Physician Leadership: The Growing Demand, The Growing Challenges

By Kurt Mosley, Associations Practice Leader, HealthSearch Partners

If you’ve been in healthcare for any time at all, you’ve undoubtedly seen the gradual evolution of the hospital/health system CEO role from administrative non-clinical to physician focused. Hospitals and health systems are increasingly searching for physicians to take the CEO reins in their organizations. Traditional thinking has led to the widely held belief physicians wouldn’t be ideal executive leaders because they lacked management training and experience and their medical training and education created solitary healers, unable to work as part of a team. Leading world-class healthcare organizations with physician CEOs are busting this myth by demonstrating outstanding results in operations, finances, quality and patient outcomes.

In a 2022 white paper “Physician Leadership: More Valuable Than Ever,” the American Association for Physician Leadership (AALP) reports an overwhelming number of top-ranked hospitals continue to be run by physician CEOs. The whitepaper notes that year after year, US. News & World Report’s annual “Best Hospitals Honor Roll” supports a strong connection between high-quality ratings and physician leadership.

St. Louis Metropolitan Medicine in its Dec. 2020/Jan. 2021 issue includes information from a 2019 study published In the July-Sept. 2019 issue of Health Care Management Review, that found large, physician-led hospital systems achieved higher quality ratings across all specialties and inpatient days per hospital bed in 2015 than non-physician led hospitals, with no differences in total revenue or profit margins. Of the top 115 hospitals reviewed in the study, 30% were physician-led.

Physician Leaders: Why It Matters and What’s Next

Healthcare organizations have awakened to the fact physician leaders are vital to navigating today’s complex healthcare environment. Their clinical expertise, combined with their leadership skills, drives improvements across the organization.

Tangible benefits of physician leadership for the organization:

• Physician-led organizations consistently outperform peer organizations in value-based care and patient experience.
• Opportunities for physicians to lead reduces physician burnout and improves overall job satisfaction and wellbeing.
• Strong physician leaders help address social determinants of health and reduce healthcare disparities.

What Motivates Physicians To Want To Become Leaders?

Neill Marshall, Chairman of HealthSearch Partners, was a recent guest on The Good Leadership Podcast and discussed with host Paul Batz what motivates physician to want to become leaders. Marshall cited several motivators:

• A desire for career growth
• A need to step away from patient care because of health, age, or burnout
• Having the innate desire to be a leader
• Possessing the ambition to be king of their kingdom.

His advice to physicians aspiring to be leaders is to embrace any opportunity to lead and take every opportunity to do so that is offered. He also strongly recommends starting their journey to leadership now. Finally, he emphasizes relationships are key to helping physicians discover the next step on their leadership path. You can listen to the podcast here.

From Sole Decision Maker To Collaborative Team Leader 

Physicians are trained to be autonomous, decisive, and accountable, traits that serve them well in private practice and clinical settings. But, when transitioning into leadership roles, they must adapt to a collaborative environment that is fueled by consensus, communication, and teamwork.

The AALP whitepaper quotes Alan Kaplan describing the challenges facing a physician transitioning to the C-suite: “Now I’m going to be hiring finance people and operational people who will have bodies of knowledge I don’t have. I not only have to respect that, I also have to be dependent on those team members. I can’t be the smartest person in the room and be comfortable not knowing everything.”

A key takeaway from the whitepaper is the insight provided by Maureen Bisognano. “Many physicians make the mistake of assuming clinical skill translates into leadership ability. The two do not always go hand in hand. Clinical skills are certainly a requirement, but they are not enough. It’s about vision and strategy and moving a system culturally toward the ‘Triple Aim’ of better health, better care, and lower costs. That’s very different from solving problems one at a time. It requires a different scope of work and a different set of skills.”

Strategies That Support The Transition

• Provide the training and education to help physicians understand leadership requires humility and the ability to value group input. This will help them gain insight that shared decision-making often leads to stronger outcomes.
• Focus on emotional intelligence and communication by offering leadership development programs focused on these topics as well as active listening and conflict resolution – skills critical for effective team leadership.
• Provide physicians with opportunities to work with interdisciplinary teams including finance, operations, and nursing. This will help them gain an appreciation for different perspectives and will help them learn to lead through influence.
• Coach and mentor physician leaders to help them shift from being individual performers to team facilitators, offering guidance through the learning curve.
• Cultivate systems thinking to help physician leaders see the broader system impact of their decisions. This will help them embrace shared responsibility and develop collaborative strategies.
• Encourage vulnerability by valuing feedback, admitting mistakes, and encouraging risk taking and diverse points of view. This will reinforce and understanding that these behaviors build trust and cohesion across the organization.
• Fortify a culture that support their transition to leadership by fostering an environment that values collaboration and supports physician leaders through structured teamwork and shared governance.

Additional strategies to smooth the way to leadership

Helping physician leaders succeed requires a recognition they have not received formal training in key leadership skills such as financial acumen, communication and active listening, emotional intelligence, team building, and collaboration. Skills in leadership and management are essential. To bridge this knowledge gap, successful organizations provide formal education leadership and management principles. They also actively support mentoring, coaching, and offering practical leadership experiences. In addition, physician leaders receive early exposure to the business die of healthcare including strategy, finance, operations, and governance.

The future of physician leadership 

The demand for physicians will only increase as healthcare grows more complex. Investing in physician leadership development now will better position the organization to improve patient outcomes, enhance physician satisfaction, and create more effective and resilient systems. The AALP whitepaper sums it up, “Physician leadership is critical to shepherd healthcare into the future, creating a delivery system grounded in better health and better healthcare at lower costs.”