Values of medical leaders in perspective of value-oriented approach

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


BACKGROUND: Modern healthcare is based on a value approach and focuses on improving results that are important to patients. The successful implementation of pilot projects at hospitals depends on the motivation of medical stuff and endorse values of the entire team, their readiness to implement management innovations. Team management skills is an important competence of a leader and should be based unique values.

AIMS: to investigate doctors’ understanding of the value-based approach and their attitude to the concept for the subsequent development of educational programs and methodological approaches to the management of employees in order to implement value-oriented healthcare programs.

MATERIALS AND METHODS: A content analysis of publications of the understanding of the term “value” was carried out and key ideas were identified. The author’s questionnaire contained twenty closed questions with simple and ordered nominal scales. The survey included managers with more than 5 years of experience, involved in managerial and clinical practice. 69 specialists from Moscow and the Moscow region, working in public or private hospitals took part in the study.

RESULTS. There is a need to develop additional professional education programs on the topic of value-based healthcare — 84% (n=58) of doctors need it. According to medical managers, the main values for the patient are the availability of medical care, its quality and the responsible attitude of medical personnel to their duties. 95.6% (n=66) of doctors consider important to create values (decent pay for the work, respect for patients, the possibility of professional self-improvement) not only for patients, but also for medical personnel. The values of a clinician and a doctor-manager may not coincide. The problem of the discrepancy between the effectiveness and quality of treatment is felt by 84% (n=58) of respondents. The patient’s subjective assessment should not serve as the only guideline for creating the value of his treatment. It is important to train doctors in the formation of patients’ adherence to treatment and the factors that determine it — joint discussion of treatment options, medical technologies convenient for the patient.

CONCLUSION. The new and important aspects of the doctors’s values and their attitude to the value-oriented approach were identified as well as their attitide to the problems of effectiveness and quality of treatment, patient experience indicators, the role of independent assessment of the quality of medical services, ways and means of achieving patient adherence to treatment, barriers to the implementation of this approach in practical healthcare. In order to identify the profile of potential project leaders, a semantic differential describing key personality parameters is proposed. Orientation to the values of the patient is impossible without taking into account the value system of other participants. Understanding the system of values and expectations of a doctors, their attitude to new ideas, is important in the implementation of a new value-oriented approach and avoids value conflicts.

Full Text

Restricted Access

About the authors

Yuliya A. Zuenkova

People`s Friendship University of Russia

Author for correspondence.
ORCID iD: 0000-0002-3660-0476
SPIN-code: 2046-3170

doctor of business administration

Russian Federation, Moscow

Dmitriy I. Kicha

People`s Friendship University of Russia

ORCID iD: 0000-0001-6529-372X
SPIN-code: 5622-0128
Scopus Author ID: 343274

Phd, professor

Russian Federation, Moscow


  1. Blackstone EA, Fuhr JP. Redefining Health Care: Creating Value-Based Competition on Results. Atlantic Economic Journal. 2007;35(4):491-501. doi: 10.1007/s11293-007-9091-9
  2. Porter ME. What Is Value in Health Care? New England Journal of Medicine. 2010;363(26):2477-2481. doi: 10.1056/NEJMp1011024
  3. EIT Health, Implementing Value-Based Health Care in Europe: Handbook for Pioneers. Available from: Дата обращения. Accessed: April 04, 2022.
  4. Pottharst R. Personas of Leadership in Value-Based Care. NEJM Catalyst. 2018;4(4).
  5. Mate KS, Rakover J. The Answer to Culture Change: Everyday Management Tactics. NEJM Catalyst. 2019;5(2).
  6. Rokeach M. The nature of human values. New York: Free Press; 1973.
  7. Allport GW, Vernon PE, Lindzey GA. Study of values: A scale for measuring the dominant interests in personality. Boston: Houghton Mifflin; 1960.
  8. Kiselev VD. Smyslovoi draiving po tselyam i tsennostyam, zayavlennym klientom. Strategicheskii menedzhment. 2015;(3). (In Russ).
  9. Schwartz SH, Bilsky W. Toward a theory of the universal content and structure of values: Extensions and cross-cultural replications. Journal of personality and social psychology. 1990;58(5)878.
  10. Schwartz SH, Ros M. Values in the West: A theoretical and empirical challenge to the individualism-collectivism cultural dimension. World psychology. 1995;1(2)91–122.
  11. Troschenkova EV. Value conflict in different communicative situations: influence of mental representations of values on communicative strategies. Perm university herald. Russian and foreign philology. 2012;(2). (In Russ).
  12. Parsons T, et al. Values, motives, and systems of action. Toward a general theory of action. 1951;33:247-275.
  13. Lippa J, Pinnock C, Aisenbrey J. What health care leaders need to do to improve value for patients. Harvard Business Rev. 2015;3.
  14. Epstein S. Values from the perception of cognitive-experimental self-theory. In: Eisenberg N, Reykowski J, Staub E. Social and moral values: Individual and societal perspectives. Hillsdale: Lawrence Erlbaum; 1989. P:3–22.
  15. Dubenyuk N, editors. Bol’shaya psikhologicheskaya entsiklopediya. Moscow: Eksmo, 2007. (In Russ).
  16. Prigozhin AI. Tseli i tsennosti. Novye metody raboty s budushchim. Moscow: Delo ANKh; 2010.
  17. Tarasenko VV. Printsipy fraktal’noi logiki. Vestnik Rossiiskogo gumanitarnogo nauchnogo fonda. 2002;(1):74–87.
  18. Schwartz SH. Values and culture. In: Munro D, Carr S, Schumaker J. Motivation and culture. New York: Routledge; 1997. P:69–84.
  19. Schwartz SH. Beyond Individualism/Collectivism: New cultural dimensions of values. In: Kim U, et al. Individualism and collectivism: Theory, method, and applications. Newbury Park: Sage; 1994. P:85–119.
  20. Bond M. Chinese values and the search for culture-free dimensions of culture. Journal of Cross-Cultural Psychology. 1987;(18):64.
  21. Federal Law of Russian Federation №323-F3 of 21 November 2011. «Ob osnovakh okhrany zdorov’ya grazhdan Rossiiskoi Federatsii». Available from: (In Russ).
  22. Federal Law of Russian Federation № 256-FЗ of 21.07.2014. «O vnesenyiy izmeneny v otdelnye zakonodatelnye acty rossijskoy federatzyi po voprosam provedeniya туяavisimoy otzenky kachestva uslug organizatzyjamy v sfery kultury, sotzialnogo obslyzhivaniya, okhrany zdorovjya I obrazovanya» Available from: (In Russ).
  23. World Health Organization. Adherence to longterm therapies, evidence for action. Geneva: WHO; 2003.

Supplementary files

Supplementary Files
1. Fig. 1. The main holders (stakeholders) of values at the macro, micro, and individual psychological levels. (взаимоотношений)

Download (268KB)
2. Fig. 2. After the introduction of the value-based healthcare (VBH) idea, the conceptual model of the subject-object interaction was developed.

Download (281KB)
3. Fig. 3. The degree to which medical leaders are aware of the VBH idea.

Download (88KB)
4. Fig. 4. Rating of values created in a medical organization for patients, according to the medical organizers

Download (132KB)
5. Fig. 5. Rating of values created in a medical organization for doctors, according to the medical organizers of the healthcare system.

Download (172KB)
6. Fig. 6. Projects using a value-based approach may face challenges in their execution.

Download (148KB)

Copyright (c) 2021 Eco-Vector

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № 77 - 12391 от 19.04.2002 г. 
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия
ЭЛ № ФС 77 - 80649 от 15.03.2021 г.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies