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Survey the first to map Canadian physician leadership landscape

There must be more physician leaders and these leaders need more recognition and, in many cases, proper compensation.

These were among key findings from a large and unique study assessing the attributes and attitudes of Canadian physician leaders that was released at a special session during the recent Canadian Conference on Physician Leadership, held in Vancouver.

The research, featuring responses from 689 physicians in formal and informal leadership positions and 15 detailed interviews, was conducted by the Canadian Medical Association (CMA), Canadian Society of Physician Executives (CSPE) and the George & Fay Yee Centre for Healthcare Innovation at the University of Manitoba.

CMA President-elect Cindy Forbes referenced the wide range of leadership experiences of physicians in her remarks on the second day of the conference.

“Leadership isn’t something that’s reserved for an ‘elite’ group of managers or directors,” she said. “Leadership competencies are essential for effective medical practice, throughout all stages of our careers.”

The survey showed that while respondents felt they had a natural inclination towards leadership roles, there was still a widespread negative perception – starting in medical school and continuing into practice – that taking on a leadership role was “going to the dark side.”

CSPE President Dr. John Van Aerde presented the data with researcher Anita Snell (PhD). They lauded the survey’s high response rate after it was sent to all CSPE members and everyone who had attended a PMI course over the past five years. Responses were received from all areas of the country except the Yukon, and from physicians in a wide range of practice settings and leadership roles.

Noting an almost equal number of male and female respondents, Van Aerde said the current physician leadership in Canada reflects demographic changes that have seen the number of female physicians increase significantly in recent years.

For physicians in formal leadership positions, remuneration increased as the number of leadership roles rose. However, one in 14 respondents with formal leadership roles were not paid for their leadership activity, and 18% received only a stipend.

The survey revealed that those in volunteer leadership positions provided between 38 and 81 hours of unpaid work a month, and overall 40% received no administrative support for their work or compensation for improving their leadership skills.

Most respondents felt that those in formal leadership roles should maintain an active clinical practice, though there was wide variation in opinions about how big this practice should be. A minority stated that if a physician had gained an understanding of the practice environment there was no need to do clinical work while holding a full-time leadership role.

Asked about the greatest satisfaction in being a leader, respondents most frequently cited helping to improve the system and provide better outcomes for patients. Bureaucracy was identified as one of the most dissatisfying aspects of the role.

Respondents felt the CMA had a role in future advancement of physician leadership by being proactive, and by providing leadership in influencing decision-making across the health care system. The value of PMI courses was also cited by many.

Asked how to encourage physician leadership, those polled identified leadership training as the most important factor — including building such training into the medical school curriculum.

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