Volume 5 Number 3 In This Issue
In keeping with the theme of the previous two issues of our Canadian Journal of Physician Leadership, this year’s Canadian Conference on Physician Leadership will focus on “Diversity, inclusion & engagement: the leadership challenge.”
As I was recently helping my young nephew with his math homework, we discussed the multiplication effect: that any number, no matter how large, when multiplied by zero is still zero. I started to reflect on how this is true in complex human systems as well as mathematical ones. Based on simple multiplication theory, addressing and fixing any “zero” is the only way to have a positive impact on the overall result.
Local leaders are increasingly being called on to advocate on behalf of their professions at the national level. This requires a degree of knowledge, rhetorical skill, focus, and experience. The best way to articulate a point of view is through the use of narrative. A narrative forces you to combine facts and emotion, which are both needed in advocacy presentations. However, the most important thing to remember is this: if you’re not telling your story, someone else is. So, prepare yourself and get into the game.
Strategic communication, be it on an individual physician level or health care organization wide, is key to getting what you want. Fundamentally, strategic communication takes account of objectives, target audiences, and understanding how human beings process information and make decisions TODAY, before determining tactics or simply winging it.
In recent years, a growing chorus has raised concerns that conventional ideas about leadership are not adequate for responding to today’s complex organizational challenges. The notion that good leadership astutely analyzes a problematic situation and provides a vision that shows the way to success doesn’t work in complex situations. This article offers a different image of leadership that has proven effective for managing conditions of uncertainty, ambiguity, and volatility: “generative leadership.” A description of when conventional modes of leadership (in complicated situations) and generative leadership (in complex situations) are most appropriate is followed by some behaviours and perspectives that characterize generative leadership. The article concludes with some thoughts on generative leadership in health care and some of the challenges leaders face in leading generatively.
Northern Ontario makes up 87% of Ontario’s land mass, is inhabited by 6% of the province’s population, and has the highest rates of cancer and diabetes, along with cardiovascular and respiratory disease in Ontario. Disease prevalence is highest among the 13% of Indigenous northerners.
Leadership education is increasingly incorporated into the early stages of medical training, but it is not always clear who should teach and how they should be prepared. Teacher training (faculty development) must be responsive to the needs of a variety of instructors, including physicians who may be unfamiliar with the topic of leadership themselves. This article looks at the limited literature on faculty development for teachers of leadership and recommends approaches.
The first part of this paper describes the rationale for optimal physician leadership and engagement and the recommendations in the Canadian Society of Physician Leaders (CSPL) white paper pertaining to “what provincial medical associations can do” to optimize this. The second reports efforts being made in British Columbia and Saskatchewan to realize the spirit of the CSPL recommendations. Both projects are efforts of co-creation: doctors and non-doctors, building health systems of the future, but creating them together. The third part outlines achievements and lessons of discovery learned along the way that they — and other jurisdictions of a similar wont — can integrate into their journey.
Leaders must ensure that staff align their behavioural choices with the values that underpin their organization’s vision and mission. When adverse events occur, the just culture model emphasizes accountability by acknowledging that adverse events are typically the result of both system design flaws and the behavioural choices of the health care providers in the system. Leaders are accountable for the design of the system and for managing health care providers’ behavioural choices. Individuals are accountable for their own behavioural choices as well as for reporting both their own errors and system flaws.
In an environment of disengagement, re-engagement of staff can be achieved and is highly rewarding. To be successful, what is needed is a clear understanding of the health care context, the current state of patient safety, and why people behave the way they do. With this understanding, coupled with a process that respects it, engagement is not only possible, but can be predictably achieved. The first of three parts, this article presents an overview of the key concepts rather than an exhaustive exploration. It aims to challenge current thinking by bringing together key elements that make implementation of quality and patient safety initiatives challenging.
“Why is the cost to attend this event so high?” I can tell you exactly why.
I am not a professional meeting planner. However, I have been the executive director of the CSPL for the past 20 years, and hosting an annual event is just one component of the job.
Reviewed by Johny Van Aerde, MD
BOOK REVIEW: Professionalizing Leadership
Oxford University Press, 2018
Reviewed by Johny Van Aerde, MD, PhD