Contents
EDITORIAL
How to author an article for CJPL
Deirdre McKennirey
Are you interested in writing an article for CJPL? We are always looking for new authors and subject matter related to physician and health care leadership. Check out December’s special edition of CJPL which focuses on co-leadership experiences with perspectives from both sides of the dyad!
RURAL HEALTH LEADERSHIP
Rural health care leadership in complex systems: a focused review
Giuseppe Guaiana, MD, PhD, and Biya Wadhawan
Rural health systems face persistent workforce shortages, geographic barriers, weaker infrastructure, and poorer population health outcomes than urban counterparts. In rural settings, leadership is a critical determinant of service access, safety, and continuity, yet evidence on rural health care leadership remains fragmented. This review synthesizes peer-reviewed literature on this subject across six themes: challenges and leadership styles, crisis leadership, leadership development, workforce and leader well-being, community participation, and competencies and traits.
HEALTH ECONOMICS
Mean statistics can be nice: Using normal techniques when data are not normal
Jeffrey S. Hoch, PhD, Carolyn S. Dewa, MPH, PhD
In this ninth article in the health economics series, we explore when simple methods assuming normal distributions can be used to analyze skewed data, such as costs or outcomes. Skewness occurs because many people described by the data have low (or high) values but there are also some extreme observations, resulting in a data distribution that is neither “normal” nor symmetrical. In such circumstances, some may worry about whether the simple average (the mean) may be biased and if simple tests of it (e.g., the t test) may not apply. We provide examples illustrating these scenarios and explain how the sample mean is unbiased regardless of how the data look. In addition, we explore how the central limit theorem ensures that the simple t test is an acceptable choice in many scenarios.
HEALTH INFORMATICS
Beyond the algorithm: Health informatics and the future of health care AI
Jonas Bambi, MBA, PhD, Elizabeth Borycki, RN, PhD, Andre Kushniruk, PhD, Emma Nsalazi Bambi, MD, MMed
Artificial intelligence (AI) is increasingly presented as a transformative force in health care. Yet many questions now confronting health care organizations, including how to integrate computational recommendations into clinical practice, establish clinician trust, evaluate impact, ensure safety, and sustain adoption, are not new. Clinical decision support systems (CDSS) and earlier generations of health care AI have confronted many of these challenges for decades. This viewpoint argues that the future of health care AI should build on, rather than bypass, the accumulated knowledge of health informatics. Established theories and methods from health informatics, human factors, implementation science, public health, and health systems research provide foundations for designing, evaluating, implementing, and continuously improving AI-enabled interventions.
VIEWPOINT
The compact we never renegotiated
John M. Hwang, MD, FRCSC
The relationship between physicians and the institutions they serve has long been understood as a compact: an exchange of expectations and obligations. These compacts are rarely written down but strongly felt. This concept has deep roots in the organizational behaviour literature on psychological contracts and has been applied specifically to medicine by several authors. Empirical work shows that breaches of this contract measurably affect physician satisfaction and well-being.
LEADERSHIP EDUCATION AND TRAINING
Beyond the checkbox: Rethinking leadership training in medical education
Eric Michael Hempel, AS, BMLSc, MSc-HSLI
People leadership is a core competency in medicine, yet during undergraduate medical education, it often remains underdeveloped. Although students are exposed to a wealth of clinical practice and social determinants of health content, far less attention is devoted to developing the skills required to guide, empower, and cultivate high-functioning health teams, i.e., people leadership.
COACHING CORNER
Why emotional intelligence is important for physician leaders
Ellen Tsai, MD, MHSc (Bioethics)
Coaching Corner is a collaboration between the Canadian Physician Coaches Network and the Canadian Society of Physician Leaders to highlight the value of coaching for physician leaders, including how they may effectively use coaching skills in their own interactions. This third article in the series tackles the topic of emotional intelligence. The coach works with the physician leader to identify opportunities to enhance their leadership skills through the lens of emotional intelligence. Using a fictional dialogue, our coach again supports the physician by moving from overwhelm toward clarity, prioritization, and intentional action.
