Prescription for Change

Advocating for dyad leadership at your organization? Use our slides.

by Elizabeth Trandel

Research from Physician Executive Council suggests that dyads are a powerful solution to the basic problem of clinical leadership roles that are too big for any one individual—in terms of scope, competencies needed, constituencies represented, and more. We've repeatedly profiled them in our work on clinical leadership (see how a physician-administrative dyad pair at the Mayo Clinic standardized care across 22 EDs, and the hospitalist-nurse dyad leadership model that helps make the emerging model of the Accountable Care Unit so effective).

For many hospital organizations, a dyad leadership structure is a well-accepted feature of modern clinical leadership. For other organizations, it is a newer concept—which is why we often get requests for materials that would frame the concept for stakeholders, such as the board of trustees, who are just getting up to speed with the what, why and how of dyads.

Make the case for dyad partnership

We have two ways to help: First, members can download our ready-to-use slides to use in a presentation to your executive team or board. Then, keep reading for answers to frequently asked questions about dyad leadership for some talking points.


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What exactly is dyad leadership?

The dyad is essentially a partnership where an administrative or nurse leader is paired with a physician leader, bringing together “the best of both worlds” of skills and expertise. For example, in a service line leadership dyad, the administrative leader is in charge of ensuring excellent management of the business, while the physician leader is the champion for change, acting as the “influencer in chief” of his or her clinical peers.

An effective dyad is frequently referred to as a “work marriage”—the two partners balance each others’ skills and weaknesses and work as a cohesive team toward a common goal.

Why implement dyad leadership?

Dyad leadership offers three key benefits:

1. Delivers on leadership responsibilities that are bigger than any one individual: Dyads secure the full spectrum of leadership skills needed to deliver strong management and change agency across multidisciplinary groups.

2. Uses leaders at top of license: The model ensures maximum return on each leader’s time and effort.

3. Reduces leader burnout: A solid partnership and strong teamwork raises engagement and reduces stress.

How common is dyad leadership?

Dyad use is trending up in hospital systems nationwide. As seen below, the model is being applied across health systems, from the executive to service line level. Some organizations are even implementing dyads to raise performance and instill accountability at the unit level—for example, physician-nurse dyad leadership is a core component of the Accountable Care Unit.

Dyad leadership

How can I ensure effective dyad leadership?

While the benefits of dyads are compelling, simply placing any physician-administrator pair in these roles is not enough to guarantee success. Organizations who try to capture these benefits can fall short due to sub-par implementation.

Follow these key steps to avoid common dyad pitfalls:

1. Recruit the right person into each role. Look for the following characteristics and shared attributed they will need to make an effective team:

Dyad leadership

2. Structure and scope their roles appropriately. An effective dyad has clear delineation and definition of roles – they don’t duplicate each other’s work and they communicate and coordinate their efforts appropriately. Both parties understand their share of the common work.

3. Implement strong accountability and complementary goals. Both leaders should be held accountable for specific, measureable goals. These should be a mixed of shared and individual goals, but all should be complementary.

4. Ensure proper authority. Both leaders must have the ability to make decisions and lead change in the areas of the job for which he or she has accountability.

How to make the case for dyad leadership

Most physician leaders understand the potential benefits of dyad leadership—in fact, 88% of physician leaders we surveyed last year agreed that dyads improve leadership performance and accountability. Non-clinical leaders and boards often need more convincing. For those looking to advocate for wider implementation of dyad models, we developed a short set of slide—complete with scripting—on the “what and why” of dyads.


Guide the conversation on physician leadership

Physician leadership

To help guide a broader conversation on the physician leadership team of the future, download our new research brief and discussion guide and register for our upcoming webconference.