A physician in his late 40s with a distinguished reputation and a robust practice in a large metro area fell in love — with the science and art of management.
He saw in this discipline an opportunity to improve the practice of medicine and delivery of care — helping people — on a much broader scale as a senior hospital 
executive than he could ever experience with his practice. So while maintaining his clinic schedule, this physician earned an MBA. It took him three years because he opted for a special program designed for physicians that blended class and online learning. It was tough on his family life but his wife was only too happy to support this new calling; she felt a renewed sense of energy and passion that had slipped over the years.
When it was all said and done, our physician was at the top of his class, a distinguished graduate. Then the reality set in. No one would hire him. He had the degree but no real leadership or medical affairs experience.
He learned a lesson that most physicians never experience: finding that first job is always the hardest. No one slammed any doors, he said, but without experience he could not even get an interview.
When he called me, his frustration was more than a little apparent. “I would like to stay here — I thought there would be ample opportunities in a metropolitan area of this size, but I obviously did not think that part of the process through.”
While there is a demand for capable physician leaders, that demand is for those with relevant experience and a track record of accomplishment.
Our physician was particularly interested in strategy, but when I asked what his strategy was for developing a career as an executive, he went silent, reaffirming yet again that sometimes the most obvious issue gets overlooked. Developing a personal career strategy had not crossed his mind.
“So how can I earn a chance show them what I can do? If I can’t find a job because I have no experience, how can ever get the experience?” His words were reminiscent of comments I frequently hear from newly minted college graduates who are entering the workforce for the first time.
Here are steps I suggested he take:
- Talk to the CEO. Let the Chief Executive at your hospital know of your interest to transition to management. Ask for his or her advice. As a big admitter they will hate to see you leave clinical practice, but most will be happy to help.
- Join the American College of Healthcare Executives and the American Association of Physician Leadership. Become active in local, regional and national activities, most especially in their excellent continuing education programs. These associations will help connect you with more opportunities.
- Sit down with the Chief Medical Officer. Outline your goals. Do not be brash and suggest that one day you want his job. Do volunteer to help him/her on projects, whether it be a quality or safety improvement initiative or even an EHR selection/implementation. You can get valuable experience but more than likely you will not be paid for it, which means you must continue the day job. This is called investing in the future. Once you successfully complete projects, develop a LinkedIn that reflects these accomplishments.
- Actively participate in standing committees. “Actively participate” does not mean showing up, eating and listening. It means doing the homework and then offering thoughtful comments and suggestions. Volunteer here as well.
- Be patient. Building experience this way will take time but it will afford you the opportunity to learn, make your mistakes and learn from those, all without the risk of losing your job, something that happens in the world of physician leadership just as it does for administrative personnel.
- Be flexible. Be prepared to relocate. Historically, many physicians spend their entire career in one community but once you move to the executive leadership side, chances are you will have to relocate to find that first paying gig, and then move again to move up. While that concept will probably not be too popular with a spouse or any remaining children living at home, it is a fact of life for those pursuing a hospital leadership career goal.
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