Preparing the Right Physicians to be Exceptional Leaders in the 21st Century: How to Maximize Their Success Most Cost-Effectively and Efficiently

The Challenge

Effective physician leadership is more critical than ever before for hospitals as well as for health systems, clinics, clinically integrated networks, and others. A physician leader on the senior team, who demonstrates both an innate understanding of the care process and the provider’s role in that process, has proven to be key to accomplishing goals. Capital decisions, service line management and supply chain management are just a few examples in which the roles of Chief Medical Officer (CMO), Medical Director, Vice President of Medical Affairs (VPMA) and service line lead brought value to many organizations. However, problems in selecting those key contributors are frequent, predictable and yet, avoidable.

Gordon L. Alexander, Jr., MD, former chief executive officer (CEO) of the University of Minnesota Medical Center and University of Minnesota Children’s Hospital, notes that physicians frequently enter their health care administration roles without the benefit of years of experience managing aspects of a complex organization. While clinical experience is valuable, it does not always translate to success in broader leadership roles. All too often, the rules of the administrative road can be anathema to even a seasoned physician. In fact, the American College of Physician Executives reported that the competencies required to be an effective physician leader often contradict those of a good practitioner. For example, a good CMO must be persuasive, effective in delegating to others, and hold them accountable for their performance. Conversely, the solo practitioner primarily needs to be self-sufficient. While a general master of business administration degree or focused leadership training is helpful, it rarely changes the ingrained characteristics of a physician or predicts the type of performance he/she will display in a new role.

In addition, great variation is seen amongst VPMA, Medical Director, Department Chair, and Chief Medical Officer roles across organizations. Purposeful dialogue to define the uniqueness of these roles to that particular organization along with clear job expectations is often lacking, serving up the avoidable recipe for failure and unhappiness. Many physician executives have radically different ideas than their senior team colleagues about what is expected of the physician in a leadership position. Candid conversations are rare, and the physician typically does not have a predecessor to tap for insights. Being a presence in the doctors’ lounge is giving way to managing service lines, taking responsibility for population health management and care transformation, monitoring value-based contracting, and many more activities. Furthermore, these responsibilities are now critical to an organization’s success. With the challenges organizations now face, the perception is that there is no room for error—operationally or financially—at this level. The importance of setting the stage for physician leadership success cannot be understated. Author Lewis Carroll’s (1865) observation applies well here: “If you don’t know where you’re going, any road will get you there.”