A Qualitative Study Defining Physician System Citizens: Expanding the Physician Role

Area of Science:

• Medical Education
• Health Systems Science
• Physician Professionalism

Background:

• 21st-century physicians require evolving roles to address healthcare system needs.
• Key needs include equitable resource distribution, inclusive care delivery, and value-based care.
• Physician system citizens (PSCs) are defined as physicians meeting these evolving demands.

Purpose of the Study:

• To define the personal characteristics and behaviors of exemplary physician system citizens (PSCs).
• To identify environmental factors that facilitate the development of system citizenship in physicians.

Main Methods:

• Employed the positive deviance concept to identify exemplary PSCs across 5 U.S. academic institutions.
• Conducted semistructured interviews with 9 PSCs and their interprofessional colleagues (April-June 2022).
• Utilized content thematic analysis and triangulation to analyze interview data.

Main Results:

• Identified four key themes from 21 interviews.
• PSCs possess strong communication and teaming skills, aligning with core competencies.
• PSCs demonstrate systems thinking and exceptional emotional intelligence.
• Mentorship was identified as a critical factor in PSC development.

Conclusions:

• Physicians require traditional competencies alongside systems thinking and emotional intelligence.
• These meta-competencies are crucial for 21st-century physicians.
• Findings offer insights into knowledge, skills, and attitudes for effective healthcare delivery.