180° view on general practitioners’ leadership skills: practice-level comparisons of leader and staff assessments using data from the cluster-randomised controlled IMPROVEjob study
Birgitta Weltermann,
Karl-Heinz Jöckel,
A Wagner,
Monika A Rieger,
Esther Rind,
S Burgess,
Albert Nienhaus,
K-H Jockel,
C Kersting,
J Block,
S Hartmann,
F Junne,
Manuela Schmidt,
Tanja Seifried-Dübon,
Horst Christian Vollmar,
Julian Göbel,
Lukas Degen,
Brigitte Werners,
Matthias Grot,
Claudia Pieper,
Karen Minder,
M Brinkmann,
A Herrmann-Werner,
A Siegel,
F Stuber,
J-M Bois,
A Dreher,
M Hippler,
L Imhoff,
C Ose,
E Tsarouha,
Stefanie Esper,
Katja Götz,
Andre Habrock,
Andrea Wittich
Affiliations
Birgitta Weltermann
Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Bonn, Germany
Karl-Heinz Jöckel
Center for Clinical Trials, University Hospital Essen, University Duisburg-Essen, Essen, Germany
A Wagner
Monika A Rieger
Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Tuebingen, Germany
Esther Rind
Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tuebingen, Tuebingen, Germany
S Burgess
Albert Nienhaus
K-H Jockel
C Kersting
J Block
2Rheumatology, Rush University Medical Center, Chicago, United States
S Hartmann
F Junne
Manuela Schmidt
Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Bonn, Germany
Tanja Seifried-Dübon
Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany
Horst Christian Vollmar
Institute of General Practice and Family Medicine (AM RUB), Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
Julian Göbel
Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Bonn, Germany
Lukas Degen
Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Bonn, Germany
Brigitte Werners
Institute of Management, Operations Research, Ruhr University Bochum, Bochum, Germany
Matthias Grot
Institute of Management, Operations Research, Ruhr University Bochum, Bochum, Germany
Claudia Pieper
Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
Karen Minder
Institute of General Practice and Family Medicine, University Hospital Bonn, University of Bonn, Bonn, Germany
Objectives Strong primary care leaders are needed to assure high quality services for patient populations. This study analysed general practitioners’ (GP) leadership skills comparing practice-level self and staff assessments based on the full range of leadership model and the leader-member exchange (LMX).Setting The questionnaire survey was conducted among German general practice leaders and their staff participating in the IMPROVEjob trial.Participants The study population comprised 60 German general practices with 366 participants: 84 GP practice leaders and 282 employees (28 physicians and 254 practice assistants).Primary and secondary outcome measures Leadership skills of the practice leaders were measured using the Integrative Leadership Questionnaire (German Fragebogen für integrative Führung) and the LMX-7 questionnaire. Leaders rated themselves and practice staff rated their leaders. The data was analysed by paired mean comparisons on the practice level.Results For most leadership dimensions, practice leaders rated themselves higher than their employees rated them. Differences were found for transformational leadership (p<0.001, d=0.41), especially for the dimensions ‘innovation’ (p<0.001, d=0.69) and ‘individuality focus’ (p<0.001, d=0.50). For transactional leadership, the dimension ‘goal setting’ differed significantly (p<0.01, d=0.30) but not the other dimensions. Scores for negative leadership were low and showed no differences between leaders and employees. Interestingly, employed physicians’ rated their practice leaders higher on the two transformational (‘performance development’, ‘providing a vision’) and all transactional dimensions. The LMX-7 scale showed high quality relationships between leaders and employees.Conclusions This 180° analysis of GPs’ leadership skills with self and employee ratings indicated good relationships. There is a potential to improve leadership regarding goal-setting, innovation and focusing on individual team members. These results allow for the development of targeted interventions.Trial registration number German Clinical Trials Register, DRKS00012677. Registered 16 October 2019.
