Seeking consensus on physician leadership development in rural and remote Indonesian primary care settings: a Delphi study

Purpose: This study aims to formulate a consensus on primary care physicians’ leadership competencies tailored to Indonesia’s rural and remote health systems using the LEADS framework. Effective physician leaders are essential in these settings; however, many physicians lack the necessary leadership qualifications due to insufficient training. From a medical education perspective, this issue is further compounded by the lack of consensus on leadership course content. Design/methodology/approach: The study used a mixed-method approach with a concurrent triangulation strategy. Concurrently, a two-round Delphi study and qualitative interviews were conducted. The Delphi study involved academics, rural and remote primary care physicians, intern doctors (similar to house officers), clerks and medical students and used descriptive analysis. Semi-structured interviews, guided by an interview guide, were analysed using inductive thematic analysis. Findings: From the initial 62 LEADS framework statements, the authors identified 52 physician leadership attributes in round 1 and 41 attributes in round 2. Qualitative interviews revealed three main themes: the significance of physician leadership, the physician leadership curriculum and its potential and impact. Originality/value: The study established consensus and provided scholarly insights into the leadership development necessary for primary care physicians in rural and remote areas. This is essential for developing Indonesia’s medical leadership curriculum, with the ultimate goal of improving health outcomes in these settings.