Physician Executives: The Answer to Improving Healthcare Leadership

“When an outstanding physician heads a major hospital, it signals that they have ‘walked the walk,’ and thus have earned credibility and insights into the needs of their fellow physicians,” Cleveland Clinic physician James Stoller and professor Agnes Baker, of the University of Zurich, and Amanda Goodall, of London’s Cass Business School, wrote recently in the Harvard Business Review.

In a separate article co-written by Goodall, titled “If Your Boss Could Do Your Job, You’re More Likely to Be Happy at Work,” it was related that other industries support the idea that technical expertise – such as that held by a physician, or a sports star going on to lead a team’s operation – can position one to be a stronger manager and leader.

“We understand the soul of the business because we’ve done it,” said Glenn Lux, MD, MBA, and CEO of Pediatric Associates., in an article for the American Association for Physician Leadership’s Physician Executive Journal in 2014.

Lux goes on to say:

“It’s hard to give someone feedback if you don’t know what they really do. That feedback is much more accepted from a physician than from a nonphysician who doesn’t ‘get it.’ When we ask our physicians to do something that’s a little bit out of the ordinary, they know that we understand what that means to them and that we wouldn’t ask unless it was important.”

The Benefits of Physician Executives

Many organizations are now encouraging physicians to take on executive healthcare positions such as chief strategy officer, chief innovation officer and chief clinical officer, according to a report in the Advisory Board Company’s Prescription for Change blog – this after a little self-examination of whether there is proper representation of physicians at the higher executive levels.

One might think that should go for the board room too, but progress there has been slow, according to the 2016 Journal of Hospital & Medical Management report, “It Is Time for More Physician and Nursing Representation on Hospital Boards in the US.”

“It is clear that despite the changing healthcare environment, there has not been a significant change in physician representation on hospital boards even though the law allows … for more physician and nursing representation,” wrote the authors, from the Ohio State University College of Medicine.

They note that a “common cause of apprehension about the expansion of clinician membership on hospitals boards is the concern for conflicts of interest” but “the potential for conflict of interest is applicable to all boards members, clinician or not, and can be mitigated with careful selection of board members.”

And there’s evidence supporting both a desire for more physician representation and the benefits therein:

  • A 2015 study B. Gai and R. Krishnan revealed a decrease of 3 percent to 5 percent in three of four measures of care quality at not-for-profit hospitals in California without physician board representation.
  • Among the CEOs and 57 board members at 14 large hospital organizations surveyed in 2011, 59 percent of respondents said board deliberations would benefit from physicians’ expertise.

The Importance of Physician Leadership

As a New York Times report in 2015 stated:

“Boards, and other hospital management, can influence care in ways that individual physicians cannot. They can promote protocols that ensure that crucial information is conveyed to the right people at the right time. They can establish systems so that equipment and supplies are available when needed. They can set expectations for a culture of high performance, not just from individuals but from teams of them that must work together. And they can require quality to be monitored against goals with incentives to push it toward those targets.”

A 2011 study of the 100 best hospitals (as ranked by U.S. News & World Report) for cancer, digestive disorders and cardiovascular care showed that hospitals run by physicians scored 25 percent higher on overall quality than those run by professionals with management backgrounds.

“From a leadership standpoint, I experientially ‘get it.’ And that helps me collaborate with others to think about how we can encourage right delivery of care every time,” said Gerald B. Hickson, MD, senior vice president of quality, safety and risk prevention at Vanderbilt University Medical Center in Nashville, in the Physician Executive Journal article.

The Potential for Physician Leaders

Leadership isn’t always second nature to a physician, however.

“It’s a wonderful sign that physicians are expanding from clinical care to include learning what it takes to be a good leader,” said Maureen Bisognano, president and CEO of the Institute for Healthcare Improvement in Cambridge, Mass., in the same article.

“When you can marry the leadership skills and the clinical background, you have an opportunity to lead in a very distinct and different way. When you get someone who knows what quality looks like, and pair that with a curiosityabout new ways to think about leading, you end up with people who are able to produce dramatic innovations in the field.

"Physician-leaders appear to be the most effective leaders precisely because they are physicians," Goodall and her co-authors wrote.

Technical competence is only one component of being a leader – and other qualities, such as administrative, management and social skills, often must be learned and cultivated.

These are the kind of skills and thought leadership available with the Executive Master of Health Administration program through USC’s Sol Price School of Public Policy.