Johtaminen lääkäriprofessiossa

Abstract

This doctoral dissertation explores specific features of leadership in the physician’s profession. The study contributes to the literature on physician leadership by increasing understanding of the path of becoming a physician leader, the content and challenges of a physician leader’s work, and the leadership roles it requires. It also singles out the elements of good physician leadership as perceived by physicians, explaining also how the findings relate to the leadership theory, as well as how bad leadership manifests itself in the physician’s profession. A qualitative research approach was adopted in the study, using open-ended, semi-structured interviews of physicians (n=50), of whom 23 were physician leaders. Content analysis by thematization was the chosen method. The thesis consists of an introductory essay, followed by five journal articles, all of which are based on empirical data. Physician leaders´ work consists of patient work and leadership work, which requires the ability to assume different leadership roles and switch between them depending on the situation. The challenges involved with leadership work include, for example, an identity conflict between the role of a physician and that of a leader, and how to balance between the leadership work and the patient work. The subordinates are physician colleagues with their own informal leader roles on their respective hierarchical levels. This puts physician leadership in a multidimensional leadership setting where formal leaders lead informal leaders, blurring the traditional leader-subordinate boundary. As medical expertise is a trait shared by leaders and subordinates alike, success in physician leadership partly comes from credibility as a medical expert, making medical leadership an inseparable part of good physician leadership. Good physician leadership is leadership through medical expertise, combined with respectful behavior, collegiality, and traits derived from various kinds of leadership theories. Seven different manifestations of bad leadership were also identified from the data.

Keywords: physician, physician leader, physician leadership, leadership theory