality care to the patients at this time of austerity in a cost efficient way.
Cost of providing healthcare is spiraling with the invention of new technologies,
expensive medications, increasing life expectancy and overall patient expectations
coupled with demand. Our own National Health Service is faced with a challenge of
its life time saving 15% of cost efficiency savings in the next three years whilst
promoting innovation and new care models to the patient care pathway.
My argument in this essay would justify the reasons behind the concept of hybrid
Clinician – Leaders and their cost effectiveness in the healthcare industry.
Doctor – Leaders are better equipped with strategic decisions in planning patient
pathways, integrated care with primary care, dialogue and engagement with
commissioning agencies. My view is supported by McKinsey and London School of
Economics (Pedro J, Castro, Stephen J Dorgan (2008) found that hospitals with greatest
clinician participation in the management scored about 50% higher on important drivers
of performance than hospitals with low levels of clinical leadership.
Definition of Organisational Leaders
According to Wireman & Carlson (2005) leadership as a process is defined more in
terms of social interaction and group dynamics in which greater emphasis is attached
to followers and context, emotional intelligence and the development of skills
in areas such as influence, relationship management, communication and motivation.
Clinical leadership as used in McKinsey Quarterly (Mountford J and Webb C (2009)
states putting clinicians at the heart of shaping and running the clinical services, so as to
deliver excellent outcomes for patients and populations, not as a one off task or project,
but as a core part of clinicians’ professional identity.
My personal view on clinical leadership after going through literature review is that
Clinical leadership is basically giving power to the frontline clinicians so as to give
them capability and accountability to improve the health care for the population they
serve whether it is a specialty level as in my case as a clinical director of renal
services or wider population as a Chief Executive of a NHS Hospital.
Corporate Versus Clinical Leadership
My next question is - Are there any differences between leaders of corporate
organisations with the leaders of health care sector. My view is that organisational
leaders in healthcare are completely different from corporate leaders. We cannot
compare the clinical leaders with the corporate leaders for obviously many reasons.
References: Pedro J Castro, Stephen J Dorgan and Ben Richardson (2008) A healthier healthcare system for the United Kingdom. The McKinsey Quarterly, February
Wirrman EJ, Carlson CL (2005) Public health leadership in primary care practices in
England: Everybody’s business? Critical Public Health 15(3): 205 -17
Mountford J, Webb C (2009) When Clinicians Lead
Malby B (1998) Clinical Leadership. Adv Pract Nurs Q4(3):40 - 3
Hartley J, Benington J (2010) Leadership for healthcare
Healthcare Commission Report (2009) Investigation into Mid Staffordshire NHS Foundation Trust. Commission for Healthcare Audit & Inspection, London
D Goleman (2004) What makes a leader? Harvard Business Review, Januay
Rajan Madhok (2011) Rapid Response Letter to the BMJ - White C. Why doctors can 't always be leaders. BMJ Careers 2011; 342: 195-6.
Department of Health (2008) High quality care for all: NHS review final report
The stationery office, London
King’s Fund (2011) The future of leadership and management in the NHS – No more heroes
NHS Institute for Innovation and Improvement, Academy of Medical Royal Colleges (2008) Medical Leadership Competency Framework, 2nd Edition
Thomas Lee (2010) Turning doctors into leaders Harvard Business Review, April
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