Authority and Authorship: Examining Leadership's Role in Medical Publications.

BackgroundAcademic medicine often struggles to balance leadership duties with maintaining research productivity. The impact of holding a position of power on authorship practices in a hierarchical environment remains underexplored. We addressed this gap by examining how leadership roles influence publication and collaboration patterns in Lithuanian medical academia.MethodsWe performed a bibliometric analysis of ten-year publication records for 633 Lithuanian medical researchers in formal leadership positions (department heads, center directors, and similar formal roles), comparing their output and authorship patterns to those of peers without such roles. Publication data were collected from PubMed and a national academic library, capturing total publications, author order (first/middle/last author positions), and co-authorship counts. We used statistical tests to compare groups and applied the Gini coefficient to assess inequality in research output.ResultsLeaders showed distinct authorship roles and collaboration patterns. Compared to equally productive non-leaders, leaders had significantly fewer first-authored papers (10.79% vs 36.31%) and more last-authored (36.42% vs 23.57%) and middle-authored contributions (52.78% vs 40.12%). Leaders published more papers (average 78.42 vs 49.41), in Web of Science-indexed journals (average 49.44 vs 27.68), and had higher h-indices (19.66 vs 12.59) (all