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Psychology of healthcare leadership

Leaders play a central role in many organizations, and healthcare organizations are not the exception.

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Leaders play a central role in many organizations, and healthcare organizations are not the exception. Leaders face significant stress in this context, knowing how much can be associated with their decisions, as healthcare often leads to life or death situations. How do they cope with this? What are the challenges they face?

Healthcare managers face a variety of challenges that occur on different levels. There are societal, historical, and cultural challenges, challenges with human resource management, those associated with change and performance measurement, and, finally, challenges associated with changing roles and expectations. The COVID-19 pandemic can be used to illustrate these. Healthcare leaders had to suddenly face a huge international pandemic that changed the way of life quickly and required them to adapt to the new requirements and the heavy workload that came with it. Leaders need to manage the bureaucratic aspects of the institution and human resources, including motivating and empowering their staff, working with stress and tension, and continuously seeking a balance between the demands of other organizations and the needs of the institution they manage. 

Clinicians often take up managerial positions after a long career working in health. However, one common issue is the role conflict that this can create, a conflict between administrative and healthcare-focused duties. In addition to this, they are often expected to step into the role without any managerial training that adds to the tension between clinical identity, the role of manager, and the actual work with the skills it requires. An emotional attachment to the role of clinician, a lack of acceptance from colleagues who might look down on these motives, and other barriers can also add stress to the transition. Many clinicians view the idea of management negatively, seeing it as a definitive step away from actual clinical work, and there might also be some negative views on those who choose to pursue administrative rather than clinical skills. This means that not all clinicians are prepared or have the right skills before stepping into a managerial position. Even if their seniority ensures they are good as clinicians, it does not mean that they have all the tools for administration, which can be reflected in a lot of stress.


This means that many healthcare leaders face significant role conflict and might lack skills and training to take on managerial duties. At the same time, there might also be personal and systemic factors that can make the situation harder for them. For instance, female leaders in healthcare might still experience a stronger role conflict than men and face additional barriers to pursuing leadership. Role conflicts with traditional roles like motherhood can make the situation more difficult.

What can help healthcare leaders find a good balance and do their functions effectively? Leaders name specific leadership development needs, seeking training and support with particular skills. For instance, a study of healthcare leaders identified key leadership needs such as financial management skills. Training that helps develop the necessary ability and knowledge is important and can help address the role conflict and a situation when an expert clinician lacks the administrative skills. Offering training and seeking professional development can serve as solutions on the side of the institutions or the professional to resolve the lack of preparation. 

Another solution is understanding the right leadership style for the occasion, as it is possible that a healthcare leader needs to have different tools for different situations. Showing flexibility in some cases is important, as is adopting a more strict style to ensure that the demands of the environment are met and that there are strong boundaries in place for a healthcare setting.
Leaders need to enforce the rules and structures, of course, but in healthcare, they also need to support their staff. Healthcare leaders can empower those working with them through specific behaviors, such as sharing information, delegating tasks, allowing staff to make decisions and giving them autonomy, coaching and developing skills, and providing feedback and accountability. This means that leaders can develop specific behaviors that allow them to reach particular results with their staff and that their choices have a direct impact on the performance of those working with them.

Read more: 

  • Faculty of Medical Leadership and Management. (2018). Barriers and enablers for clinicians moving into senior leadership roles: Review report.  Retrieved from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/756483/Clinical_leadership_report_f.pdf
  • Figueroa, C.A., Harrison, R., Chauhan, A. et al. Priorities and challenges for health leadership and workforce management globally: a rapid review. BMC Health Serv Res 19, 239 (2019). https://doi.org/10.1186/s12913-019-4080-7
  • Ghiasipour, M., Mosadeghrad, A. M., Arab, M., & Jaafaripooyan, E. (2017). Leadership challenges in health care organizations: The case of Iranian hospitals. Medical journal of the Islamic Republic of Iran, 31, 96. https://doi.org/10.14196/mjiri.31.96
  • Oducado, Ryan Michael. (2019). Leader Empowering Behaviors and Psychological Empowerment as Perceived by Young Hospital Staff Nurses: A Pilot Study. Jurnal Ners. 14. 47. 10.20473/jn.v13i2.15056. 
  • Rasa, J. (2020). Developing effective health leaders: the critical elements for success. Journal of Hospital Management and Health Policy. 4(6).
  • Shaffer, L.A., Robiner, W., Cash, L. et al. Psychologists’ Leadership Roles and Leadership Training Needs in Academic Health Centers. J Clin Psychol Med Settings 28, 252–261 (2021). https://doi.org/10.1007/s10880-020-09707-7
  • Xu, J. (2017). Leadership theory in clinical practice.Chinese Nursing Research, 4(4), 155-157. Zheng, H. (2018) Female Leaders’ Role Conflict and Its Balanced Solution. Open Journal of Social Sciences, 6, 226-234. doi: 10.4236/jss.2018.68018.

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