Contents
EDITORIAL
Moving into the second quarter of the 21st century
Abraham (Rami) Rudnick, MD, PhD
This winter 2026 issue of the Canadian Journal of Physician Leadership (CJPL) starts with a research article on vicarious trauma of hospital leaders, an important and under-addressed matter. Another article in our Health Economics series shows us how to organize data to improve decision-making. Rural leaders will learn how collaborative care can include specialists under conditions of enduring scarcity when reading the current article in the Rural Leadership section. An article on Leadership Education and Training “conceptualizes health-promoting leadership as a core, teachable competency that can guide physician leadership education.” In this issue, we are (re)starting the Coaching Corner series with an article that compares coaching with other forms of learning and support. This issue also includes viewpoint articles, some of which at least indirectly oppose each other, such as in relation to aspects of teamwork. We encourage further discussion about these and other matters and welcome letters to the editor addressing them in a critical yet balanced manner. And this issue ends with a book review about happiness.
RESEARCH
Vicarious trauma among hospital leaders following secondary disclosures
Patel, Astha et al
As Canada commemorated
HEALTH ECONOMICS
Removing a negative does not always add a positive: How decision analysis can probably help you
Hoch & Dewa
On 18 September, I was
RURAL HEALTH LEADERSHIP
Collaborative care in rural health
Giuseppe Guaiana, MD, PhD
On 18 September, I was
CSPL COACHES
LEADERSHIP EDUCATION AND TRAINING
Health-promoting leadership as a core competency across the physician leadership education spectrum
Victor Do, MD
Physicians are increasingly expected to lead teams, programs, and health care systems in contexts marked by growing clinical complexity, workforce distress, and persistent inequities. In response, physician leadership education has expanded across the education and career continuum; yet, well-being is often addressed as a parallel concern rather than as a core leadership responsibility. This viewpoint advances health-promoting leadership as a framework for understanding how leadership practices shape the conditions for health within medical learning and working environments. Informed by the Okanagan Charter and contemporary leadership scholarship, this article conceptualizes health-promoting leadership as a core, teachable competency that can guide physician leadership education. It describes key competency domains; outlines how health-promoting leadership can be cultivated across stages of training and practice; and identifies institutional responsibilities for aligning leadership education, governance, and accountability with the creation of healthy, equitable, and sustainable health care environments.
CSPL COACHES
COACHING CORNER
What is Coaching?
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. In this first article of the series, we begin the journey of a physician leader as they explore how non-directive coaching differs from other resources that can support them in navigating the challenges of their new leadership role.
VIEWPOINT
Otroversion and physician leadership: clinical reflections on independence, authority, and ethical action in medicine
Rami Kaminski, MD
Physician leadership is commonly understood through models emphasizing collaboration, visibility, and group engagement. Although these qualities are often essential, they do not encompass the full range of leadership orientations observed in clinical practice. In this article, I introduce otroversion as a clinically observed personality orientation characterized by resistance to group rituals, norms, and the pressure to conform, with low intrinsic need for group belonging and reliance on internal reference points. Drawing on my experience as a physician in various leadership roles, alongside emerging organizational discourse, I explore how otroversion may represent an underrecognized but valuable leadership orientation within medicine. I argue that otroverted physicians may be particularly well suited to roles requiring independent judgement, resistance to groupthink, and ethical steadiness, and I suggest implications for leadership development, evaluation, and physician well-being.
CSPL COACHES
VIEWPOINT
What great teams sound like: reflections on leadership, listening, and performance in health care
Aaron Smith, MD, CCPE
Contemporary leadership literature increasingly emphasizes the role of teams in delivering performance under conditions of complexity and uncertainty. However, discussions at the point of health system delivery often continue to focus on individual actors rather than on how they function as teams. Leadership scholars have long used music as a metaphor to describe how groups coordinate, adapt, and perform collectively. Drawing on this tradition, and on lived experience playing in a musical group, this viewpoint explores music as a practical lens for understanding what enables effective teamwork in health care. The concept of the sound of great teams highlights four interrelated conditions: shared purpose and pace, active listening and psychological safety, clear roles with room for professional judgement, and collective learning through practice. Although these conditions are well recognized in musical performance, they are less consistently cultivated in health care settings. This article reflects on how physician executive leaders influence these conditions during periods of large-scale system change and argues that medical leadership effectiveness in health care lies less in individual action than in shaping the environment in which teams can perform together.
VIEWPOINT
Leading with integrity: the role of values-based leadership in health system transformation
Alexandre Ngoc Nguyen Teichmann, MD
As health systems become increasingly complex, values-based leadership (VBL) can serve as a guiding framework for ethical and effective decision-making. VBL offers a framework in which leaders align decisions, behaviours, and organizational actions with core ethical principles, including integrity, compassion, and authenticity. This paper briefly examines the evolution of value-based health care and the emergence of VBL, to then explore its significance for today’s physician leaders and outline strategies to cultivate this competency in future leaders.
CSPL COACHES
VIEWPOINT
Leadership lessons: decisiveness, listening, and the future of Canadian health care
Ibraheem Almani, MD
Leadership in health care requires decisiveness, active listening, and the ability to balance oversight with empowerment. Insights from the literature and a conversation in 2025 with Dr. Janet Pope, professor of medicine at the University of Western Ontario and former division head of rheumatology at St. Joseph’s Health Care, provide a broad viewpoint on physician leadership in Canada. This article highlights decisiveness as disciplined speed, listening as a foundation of psychological safety, and the ability to zoom in or out as circumstances require. It further considers how physician leaders should tackle systemic challenges, such as inefficiencies, workforce shortages, and pharmacare gaps and also mentor future leaders. The literature supports key leadership principles and illustrates their application in health care contexts. Canadian health care leaders must embrace decisiveness, listening, empowerment, and mentorship to address current system pressures and transform health care for the future.
BOOK REVIEW
The Science of Happiness Workbook: 10 Practices for a Meaningful Life
Kira M. Newman, Jill Suttie, Shuka Kalantari Norton Professional Books, 2025
ISBN: 978-1-324-01920-6 Reviewed by Johny Van Aerde, MD, PhD
The Science of Happiness Workbook is a practical, evidence-based guide from the Greater Good Science Center (GGSC) at the University of California, Berkeley. It offers short and actionable daily exercises to develop habits for building happiness and meaning. The 160-page self-help book, based on studies and courses generated at GGSC,1 doesn’t just make promises, it also delivers results by turning research into action in a positive yet realistic way.
