Physician Understanding of and Beliefs About Leadership

Little is known about how physicians conceptualize leadership, what factors influence that conceptualization, and how their conceptualization may impact willingness to lead. We sought to explore how physicians conceptualize leadership.

We conducted an exploratory study of data from a convenience sample of physicians across the United States using an anonymous, 54-item, online survey. We devised a novel leadership resonance score (LRS) to distinguish between leadership and management based on published definitions and prior pilot work. The activities fit on a spectrum from purely leadership actions to purely management actions, and we assigned a numeric value to each activity, allowing for quantification of a respondent's conceptualization of leadership as either more managing or more leading.

There were 206 respondents (57% male; median age of 43 years [interquartile ranges, IQR: 32, 72]) who completed the survey. Respondents viewed leadership abilities to be highly important for physicians, with a median importance score of 80 (range 0-100, IQR: 50, 100). LRS indicated most physicians conflate leadership and management. Compared to other physicians, respondents assessed their own preparedness for leadership highly (median preparedness score: 70, IQR: 2, 100). Respondents' assessment of their preparedness for leadership was associated with age (Spearman's rho = 0.24, p < .001). LRS was not associated with preparedness for leadership (Spearman's rho = 0.12, p = .08). "Aversion to politics" was the most common barrier to interest in leadership (45%, 93/206), with "loss of personal time" being second (30%, 62/206).

Our data demonstrate physicians misunderstand the differences between leadership and management. We surmise that if an accurate conceptualization of leadership by physicians is associated with increased willingness to lead, then educational activities designed to improve physicians' understanding of leadership could be beneficial in increasing physicians' willingness to take on leadership positions. An increased willingness by physicians to take on leadership roles would ultimately have a positive impact not only on individual patient care, but also on the healthcare system as a whole.