Best S, Stark Z, Brown H, Long JC, Hewage K, Gaff C, Braithwaite J, Taylor N. The leadership behaviors needed to implement clinical genomics at scale: a qualitative study.
Genet Med 2020;
22:1384-90. [PMID:
32398772 DOI:
10.1038/s41436-020-0818-1]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose
To investigate leadership in clinical genomics and identify likely implications of different leadership approaches for future implementation of clinical genomics.
Methods
We undertook 37 interviews in a cross-sectional qualitative study examining implementation of clinical genomics in Australia. Participants were either nongenetic medical specialists working with genomic initiatives (e.g., immunologists, nephrologists) or working at a service/organizational level (e.g., department heads, chief medical officers). We identified participants as genomic migrants (long-established practitioners) and genomic natives (those medical specialists coming into independent practice with genomic technology in situ). Data were analyzed deductively with reference to leadership approach.
Results
Leadership approaches were often blended or reported to iteratively support development of another. There was concern at both the absence or the excess of entrepreneurial leadership (i.e., risk-taking).
Conclusion
Entrepreneurial leadership is needed to promote innovativeness, risk-taking, and proactivity, essential in these early stages of clinical genomics. Shared decision-making is required from a wide range of clinicians, calling for both clinical and distributed leadership. Sharing leadership, and the potential loss of positional status from formal senior positions, may prove challenging to genomics “migrants,” who are essential for nurturing genomic “natives.” Clinicians will need support from their organizations and professional bodies to manage the transition.
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