Exploring Physician Leadership Development in Health-Care Organizations through the Lens of Complexity Science

Abstract

Physician leaders are viewed as critical in the transformation of health care and in improving patient outcomes and yet significant challenges exist that limit their development. Leadership in health care continues to be associated with traditional, linear models, which are incongruent with the behaviour of a complex system such as health care. Physician leadership development remains a low priority for most health-care organizations although physicians admit to being limited in their capacity to lead. This research was intended to provide conceptual and practical considerations to both physician leaders and health-care organizations that recognize the importance of developing them. This study was based on five principles of complexity science and used grounded theory methodology to understand how the behaviours of a complex system can inform leadership development for physicians. These principles include; connectivity, interdependency, feedback, exploration-of-the-space-of-possibilities, and co-evolution and were associated with either behaviour of agents within a system, or patterns of behaviour. Semi-structured interviews and documents provided the basis for data collection. Twenty-one experts in areas of health-care management, physician leadership, or leadership development participated. Participants included authors, academics, advisors, physicians and non-physicians, at both middle and senior operational levels. The study demonstrated that there is a strong association between physician leadership and patient outcomes and that organizations play a primary role in supporting the development of physician leaders. Findings indicate that a physician’s relationship with their patient and their capacity for innovation can be extended as catalytic behaviours in a complex system. The findings also identified limiting factors that impact physicians who choose to lead, such as reimbursement models that do not place value on leadership, and medical education that provides minimal opportunity for leadership skill development. This study presents convincing evidence that organizations play a primary role in developing physician leaders, giving them a competitive advantage and an increased ability to affect patient outcomes. The participation of highly knowledgeable and experienced participants strengthens the value of the results of this study and is likely to provide further research opportunities in health-care organizations that prioritize physician leadership development.