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.
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.
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.
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.
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.
