It’s not uncommon for busy physicians to turn to their trusted partners—nurses—and instinctively know what we need from them in our care plans for patients, bloodwork and studies ordered, and referrals and follow-ups scheduled.
Undoubtedly, there are physician hospital chief executives who might long for those days when someone could just translate a vision into a smoothly running operation with perfect outcomes and no barriers or unintended consequences. Instead, they must consider the big picture and the data available and decide along with their teams what the strategic direction needs to be and work together to achieve agreed-upon goals.
Nationally, healthcare organizations led by physicians increased to 282 in 2021 from 90 in 2000, according to an analysis of the American Hospital Association Guide to the Health Care Field 2021 Edition by Carson F. Dye, FACHE, president and CEO, Exceptional Leadership LLC. How do we ensure that these physicians are ready and equipped to lead? Simply sending them to business school is not the solution.
Much has been written about the differences between what makes a great physician and a great leader. Physicians are used to making decisions quickly and executing plans to care for patients in an expeditious fashion. Leaders cogitate over situations with a team and often compromise to attain what is achievable within the constraints they have. It could be argued that physician leaders are a hybrid group with skills and characteristics that can flex to situations as warranted.
There are three critical components that make a successful physician leader: They need to be credible as clinicians; they need to know how to operate as a team with experts in other areas, such as finance and operations; and they need to have patience. They are now part of a decision-making process that may be slower than what they are accustomed to in clinical practice. This is because decisions need to be made based on the overall good of the organization, instead of the physician’s area. When decisions occur that may not be in line with the physicians’ interests, the physician leader must fully support them.
Be Credible
For physician leaders to be successful, they must first be respected as a clinician by their peers and teammates. This may appear obvious, but unfortunately many aspiring physician CEOs have never even practiced medicine in their specialty or don’t have an understanding of how a hospital or medical practice runs. It is not enough for physicians to come out of medical school, earn an MBA to gain the business knowledge they need and take the helm of a department without a real-world understanding of the work the department does. Physician leaders will be followed if they have a practical working knowledge of their specialty. Similarly, having experience in the basic medical staff leadership functions, such as peer review or credentialing, provides a foundation for a physician leader to then expand into operational hospital areas.
Be a Team Player
It is not expected that a physician leader be an expert in finance or marketing; there will always be experts in other areas to provide support. Understanding the contribution of these areas as part of the overall picture is critical, however, and being able to work collaboratively with these experts is important for running a healthy healthcare organization. Physicians sometimes believe they know all there is to know about how to staff an OR, or what makes a medical practice financially successful or how to market a product. More experienced physician leaders will realize there are nuances in operations and trends in payer and vendor contracting and market data from consumers that many physicians are not aware of. The need to defer to their colleagues in those arenas will help guide discussions on a broader level to make decisions based on overall healthcare trends and experience.
Be Patient
As part of the medical training process, physicians are expected to absorb a vast amount of knowledge, then trained to take clinical data points and process them quickly to generate a differential diagnosis. This list is narrowed based on diagnostic testing until a diagnosis is established, followed by a plan of action finely hewed based on specific individual data.
On a daily basis, physicians go through this process dozens of times as they see patients and swiftly make decisions about their care. This is very different than a day in the life of leaders, who have numerous scenarios they must address, few of which necessarily need to be decided upon quickly. For a front-line leader, routine tasks may need to be done, such as approving payroll or paid time off. But for a higher-level leader who has strategic responsibilities, the steps required are identifying a situation, analyzing all the different ramifications associated with the situation, seeking out input and discussion with all subject-matter experts, and determining a path forward.
Although it can be said that this is not different from a clinical decision, in leadership rarely does a decision have an immediate life-or-death impact, and careful and thoughtful vetting with a team allows for better decision-making. Learning patience with this process and engaging in it are important for physician leaders to be successful.
Physician leaders must recognize they have a higher responsibility to their organization than just the specialty from which they come. As leaders, we must look at the big picture and make calculated decisions good for the overall organization rather than the areas we are responsible for. It is a balance to passionately advocate for the needs of our own department or specialty but also understand that the overall success of the organization outweighs any individual area’s needs. As such, sometimes physician leaders have to set aside what they may desire for a decision that may be better for the larger group. And after making a group decision, physicians must support and embrace the final plan as their own.
Representation in healthcare organizations by physician leaders is increasing. Having well-respected clinical leaders who understand how to work collaboratively with other healthcare leaders to make decisions for the overall good of the organization will enhance the success of our healthcare systems and help us provide better care for the communities we serve.
Lily J. Henson, MD, FACHE, is CEO of the Piedmont Augusta (Ga.) Hub, with three campuses—Piedmont Augusta, Piedmont McDuffie and Piedmont Summerville—(lily.henson@piedmont.org).
There are three critical components that make a successful physician leader: They need to be credible as clinicians; they need to know how to operate as a team with experts in other areas, such as finance and operations; and they need to have patience. They are now part of a decision-making process that may be slower than what they are accustomed to in clinical practice. This is because decisions need to be made based on the overall good of the organization, instead of the physician’s area. When decisions occur that may not be in line with the physicians’ interests, the physician leader must fully support them.
Be Credible
For physician leaders to be successful, they must first be respected as a clinician by their peers and teammates. This may appear obvious, but unfortunately many aspiring physician CEOs have never even practiced medicine in their specialty or don’t have an understanding of how a hospital or medical practice runs. It is not enough for physicians to come out of medical school, earn an MBA to gain the business knowledge they need and take the helm of a department without a real-world understanding of the work the department does. Physician leaders will be followed if they have a practical working knowledge of their specialty. Similarly, having experience in the basic medical staff leadership functions, such as peer review or credentialing, provides a foundation for a physician leader to then expand into operational hospital areas.
Be a Team Player
It is not expected that a physician leader be an expert in finance or marketing; there will always be experts in other areas to provide support. Understanding the contribution of these areas as part of the overall picture is critical, however, and being able to work collaboratively with these experts is important for running a healthy healthcare organization. Physicians sometimes believe they know all there is to know about how to staff an OR, or what makes a medical practice financially successful or how to market a product. More experienced physician leaders will realize there are nuances in operations and trends in payer and vendor contracting and market data from consumers that many physicians are not aware of. The need to defer to their colleagues in those arenas will help guide discussions on a broader level to make decisions based on overall healthcare trends and experience.
Be Patient
As part of the medical training process, physicians are expected to absorb a vast amount of knowledge, then trained to take clinical data points and process them quickly to generate a differential diagnosis. This list is narrowed based on diagnostic testing until a diagnosis is established, followed by a plan of action finely hewed based on specific individual data.
On a daily basis, physicians go through this process dozens of times as they see patients and swiftly make decisions about their care. This is very different than a day in the life of leaders, who have numerous scenarios they must address, few of which necessarily need to be decided upon quickly. For a front-line leader, routine tasks may need to be done, such as approving payroll or paid time off. But for a higher-level leader who has strategic responsibilities, the steps required are identifying a situation, analyzing all the different ramifications associated with the situation, seeking out input and discussion with all subject-matter experts, and determining a path forward.
Although it can be said that this is not different from a clinical decision, in leadership rarely does a decision have an immediate life-or-death impact, and careful and thoughtful vetting with a team allows for better decision-making. Learning patience with this process and engaging in it are important for physician leaders to be successful.
Physician leaders must recognize they have a higher responsibility to their organization than just the specialty from which they come. As leaders, we must look at the big picture and make calculated decisions good for the overall organization rather than the areas we are responsible for. It is a balance to passionately advocate for the needs of our own department or specialty but also understand that the overall success of the organization outweighs any individual area’s needs. As such, sometimes physician leaders have to set aside what they may desire for a decision that may be better for the larger group. And after making a group decision, physicians must support and embrace the final plan as their own.
Representation in healthcare organizations by physician leaders is increasing. Having well-respected clinical leaders who understand how to work collaboratively with other healthcare leaders to make decisions for the overall good of the organization will enhance the success of our healthcare systems and help us provide better care for the communities we serve.
Lily J. Henson, MD, FACHE, is CEO of the Piedmont Augusta (Ga.) Hub, with three campuses—Piedmont Augusta, Piedmont McDuffie and Piedmont Summerville—(lily.henson@piedmont.org).