As a primary care physician who also is a hospital CEO, Susan Ehrlich, MD, occupies rare air.
According to a 2025 McKinsey survey, only about 15% of CEOs across healthcare organizations have clinical backgrounds; that figure includes health systems and pharmaceutical companies. And according to a study published in 2023 in the Journal of the American Board of Family Medicine, only 4% to 7% of hospital CEOs have a primary care background.
Dr. Ehrlich checks both boxes. She has been at the helm of Zuckerberg San Francisco General Hospital and Trauma Center since 2016 and also serves as a professor at University of California San Francisco and as a primary care internist.
She also took an unconventional path to her current role in that she earned her medical degree midcareer. Seeing healthcare from myriad perspectives has been crucial for her, she said.
“What I love about my job is that I get to do the ground-level work, literally taking care of patients,” she said. “I have a panel of about 125 patients I follow, and I’m in clinic almost every Thursday morning. That goes all the way up to local, state and national advocacy, and in the middle is running this hospital. So I get to do all of those things.
“The patient care work that I do informs the policy work and the operational work that I do, and vice versa. Seeing all of that and being able to participate in all of it keeps life exciting at every moment, and I feel informed in all of that work in ways that I wouldn’t be if I weren’t doing the full spectrum of it.”
Dr. Ehrlich joined the “Becker’s Healthcare Podcast” to share what she and her team learned from the COVID-19 pandemic, two traits great leaders put to use and the issue on which she would shine a brighter spotlight.
Question: What do you consider the most memorable day or period from your career?
Dr. Susan Ehrlich: In the last 10 and a half years here at ZSFG, so many memorable things have happened. Three weeks after I started, we moved into our new acute care tower, which was a huge change: moving out of a 1970s-era building into a brand-new acute care building. It was exciting, and it was a big culture change.
The culture change didn’t stop, though. In August 2019, we went live with Epic, and that was an even bigger culture change for our organization. Moving from 60-plus different online applications to one was a very big deal. It was really exciting and a huge leap forward for our organization.
And then, of course, six months later, the COVID-19 pandemic hit, and there were many, many memorable moments during COVID. We learned a lot. It changed pretty much everything about us, like it did the rest of the world.
Q: Your organization developed community outreach and community programs during the early phases of the pandemic. What do those programs look like now?
SE: What the pandemic did was really help cement our connection to the community, and we do that in partnership with the San Francisco Department of Public Health, of which we are a part. It’s changed a lot of what we do here at the hospital. For example, we’re much more attentive to how people enter the hospital. It’s changed us in ways that are hard to enumerate.
Q: I preface this question by saying no one is suggesting your time as CEO is coming to an end, but when that day does come, what advice would you give your successor?
SE: One thing I’ve tried to do in my career, and that I admire when I see it in other people, is knowing when to be at the 30,000-foot level, really focused on strategy and the way forward, and when you need to be in the weeds. That’s one of the hardest balances to strike. If you’re not strategic enough, you’re failing your team as CEO, because our job as leaders at that level is to lead strategy. But at the same time, if you don’t recognize when there are problems in the organization that require your attention, to support leaders and remove barriers, then you’re also failing. So finding that balance is, I think, an admirable goal.
The second thing I would focus on is patience, especially in the public world we work in. There are many things we want to get done here, and it’s hard to do them quickly. But what I’ve noticed is that if you’re focused, persistent and patient, and you wait for the right opportunities, you can get things done. Especially now that I’ve been here for 10 years, I can really see changes that I might have thought weren’t possible early on.
Q: What is an issue in healthcare that deserves a brighter spotlight, and who should be shining that spotlight?
SE: All of us in healthcare these days are focused on being more efficient. Healthcare costs are a big deal for everyone, not least patients, who are really shouldering the impact of high healthcare costs. So we’re all working on that. We’re all working on how we remain afloat, bringing in new revenue and new services that could keep us afloat with the impacts of HR 1 coming down the road.
But I think a little-known topic that really deserves a much brighter light is the disparities we see in healthcare. For any issue you look at that involves patient wellness, whether it’s cancer detection, diabetes control, blood pressure control or access to care, if you really look at the data, you’re going to see disparities. Some groups are doing well, and some groups are not. And it’s not just between an organization like mine and an organization that has a much better payer mix; we also see those disparities within our organizations. So I think that’s a big deal, and the light should be shone from every angle.
At Becker's 4th Annual CEO + CFO Roundtable, taking place November 2–5 in Chicago, more than 1,500 hospital and health system executives tackle decisions that determine whether organizations thrive or merely survive: protecting margins under cost pressure, choosing where to grow, renegotiating payer relationships, stabilizing the workforce and proving real ROI on technology. This is where leaders work through them together, face-to-face. Apply for complimentary registration now.
