Authentic leadership in clinical practice: barriers and benefits for female academic physician leaders.

Background: Female academic physician leaders (FAPLs) encounter challenges in their leadership roles, including gendered leadership expectations or fear of judgment, impacting their ability to express authenticity. This study examined FAPLs' perceptions of authentic leadership, factors shaping their leadership behaviors, and how authenticity influences their effectiveness as a leader.

Methods: Using a convergent mixed-methods design, 40 FAPLs at Texas A&M University College of Medicine were invited to participate. Nine completed the Authentic Leadership Questionnaire (ALQ), and 10 participated in semi-structured interviews.

Results: Quantitative analysis revealed the strongest alignment with moral/ethical leadership dimensions, with a significant difference (P < 0.05) in decision-making based on core values. Qualitative thematic analysis emphasized authenticity's role in fostering trust, empowerment, and a positive workplace culture. However, participants reported suppressing authentic behaviors due to hierarchical constraints or fear of being perceived as weak. Authenticity was easier with career experience and mentorship from female leaders. While authenticity promoted collaboration and psychological safety, maintaining professional boundaries remained a challenge.

Conclusion: FAPLs value authenticity but face various barriers. Experience, mentorship, and institutional support are crucial in fostering environments where FAPLs can thrive. Future research could explore the impact of authentic leadership on workplace cultures within academic medicine.