From leader to leadership: clinician managers and where to next?

Abstract

Individual clinician leadership is at the forefront of health reforms in Australia as well as overseas with many programs run by health departments (and hospitals) generally focus on the development of individual leaders. This paper argues, along with others, that leadership in the clinician management context cannot be understood from an individualistic approach alone. Clinician managers, especially in the ranks of doctors, are usually described as ‘hybrid-professional managers’ as well as reluctant leaders for whom most leadership theories do not easily apply. Their experiences of leadership development programs run by health departments both in Australia and internationally are likely to be based on an individual leader-focussed approach that is driving health care reforms. These approaches work from three key assumptions: (1) study and fix the person; (2) give them a position or title; and (3) make them responsible for results. Some would argue that the combination of these three approaches equates to heroic and transformational leadership. Several alternative approaches to leadership development are presented to illustrate how reforms in healthcare, and notably in hospitals, must incorporate alternative approaches, such as those based on collective and relational forms of leadership. This does not mean eschewing individual approaches to leadership but rather, thinking of them differently and making them more relevant to the daily experiences of clinician managers. We conclude by highlighting several significant challenges facing leadership development for clinician managers that arise from these considerations.

What is known about the topic? The professional development of clinical managers is topical in Australia at this time. Several professional development approaches emphasise the individual development of the clinician manager. The main emphasis of current programs is developing behaviours and traits in individual managers to make them better leaders. There is little empirical evidence of programs that are designed to strengthen a more distributed model of leadership in Australia.

What does this paper add? At the very least a distributed leadership approach that emphasises relationship-based models should be considered as an alternative to professional development programs that concentrate on developing stronger skills in the individual clinical manager. Other relational-based approaches need to be explored to add to leadership development programs.

What are the implications for practice? Consideration needs to be given to increasing leadership capacity through professional development models that cultivate a shared or distributed leadership approach amongst its clinical leaders and in which the notion of relationship-based or relational-focussed approaches are incorporated.