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Article
Publication date: 31 October 2008

Sudha Xirasagar

The purpose of this paper is to examine the empirical validity of transformational, transactional and laissez‐faire leadership and their sub‐scales among physician managers.

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Abstract

Purpose

The purpose of this paper is to examine the empirical validity of transformational, transactional and laissez‐faire leadership and their sub‐scales among physician managers.

Design/methodology/approach

A nation‐wide, anonymous mail survey was carried out in the United States, requesting community health center executive directors to provide ratings of their medical director's leadership behaviors (34 items) and effectiveness (nine items), using the Multifactor Leadership Questionnaire 5X‐Short, on a five‐point Likert scale. The survey response rate was 40.9 percent, for a total 269 responses. Exploratory factor analysis was done, using principal factor extraction, followed by promax rotation).

Findings

The data yielded a three‐factor structure, generally aligned with Bass and Avolio's constructs of transformational, transactional and laissez‐faire leadership. Data do not support the factorial independence of their subscales (idealized influence, inspirational motivation, individualized consideration, and intellectual stimulation under transformational leadership; contingent reward, management‐by‐exception active, and management‐by‐exception passive under transactional leadership). Two contingent reward items loaded on transformational leadership, and all items of management‐by‐exception passive loaded on laissez‐faire.

Research limitations/implications

A key limitation is that supervisors were surveyed for ratings of the medical directors' leadership style. Although past research in other fields has shown that supervisor ratings are strongly correlated with subordinate ratings, further research is needed to validate the findings by surveying physician and other clinical subordinates. Such research will also help to develop appropriate content of leadership training for clinical leaders.

Originality/value

This study represents an important step towards establishing the empirical evidence for the full range of leadership constructs among physician leaders.

Details

Journal of Health Organization and Management, vol. 22 no. 6
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 28 October 2013

Florian Röthlin

Reorienting health services towards health promotion is one of the major health promotion strategies stipulated by the Ottawa Charter). Important contradictions, tensions and…

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Abstract

Purpose

Reorienting health services towards health promotion is one of the major health promotion strategies stipulated by the Ottawa Charter). Important contradictions, tensions and barriers to health promotion implementation associated with organisational structures have, thus far, been underexposed in the hospital health promotion discourse. This paper aims at identifying risks and the chances for hospital management to strategically and sustainably reorient their hospitals towards health promotion.

Design/methodology/approach

The paper combines theories and findings from organisational science and management studies as well as from capacity development in the form of a narrative literature review. The aim is to focus on the conditions hospitals, as organisational systems with a highly professionalised workforce, provide for a strategically managed reorientation towards health promotion. Models and principles helping managers to navigate the difficulties and complexities of health promotion reorientation will be suggested.

Findings

Hospital managers have to deal with genuine obstacles in the complexity and structural formation of hospital organisations. Against this background, continuous management support, a transformative leadership style, participative strategic management and expert governance can be considered important organisational capacities for the reorientation towards a new concept such as health promotion.

Practical implications

This paper discusses managerial strategies, effective structural transformations and important organisational capacities that can contribute to a sustainable reorientation of hospitals towards health promotion. It supports hospital managers in exploring their chances of facilitating and effectively supporting a sustainable health promotion reorientation of their hospitals.

Originality/value

The paper provides an innovative approach where the focus is on enhanced possibilities for hospital managers to strategically manage the reorientation towards health promotion.

Details

Journal of Health Organization and Management, vol. 27 no. 6
Type: Research Article
ISSN: 1477-7266

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