Perspectives on physician leadership: The role of character-based leadership in medicine.

Introduction: Physician leadership is multifaceted, but leadership training in medicine often is not. Leadership education and training for physicians are rarely grounded in conceptual leadership frameworks and suffer from a primary focus on cognitive leadership domains. Character-based leadership is a conceptual leadership framework that moves beyond cognitive competencies and articulates dimensions of character that promote effective leadership. The purpose of this study was to explore the relevance of character-based leadership in the medical context.

Methods: This qualitative descriptive study used semi-structured interviews to explore health care professionals' perceptions of character in relation to effective leadership in medicine. All interviews were audiorecorded and transcribed. Consistent with descriptive qualitative inquiry, a qualitative latent content analysis was used. Simultaneous data collection and analysis incorporating character-based leadership as a theoretical framework was used to help organise the analysis of the data. The researchers met regularly to clarify coding structures and categorise codes until sufficiency was reached.

Results: Twenty-six individuals (12 doctors, 5 nurses, 2 social workers, 2 directors and a pharmacist, dietician, coordinator, administrator and unit clerk) participated. Character-based leadership resonated with participants; they deemed character essential for effective physician leadership. Participants reflected on different character dimensions they attributed to an effective physician leader, in particular, collaboration, humility and humanity. They shared examples of working in interdisciplinary health care teams to illustrate these in practice. Moreover, participants believed that effective physician leaders need not be in a positional leadership role and asserted that physicians who demonstrate character stand out as leaders regardless of their career stage.

Discussion: Our findings suggest a role for a character-based leadership framework in medical education. Participants recognised the execution of character in everyday practice, associated character with effective leadership and understood leadership in dispositional rather than positional terms. These findings provide important insights for expanding and enhancing existing leadership training interventions.