Traditionally, physicians have tended to be disinterested in management and leadership roles. But that is changing, and physicians are applying and training for these positions in greater numbers.
Dr. Gary Kaplan (No. 3), chairman and CEO of Virginia Mason Health System in Seattle, said historically, physicians saw administrators as “bean counters.” More physicians now are participating in leadership roles because they have opportunities to implement organizational change and vision, create clinical integration and design workflows, he said.
While statistics on the overall number of physician executives are not available, Dr. Andrew Agwunobi, director of hospital performance improvement for the Washington-based Berkeley Research Group, said he sees more organizations appointing physician leaders.
“There is no doubt this will be an accelerating phenomenon,” said Agwunobi, former CEO of Providence Healthcare in Spokane, Wash., and former CEO of Grady Health System in Atlanta.
And there are now more opportunities for physicians to step into hospital leadership roles given that the American College of Healthcare Executives reported 20% turnover in hospital CEOs in 2013. That's the highest rate since the group started tracking this statistic in 1981.
Kaplan said high CEO turnover could be at least partly due to nonphysician executives feeling overwhelmed by the challenging transition to value-based reimbursement, population health strategies and cost transparency. They might have been thinking, “This isn't what I signed up for,” he said.
Having more physicians and nurses move into senior leadership positions is a good thing, argued Dr. Steven Safyer (No. 35), president and CEO of Montefiore Medical Center in the Bronx. Montefiore's other senior leaders include COO Dr. Philip Ozuah, senior vice president and chief of staff Lynn Richmond, a nurse practitioner, and Senior Vice President of Operations Susan Green-Lorenzen, a nurse. “The business of the business is medicine, and nurse leaders and physicians know the subject,” Safyer said.
For people who intend from the start to be doctors serving in leadership roles, there has been significant growth in the number of academic programs combining M.D. and MBA degrees. Agwunobi, who has an MBA himself, said there are at least 65 such programs now.
While more younger physicians receive business and leadership training early in their careers, Agwunobi urged hospitals and other organizations not to overlook older, entrepreneurial physicians as potential leaders. Doctors who ran and expanded their own practices have a lot to offer larger organizations in terms of management skills. “They were not just accomplished physicians, but accomplished business people as well,” he said.
But Ziskind said there's one major pitfall that physician leaders need to keep in mind. “The essential character traits that made them a successful clinician are not necessarily the essential character traits that make an effective leader,” he said. “One of the mistakes physician leaders often make is applying the same 'I can do it' approach from clinical training.”
New physician leaders need to change their mindset from achieving success as an individual to achieving success as a team. Still, he said, physicians “certainly understand what's needed to make changes in the way care is delivered.”
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