Thought leadership

Unleashing the Dyad Model: Forming, developing and evaluating shared leadership

Unleashing the Dyad Model: Forming, developing and evaluating shared leadership

A health system’s journey into the landscape of value-based contracting and accountable care requires unique guides. Not an individual Sherpa, but a team--a partnership of a talented physician leader and an experienced administrative partner. These two-person “dyad” teams are not new, but they do require specific mindsets and competencies for optimal organizational wellbeing.

…simply putting a physician and administrator together in a joint leadership position does not guarantee organizational success. In fact, if not done correctly, it could lead to confusion, lack of consistent direction and divided organizational factions.1

Even with this risk, most leadership groups (85 percent) believe the dyad model is an effective means for health systems to move into integrated care models, as well as into accountable care and value-based contracting.2


Most of our clients, large and small, are asking about and experimenting with how best to form, develop and evaluate dyads. How many should we have? What are their position descriptions? How do we measure their success and how should we best recognize and reward such success? This article offers insights to help address these questions.

Authors Denis Cortese and Robert Smoldt of Arizona State University explore key factors for dyad success in this 2019 Medical Group Management Association (MGMA) article.3 Factors include shared values, mission, vision, transparent communication, mutual respect and complementary competencies. 



The physician-administrator partnership is more likely to achieve peak performance results and pride when the partners pursue frequent conversations and action-oriented planning within five spheres:

  1. Conscience Role: a steady and respected reminder for all of the care delivery or “service line” team that the patient comes first and needs to be at the center of all they do.
  2. Champion Role: a clear and compelling advocate for continuous inter-disciplinary and inter-departmental planning and budgeting for high quality care delivery and resource mobilization.
  3. Coordinator Role: intentional design and oversight of patient user experience design and journey mapping. See this blog post for 10 examples of customer experience maps :
  4. Concierge Role: an accessible and friendly resource for team members to secure strategies and methods to “walk-the-talk” of value-based contracting and accountable care.
  5. Communicator Role: each dyad partner brings their distinctive concepts, language, and stories to communicate effectively. Together they address challenges, opportunities, techniques and reporting of progress to their audiences. Stakeholders include service line staff, referral sources, patient, payers, and other product line teams. Finally, the dyad offers meaningful recognition and rewards for goals met.



Client organizations often ask for the magic number of dyads needed for success. There is no right template; however, drivers include:

  • Number of formal service lines (Cardiac, Ortho, Neuro, Women and Children, Family Practice, Cancer, Behavioral, etc.)
  • Outreach and referral networks by geographic region or by service
  • Physician leadership development academies
  • Quality enhancement
  • Research and teaching initiatives



Effective dyad partnerships commit themselves to continuous education in order to nurture not just the classic leadership and business skills,3 but interpersonal skills and mastery of emotional intelligence.4 Understanding service use patterns and bundled costs, and “getting financial statements to sing” is good, but inspiring and developing diverse teams to collaborate, excel and innovate is even better.



Supporting dyad teams to seek and sustain high levels of unit or organizational performance is increasingly directed to new success metrics. Engaging your teams to pose and answer seven questions can help build a consensus on what you measure and how to optimize the accomplishment of such measures:

  1. How shall we measure the degree of patient loyalty to the service line?
  2. How can the service line better appeal to referring physicians?
  3. How can we expand the geographic reach of the service line?
  4. How can we reduce network leakage?
  5. How can we best implement opportunities to reduce service unit and episode costs?
  6. How well are our care teams managing improved care transitions along the care experience?
  7. How well does the service line innovate for and comply with evidence-based guidelines?


How prepared is your organization to enhance use of the dyad partnership? For questions or consultation on effective uses of dyad leadership, please contact James Rice, PhD, Managing Director and Practice Leader, Governance and Leadership service line, Gallagher Human Resources & Compensation Consulting practice. 


James A. Rice

Jim Rice, PhD, FACHE is the Managing Director & Practice Leader with the Governance & Leadership service line of Gallagher’s Human Resources & Compensation Consulting practice. He focuses his consulting work on strategic governance structures and systems for high performing, tax-exempt nonprofit, credit union and health sector organizations and integrated care systems; visioning for large and small not-for-profit organizations; and leadership development for Boards and C-Suite Senior Leaders. 

Dr. Rice holds masters and doctoral degrees in ...

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