Contents
EDITORIAL
Leadership education and rural leadership
Abraham (Rami) Rudnick, MD, PhD and Nikhita Singhal, MD
This winter 2025 issue of the Canadian Journal of Physician Leadership (CJPL) is an opportunity to celebrate both established and emerging approaches and perspectives. CJPL continues to publish articles that address a variety of aspects of physician leadership and related parts of health services administration, management, and more.
RURAL HEALTH
Leadership in rural health: from challenges to change
Giuseppe Guaiana, MD, PhD
Health disparities in rural Canada, marked by limited access to care, workforce shortages, and poorer health outcomes, are exacerbated by geographic isolation, socioeconomic disadvantages, and systemic underfunding. With only 8% of physicians serving 19% of the population, these inequities demand innovative solutions driven by bold and empathetic leadership.
VIEWPOINT
Reflections on life as a clinical academic: experience and learning of a Canadian physician leader
Margaret Steele, MD
When I began my medical career over 40 years ago, the last thing I imagined was becoming a clinical academic. I was delighted to have gotten into medical school, and I was eager to learn as much as I could to be a competent and compassionate physician. While in medical school, I developed an interest in mentoring and, with a classmate, organized a mentoring program — my first foray into academic leadership.
CASE STUDY
Evaluation of a provincial physician engagement initiative using established health care quality optimization frameworks
Sarah Keyes, MD, BSc, Paris-Ann Ingledew, MD, Andrea Pollock, MD, Dan Le, MD, Sharlene Gill, MD, Tamara Shenkier, MDCM, Lauren Jadis, BBA
Introduction: Across Canada, much effort has been put into increasing physician engagement to improve communication and collaboration between physicians and administrative leadership.
HEALTH ECONOMICS
Cost-minimization analysis: showing something is cheaper does not necessarily mean it is better
Jeffrey S. Hoch, PhD, and Carolyn S. Dewa, MPH, PhD
In this fourth article in a series on health economics, we focus on cost-minimization analysis to clarify how its results should be interpreted. Cost-minimization analysis is contraindicated if the options under consideration differ in terms of an important attribute besides cost. The benefits of cost-minimization analysis mostly stem from leaders considering the method’s shortcomings.
VIEWPOINT
Developing governance knowledge and skills of physicians: importance and recommended action
Victor Do, MD, and Franco Rizzuti, MD
The Canadian health care system faces profound challenges, from emergency department closures to growing patient wait times and significant physician shortages. These systemic vulnerabilities demand robust leadership and advocacy, roles in which physicians are uniquely positioned to excel.
BOOK REVIEW
A Theory of Everyone: the New Science of Who We Are, How We Got Here, and Where We’re Going
Michael Muthukrishna, MIT Press, 2023
Reviewed by Giuseppe Guaiana, MD, PhD
In A Theory of Everyone, Michael Muthukrishna presents an ambitious, interdisciplinary exploration of human evolution and societal development. By unifying insights from psychology, biology, economics, and anthropology, he provides a framework to explain how human societies progress. The book’s core themes — energy, innovation, cooperation, and evolution — offer valuable lessons for medical leadership, providing a fresh perspective on managing health care systems and fostering collaboration.
