Abstract
Transforming health care organizations to improve performance requires effective strategies for engaging doctors and developing medical leadership. Most efforts in the US and UK to develop medical leadership have focused on structural changes that integrate doctors into administrative structures, but these have had limited impact. Recognizing the distributed and collective character of effective leadership, some health care organizations are now attempting to create greater alignment between clinical and managerial goals, focusing on improving quality of care. These initiatives aim to create effective systems at a team and organizational level, not just the development of medical leadership competencies.
Notes
* The Kennedy Report on the Bristol Royal Infirmary stated: ‘Sadly, a system of separate and virtually independent clinical directorates, combined with a message that problems were not to be brought to the chief executive for discussion and resolution, meant that there was power but no leadership. The environment was one in which problems were neither adequately identified nor addressed’ (Kennedy, Citation2001, p. 5).