Co-leadership in healthcare organizations: expanding and constricting new senior management roles for physicians
Bibliographic record
Abstract
PURPOSE: Co-leadership between physicians and senior managers is being explored as an avenue to improve decision processes and ensure support of orientations. Reaching those objectives depends partly on the role played by physician co-leaders, a role crafted through ongoing negotiation between actors attempting to expand or constrict the role. The study aims to contribute insight into how physicians entering senior co-leadership roles, and those around them, craft their roles. DESIGN/METHODOLOGY/APPROACH: A qualitative, inductive study of new senior co-leadership roles for physicians in four healthcare centers in Quebec, Canada, was conducted over 21 months, involving interviews, observations and document analysis. FINDINGS: A total of 16 practices mobilized by actors to expand and/or constrict the new roles are identified, revealing that role crafting can occur by creating emptiness in one's role or adjacent roles, by shaping other actors' agency and by influencing processes. PRACTICAL IMPLICATIONS: During the early phases of implementation of co-leadership, attention should be paid to agency and processes, since much role crafting can be done through others or by refraining from exerting influence. A balanced level of cultural sensitivity is more important than a unified culture, and a positioning exercise should be conducted to contemplate the new role relative to its wider organizational leadership context, beyond the dyad. ORIGINALITY/VALUE: The study suggests that the shared role of co-leaders, during the early phases of implementation of co-leadership, is much more vulnerable than portrayed in previous work, overlapping with other constellations and subject to significant intervention from outside the dyad itself.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.015 | 0.017 |
| Scholarly communication | 0.008 | 0.004 |
| Open science | 0.001 | 0.006 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".