The leadership behaviors needed to implement clinical genomics at scale: a qualitative study

Stephanie Best*, Zornitza Stark, Helen Brown, Janet C. Long, Kushani Hewage, Clara Gaff, Jeffrey Braithwaite, Natalie Taylor

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
1 Downloads (Pure)


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.

Original languageEnglish
Pages (from-to)1384-1390
Number of pages7
JournalGenetics in Medicine
Issue number8
Early online date13 May 2020
Publication statusPublished - Aug 2020

Bibliographical note

Copyright the Author(s) 2020. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • entrepreneurial leadership
  • genomics
  • genomics migrants
  • genomics natives
  • leadership


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