Physician Leadership

The Journey From the ED to the C-Suite

An emergency physician shares her expertise on transitioning to physician leadership.

By Topic: PhysicianClinical Relationships Leadership Development Credentialing


 

For many physicians, the attraction to healthcare is born out of a love of science, a desire to help others or both. As they go through their residency and begin to practice medicine, some physicians may increasingly become interested in the business side of healthcare, realizing there are many other factors outside of that nurturing doctor-patient relationship that affect patients—affordable and accessible care, preventative approaches, community health, care delivery, etc. For physicians who want more exposure to these factors, there are many different routes they can take. This column offers guidance and recommendations for physicians who are considering embarking on the journey from physician to physician leader.

The Desire to Make a Difference
Physicians who are considering taking on leadership roles may want to start with some soul searching to determine if this is something they really want and why they want it. The desire to make a difference and the ability to think past some of the limitations in this field are key to physician leadership. Major limitations typically center around capital and staff resources. 

Some ways to begin pursuing leadership opportunities include volunteering to serve on a committee, leading an improvement project within their organization’s clinical department or attending a leadership conference. However, it is important for physicians to realize that becoming a leader doesn’t mean only implementing their own thoughts. Rather, it’s about getting perspectives from every aspect, considering the ramifications and then forming a decision. It’s a long journey, but with focus and dedication, it’s possible. 

When a physician realizes they are interested in the administrative aspect of healthcare, it’s important to find opportunities to connect with clinical and nonclinical department leaders. Such meetings can reveal not just the “how” of strategies and plans but also the “why," which is important for understanding the reasoning behind decision-making. 

Gaining Exposure to the Business of Healthcare
Joining professional organizations specific to their specialty could offer other opportunities for clinicians to gain exposure to the business side of healthcare. Finding opportunities to attend leadership development programs may also help, as such programs can be gateways to learning about other training and volunteer or job opportunities. They can also serve as opportunities to liaise with CEOs, COOs, CFOs and other hospital executives. (See sidebar on Page 53 for three approaches C-suite and other senior-level executives can use to ensure a successful transition for physician leaders in their organizations.)

Understanding the language of medicine is learned in the classroom and exam room, but understanding the language and vision of such executives is essential to becoming one. Mentors can also help in this regard, and they do not necessarily need to be another physician.  

Earning credentials, such as the FACHE®, through professional organizations can be invaluable to an aspiring physician’s career progression. It’s imperative that clinical healthcare professionals become more aware and knowledgeable of the economics of healthcare, market structure and the operational environment. Nonclinical education and training can provide physician leaders with the ability to look at situations differently than their other clinical colleagues. For example, the ED is seen not just as a place for acute care delivery. It is, in most instances, the front door to the hospital and an eye into the community that provides opportunities to capture market share and guide needed community interventions. 

When graduating from residency, physicians can choose to search specifically for administrative and clinical positions, although they may not be hired as a medical director right out of residency.

Learning as They Go
With promotions to leadership roles or multiple executive positions comes increasing decision-making power. In some ways, this is similar to practicing medicine—physicians will use their fundamental training but also learn as they go. However, for clinicians who want formal training in finance, operations and management as they seek higher-level leadership roles, earning master’s degrees in health administration, public administration or business administration may be an advantageous course of action. 

Regardless of how many multidisciplinary meetings are held, physician leaders will find it’s best to share knowledge and facilitate a free flow of information. Transformational work typically starts with aligning goals, then taking a deeper dive into the current state before building out the strategy for a future one. Being open-minded and collegial during each step is critical to that.

As a physician executive, it is still important to continue to use one’s medical expertise and training in opportunities while leading and engaging with front-line staff. Although this profession is a business, the patient and their clinical outcomes and experience remain at the center of what physician leaders do. Physicians can make an impact at all levels across an organization. Their clinical input in professional standards, quality assurance, operations and process improvement cannot be understated. Additionally, it’s important to bear in mind that although the one-on-one doctor-patient relationship that initially lured many physicians to the healthcare field may shift to a less intimate relationship with many patients, the reach of a physician executive’s work is multiplied, and can definitely be just as rewarding.

Kaedrea Jackson, MD, FACHE, is deputy CMO and medical director, Department of Emergency Medicine, Mount Sinai Morningside, New York; and system vice chair, Quality, Safety and Patient Experience, Department of Emergency Medicine, Mount Sinai Health System, New York (kaedrea.jackson@mountsinai.org or kaedreaj@yahoo.com). 

Editor’s note: Jackson began her career as an attending physician in the ED of Kings County Hospital Center, New York. After realizing she wanted to transition to physician leadership, she earned an MBA from New York University, became board certified in healthcare management as a Fellow of ACHE and began to assume leadership roles with increasing responsibility before arriving at the positions she holds today.  

Ensuring Successful Transitions for Physician Leaders

Following are three approaches senior executives can take to ensure a successful transition for physician leaders.

  1. Just as aspiring physician leaders should seek out opportunities to liaise with various healthcare organization executives, senior executives can encourage physicians in leadership roles to take part in development programs that provide an understanding of the way C-suite executives think and the language they use. For example, executives might consider recommending programs that will provide “real-life” insights and training for interacting with individuals in executive roles. 
  2. When implementing new programs or initiatives, senior executives will find it is helpful to have truly multidisciplinary teams, such as a planning team composed of a physician, nurse and an administrator. Including other disciplines and providers would be optimal. When senior executives encourage the development of new physician executives and engage current physician leaders, the whole leadership team benefits.
  3. Physicians are often accustomed to taking the lead. However, depending on their experience with administrative duties, this may be challenging. Senior executives can help by encouraging up-and-coming physician leaders to seek the expertise of other administrative leaders for guidance, advice or knowledge when they are challenged with an administrative task or an area of administrative work they don’t understand. This kind of support from a senior executive can go a long way.