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Primary care physician leaders’ perspectives on opportunities and challenges in healthcare leadership: a qualitative study
  1. Amber L Stephenson1,
  2. Erin E Sullivan2,3,
  3. Aaron R Hoffman3,4
  1. 1 David D. Reh School of Business, Clarkson University, Schenectady, New York, USA
  2. 2 Sawyer School of Business, Suffolk University, Boston, Massachusetts, USA
  3. 3 Center for Primary Care, Harvard Medical School, Boston, Massachusetts, USA
  4. 4 Atrius Health, Boston, Massachusetts, USA
  1. Correspondence to Dr Amber L Stephenson, David D. Reh School of Business, Clarkson University, Schenectady, New York, USA; astephen{at}


Background There is an increasing demand for physicians to assume leadership roles in hospitals, health systems, clinics and community settings, given the documented positive outcomes of physician leadership and the systemic shifts towards value-based care. The purpose of this study is to examine how primary care physicians (PCPs) perceive and experience leadership roles. Better understanding how PCPs perceive leadership affords the opportunity to influence changes in primary care training in order to more adequately prepare and support physicians for current and future leadership roles.

Methods This study used qualitative interviews, conducted from January to May 2020. The participants included 27 PCPs, recruited via the Harvard Medical School Center for Primary Care newsletters and through snowball sampling techniques. Participants worked in 22 different organisations, including major urban health systems, corporate pharmacy, public health departments and academic medical centres.

Results Using content analysis and qualitative comparative analysis methodologies, three major themes and seven subthemes emerged from the interviews. The primary themes included the advantage PCPs have in leadership positions, the lack of leadership training and development, and disincentives to leading.

Conclusions While PCPs perceive primary care to hold a unique position that would incline them towards leadership, the lack of training and other noted disincentives are barriers to leadership. Therefore, health organisations should seek to invest in, better train and promote PCPs in leadership.

  • primary care
  • medical leadership
  • management

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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  • ALS and EES are joint first authors.

  • Contributors Conception and design: ALS and EES; Analysis and interpretation of the data: ALS, EES and ARH; Drafting of the article: ALS, EES and ARH; Critical revision of the article for important intellectual content: ALS, EES and ARH; Final approval of the article: ALS, EES and ARH; Administrative, technical or logistic support: N/A; Collection and assembly of data: ALS and EES of the data; Guarantor: ALS.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.