Health systems and hospitals are making significant changes to leadership and educational roles in an attempt to draw more young physicians into the positions, leaders told Becker’s.
Last year, Becker’s found many systems grappling with a physician leadership shortage. Leaders said residents and new physicians seemed uninterested in leadership, teaching and even committee responsibilities.
The declining willingness came down to two things: an increased interest in work-life balance, and wanting leadership and educational roles to be integrated into their day-to-day work, rather than an added responsibility on top of their existing clinical work.
In 2026, this trend appears to be persisting.
Why leadership positions are hard to fill
Smaller hospitals are most affected by physicians’ reluctance to take on leadership roles.
“Leadership is often viewed as the pinnacle of professional success,” Joseph Ng, MD, medical director at Port Jefferson, N.Y.-based Mather Hospital, part of Northwell Health, and president of Mather Medical Group, told Becker’s. “However, in medicine, the financial differential between a leader and a practicing clinician is not as pronounced as in other industries. When you consider the additional workload and the departure from clinical practice, the trade-off may not be appealing to many physicians.”
Leadership responsibilities also require holding colleagues accountable for quality and conduct, and in a hospital, “you’re essentially on call 24/7,” Dr. Ng said. This can make leadership roles a challenging sell for younger physicians.
Many younger physicians are also less willing to adopt roles due to a lack of experience, exposure or vision for how the role can be impactful, Shawn Parekh, PharmD, CEO of Roxborough Memorial Hospital in Philadelphia, told Becker’s.
“Whether it’s a lack of exposure during residency or the absence of mentorship, these factors contribute to the perception among many physicians that leadership roles may not be a good fit,” Dr. Parekh said. “Furthermore, these roles can represent uncharted territory compared to their current employed positions, which offer defined goals, compensation and control. Physicians are astute and recognize that leadership roles can be eliminated more commonly than direct patient care positions.”
Large systems such as Renton, Wash.-based Providence are not necessarily seeing the same unwillingness or leadership shortage as smaller facilities, but physicians’ perspective on the roles still is changing.
“What I have seen is physicians being really intentional about where they want to invest their time — looking for roles with clearly delineated responsibilities, clear mechanisms of support, and a clear understanding of where their administrative role lives versus their clinical role, and how that fits into their overall balance at work and outside of it,” Brendan Lloyd, MD, chief medical officer for care delivery at Providence, told Becker’s.
How systems are filling roles anyway
Leaders are combatting diminished interest by rethinking the structure of leadership roles and how they are supported.
This includes reassessing legacy roles to mitigate burnout; splitting leadership roles into multiple positions, such as a director and assistant director; reducing administrative burdens; enhancing support systems to allow leaders to focus on both clinical and administrative responsibilities; and creating topic-based leadership opportunities for physicians who want to participate in time-limited opportunities, such as physician well-being, how technology is applied and optimizing health records.
Setting clearer expectations has also made a difference.
“We try to be thoughtful about meeting them where they’re at in terms of what they expect — making sure the roles we offer have clearly delineated responsibilities and support, and a clear picture of how their contribution will have a meaningful impact,” Dr. Lloyd said. “That includes having measurable outcomes associated with those roles.”
Current leaders are also working to help physicians understand how leadership can further their clinical impact.
“It amplifies your impact on patient care, enabling you to ensure quality, build strong cultures, and make decisions centered on patient welfare rather than the bottom line,” Dr. Ng said.
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