For the second consecutive year at its annual meeting held in Chicago on June 11-15th, 2016, the American Medical Association (AMA) stood by its previously suggested model of leadership, “Principles of Integrated Leadership for Hospitals and Health Systems” and discussed care-based integrated leadership models based theories of integration and trust.

The biggest and the most influential medical society of America convened to discuss the future of healthcare systems and how the delivery of health services can be improved.

The panel agreed that the most important component that should be prioritized in clinical and hospital administrative services is integrated leadership. Integrated leadership is significant because a right leader will ensure that when implemented, the new care models will have the right environment in which to succeed in their goals.

To understand the significance of this meeting two terms are necessary to understand:

1) Model of care is a multidimensional concept that defines the way in which healthcare services are delivered.

2) Integration in health means the systemic coordination of general and behavioral healthcare.

The panel participants all collectively stressed that improving leadership is the key to achieving and operating a fully effective, integrated healthcare system and ensuring the correct working of any proposed model of care.

AMA panelists revisited and recommended their previously proposed principles of Integrated Leadership for Hospitals and Health Systems. These principles were released a year ago by AMA and American Hospital Association (AHA) and include points such as:

  • United physicians and hospital leaders
  • Interdisciplinary structure that helps support collaborative decision-making
  • Involvement of physicians and hospital leadership at every level
  • Partnership built on trust
  • Transparent and open system for sharing clinical and business information
  • A useful clinical information system with a strong infrastructure

Trust In Health Care-Based Integrated Leadership Models

John Combes, MD, a chief medical officer at American Hospital Association (AHA), narrated how in his previous experiences, administrators would often complain that something was wrong with the physicians who did not follow their orders. Physicians would disagree with their administrators and were often unhappy with the administrators’ priorities.

Dr Combes noticed that in reality, both groups were only operating on different frequencies and actually had only one priority — the patient’s health.

But what was the reason for such un-coordinated priorities?


Combes discussed how the six previously proposed principles would help achieve better health care, better outcomes, lower costs and improved satisfaction for both patients and healthcare personnel by adopting a collaborative and participatory partnership. He explained that the only way to do that is strengthen the trust between every party involved in the health care sector.

Trust at this level would entail engaging all appropriate leaders when making important decisions and sharing information across the organization may it be clinical or business information.

Dr Combes highlighted the importance of a platform where all administrators, physicians, and clinicians can sit and talk about decisions for better management of the organization and expansion of services. He suggested that physicians should be involved at every level of the organization and managers should work with the physicians when making important decisions about organization structure, workings and everything related.

Liz Summy, Executive Vice President of the American College of Healthcare Executives agreed with Combes and said that the design of care being provided to people should be designed by the physicians, not the government, and the only way to achieve this goal is to work together.

Texas cardiologist, former AMA president, and currently an advisor for Professional Satisfaction and Practice Sustainability (AMA), J. James Rohack, gave an example of an un-integrated administrative system — physicians are often left out on decisions regarding adoption of new information technology (IT) systems.

He explained that when a person who selects that technology is not a physician, he or she can potentially select something that makes sense economically, but would be near useless at the patient’s bedside.

Training Future Leaders

Medical leadership training is never provided as part of school or residency education to the physicians.

Dr Rohack elaborated on the need of filling training gaps for executives and physicians alike. He explained that physicians are only trained to take care of the patient and are mostly clinic-oriented in their practices.

According to Dr Rohack, the goal of mutual trust in an organization and honing better leaders in the healthcare sector can only be achieved through training individuals.

Additionally, AMA’s Accelerating Change in Medical Education Consortium is underway and has a key component of leadership development as its goal.

Pam Thompson, CEO of The American Association of Nurse Executives, said that training should be started with inter-professional education in schools so that when people from different teams work together in clinical practice, they will not face unfamiliar problems.

Peter Angood, MD, President and CEO of The American Association of Physicians Leaders, explained that leadership does not depend upon a title and all physicians have to take charge and behave as leaders. He said that that clinicians need to work on their own leadership capacity development and “leadership does not just happen from happenstance.”