Being a medical doctor does not automatically qualify someone to run what Peter Drucker described as …one of the most complex of all human organizations ever devised by man – a hospital.
We are on the front end of an emerging school of thought that says physician CEOs, with their years of clinical training and experience as hospital customers, are ideally suited to lead these very challenging organizations through healthcare reform. This reasoning suggests that so much that is wrong with the US healthcare delivery model – exorbitant costs and stunningly inconsistent quality – can better be addressed by physician leaders. Physicians would be much better running a hospital, however, it can be difficult for them to get there. Of course, it has been done before by physicians who have participated in management and leadership courses. Some have even applied for loans for physicians to ensure they can afford a hospital facility. This helps them to run effective hospitals.
That may well be true. However, there is a foundational issue that cannot be overlooked. Leadership is a skill that emerges from management education and experience, from the pain and joy of successes and failures, and frequently, with the support of an executive coach. It is rare for a lay executive to complete his MBA and immediately jump to the front of the leadership line. Most spend years moving from position to position to garner the necessary experience – to hone their skills – to be an effective leader.
When a trend emerges in healthcare, there has always been a rush to participate. That is certainly the case with the current one of trying to incorporate physicians as a part of the senior leadership team. There is some early evidence that the demand for seasoned, experienced physician executives is outstripping supply; there has been some fallout from physician executives who were promoted up without sufficient experience or ongoing coaching support. There are many physicians interviewing who are not adequately prepared, who do not understand their value proposition. These issues are certainly correctable.
I support the idea that physician executives can make meaningful leadership contributions in the field of cost containment, quality of care and safety, and patient satisfaction. I also believe physician leaders can serve as a vital moral compass for those organizations that think they can game the Medicare reimbursement system to spur higher revenues through questionable upcoding or outright fraud and abuse.
Today, there are some exceptional success stories found in the ranks of physician executives. It is exciting to watch them make great progress and to plan for a future health service delivery model that ensures safer patient care and lower costs – both moral imperatives. The American College of Physician Executives is doing some impressive work with leadership education, but organizations that employ physician leaders — specifically those with limited or no prior experience — have an obligation to develop support systems to ensure they thrive in success.
Let’s not make the mistake of promoting physicians into critically important leadership roles without the mentoring and leadership coaching support they will need to succeed. Pushing up and out before they are ready is a bad idea. It will only set back this important school of thought.