Viewpoint: 3 reasons the best hospitals are led by physicians

Healthcare organizations need extraordinary leaders to guide them through the complex regulatory, technological and consumer challenges that characterize the healthcare industry today. While physicians have not always been viewed as qualified to serve as healthcare CEOs, this is changing, according to an op-ed published in the Harvard Business Review.

James K. Stoller, MD, a pulmonary/critical care physician at the Cleveland Clinic and chairman of the Education Institute; Amanda Goodall, PhD, senior lecturer in management at Cass Business School in London; and Agnes Baker, PhD, assistant professor at the University of Zurich, purport that the increasing "emphasis on patient-centered care and efficiency in the delivery of clinical outcomes means that physicians are now being prepared for leadership."

Physicians may be best equipped to lead hospitals for three key reasons, according to the authors of the op-ed.

1. There is a positive correlation between physician leaders and quality outcomes. U.S. News & World Report ranked Rochester, Minn.-based Mayo Clinic and Cleveland Clinic the No. 1 and No. 2 U.S. hospitals in 2016, respectively. Both health systems are currently run by physician CEOs: John Noseworthy, MD, runs Mayo Clinic and Delos "Toby" Cosgrove, MD, heads the Cleveland Clinic. In fact, both institutions have had physician leaders since their formation about a century ago, according to the op-ed.

A 2011 study led by Dr. Goodall, which examined CEOs in the top-100 best hospitals, according to U.S. News & World Report, indicated hospital quality scores are roughly 25 percent higher in physician-led hospitals than in manager-led hospitals. While such studies don't prove causation, research does support the idea that the separation of clinical and managerial expertise is associated with inferior hospital management.

2. Physician CEOs automatically have enhanced credibility with other clinicians. When asked to point out the attributes of physician leaders that might account for the association with superior organizational performance, Dr. Cosgrove immediately said, "Credibility … peer-to-peer credibility," according to the op-ed. Because of commonalities in training and experience — and the challenges associated with both — the ranks of physicians are more inclined to trust that a physician CEO understands their motivations, incentives and desire to focus on the patient. Additionally, physician CEOs are more likely to create a more sympathetic and productive work environment for clinicians.

3. With the right training, the pool of qualified physician leaders will expand greatly. Great leadership requires depth in a variety of social skills, especially teamwork. However, physicians are not trained to be team players. Instead, many have been trained in "command and control," hierarchical environments and struggle with collaboration. However, the success of managerial training programs for medical students and residents shows that physicians who can overcome this leadership and followership handicap have great potential as leaders and team players. 

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