A qualitative meta-synthesis of critical factors affecting physician leadership roles in health systems.

摘要

Although speculated for some time that having physicians in leadership positions is valuable for overall hospital performance, there is little published empirical work on this hypothesis (Goodall, 2011, Dine, 2011). Using a qualitative meta-synthesis (ethnography) of the research literature on physician leadership, this research sought to address the question of whether or not there are clear and discernible differences, if any, between physicians in leadership roles in hospital or health systems and non-physician executives in comparable roles and organizations.;The use of meta-synthesis (ethnography) for this research provided a mechanism to take intuitive themes (or metaphors) of research articles around physician leadership and align them around meaningful and structured interpretation. Key words selected by the researcher created themes in the literature that were compared against lay meanings of the key word and then analyzed for consistency or contrast of that interpretation. The assessment results determined if the key word (or Keyword Theme) matched meanings (concurrence) or provided alternative meanings (dissonance or ambiguity) of the same word across articles. The outcome of this comparative assessment is called translation in meta-ethnography. Keyword Themes in the translation step are then expressed as the original author intended and these expressions are compared and contrasted to determine distinctions of meaning across articles. The Keyword Theme distinctions were the basis of the leadership comparison, i.e. the research was not comparing physicians to administrative peers, but to other researcher's perceptions of leadership traits amongst physicians.;The discernible traits of physician leaders that the research sought to identify were to be clear and convincing. From the qualitative meta-synthesis of the applicable literature and subsequent assessment , it was determined that although there were critical factors that were attributable to physicians in leadership and that these results provided substantial evidence of unique elements, these traits were not to the clear and convincing standard.;Although the data did not directly answer the initial research question, it did provide important results identifying critical factors, or elements, affecting physician leadership and leadership training. These elements are applicable to future leadership, management and educational initiatives that affect developing physician leaders for healthcare institutions.