I have recently taken a little hiatus from blog posting recently as a result of an accident playing soccer that resulted in a broken hand. As it turns out, if you are right handed then breaking your right hand isn’t great for getting writing done (or pretty much anything else in life). I’m pretty confident I’m on the mend now, but it has been a frustrating few weeks.
Lucky then that the world of journal publications tends to move pretty slowly so although I’ve been out of writing action pieces have still been coming through into publication. A few of those pieces that have recently been published are on the topic of medical engagement.
The first paper is based on research done in the English National Health Service (NHS) a few years ago, written with Chris Ham, Peter Spurgeon and Iain Snelling and can be found here. The literature suggests that medical engagement is an important component of high performing health systems, although the NHS has traditionally struggled to engage doctors and has been characterised as a professional bureaucracy. This study explored the ways in which health care organisations structure and operate medical leadership processes to assess the degree to which professional bureaucracies still exist in the English NHS.
Drawing on the qualitative component of a research into medical leadership in nine case study sites, this paper reports on findings from over 150 interviews with doctors, general managers and nurses. In doing so, the authors focus specifically on the operation of medical leadership in nine different NHS hospitals. The paper finds that although concerted attention has been focussed on medical leadership and this has led to significant changes to organisational structures and the recruitment and training processes of doctors for leadership roles. There is a cadre of doctors that are substantially more engaged in the leadership of their organisations than previous research has found. Yet, this engagement has tended to only involve a small section of the overall medical workforce in practice, raising questions about the nature of medical engagement more broadly.
The second paper is written with a team that I have done Australian-based work on medical engagement with – Marie Bismark, Grant Phelps and Erwin Loh. This piece doesn’t present empirical data but is a think piece arguing that perspectives on medical management and leadership are in a time of transition, but there is much we still need to understand better. This paper explores some of the tensions and dilemmas inherent in understandings of medical management and leadership and can be found here.