Self-determining medical leadership needs of occupational health physicians

Purpose: Medical leadership is seen as crucial to the transformation of healthcare services, yet leadership programmes are often designed with a top-down and centrally-commissioned 'one-size-fits-all' approach. In the UK the Smith Review (2015) concluded that more decentralised and locally-designed leadership development programmes were needed to meet the healthcare challenges of the future. However, there is an absence of an evidence-base to inform the design of effective strategies to motivate doctors to take up leadership roles, while at the same time the development of clinical leadership roles is becoming an increasingly popular strategy in order to secure formal leadership roles for doctors in healthcare organisations. The problem is further compounded by a lack of validated leadership qualities assessment instruments which support researching this problem further. The purpose of this national study was to frame an inquiry of medical leadership self-assessment within Self Determination Theory (SDT) in order to identify the extent to which a group of Occupational Health physicians (OHP) were able to self-determine their leadership needs, accurately and reliably using a National Health Service (NHS) England competency approach promoted by the NHS England Leadership Academy as a self-assessment leadership diagnostic. Design/Methodology/approach: The analysis draws on a sample of about 25% of the total population size of the Faculty of Occupational Medicine (n=250). The questionnaire used was the Leadership Qualities Framework tool as a form of online self-assessment (NHS Leadership academy, 2012a). The data were analysed using descriptive statistics and simple inferential methods. Findings: OH Physician Consultants are open about reporting their leadership strengths and leadership development needs and recognise leadership learning as an ongoing development need regardless of their level of personal competence. This study found that the single most important factor to affect a doctor’s confidence in leadership is their experience in a management role. Management experience accounted for the usefulness of leadership training, suggesting that doctors learn best through applied 'leadership learning' as opposed to theory-driven programmes. Drawing on Self Determination Theory (SDT) this article provides a theoretical framework that helps to understand those doctors who are likely to engage in leadership and management activities in the organisation. More choice and self-determination of medical leadership programmes is likely to result in more relevant leadership learning that builds on doctors' previous experience in this area. Research Limitations and Implications: While this study benefitted from a large sample size, it was limited to the use of purely quantitative methods. Future studies would benefit from the application of a mixed methodology. Practical Implications: This study suggests that doctors are able to determine their own learning needs reliably and that they are more likely to increase their confidence in leadership and management if they are exposed to leadership and management experience. Originality Value: This is the first large scale study of this kind with a large sample within a single medical specialty. The study is considered as insider research as the first author is an Occupational Health Physician with knowledge of how to engage OH Physicians in this work.