There is no single road to health system CEO anymore.
Transplant surgeons, human resources executives and emergency medicine physicians who spent years in the private sector are all finding their way to the corner office.
Boards that once largely defaulted to experienced sitting CEOs and COOs are increasingly open to candidates whose careers look different, according to Dan Young, senior partner at executive search firm WittKieffer.
Mr. Young breaks down the current pipeline into roughly three buckets: regional or division-level business leaders, who often bring experience with large budgets and boards; experienced COOs, especially those with a strong track record and exposure to strategic planning and external affairs; and functional leaders, a category that now includes CFOs, chief physician executives, chief information officers and chief human resources officers.
“You’re starting to see a good bit of these functional leaders, so long as they’ve had that exposure and credibility at the system level, either in their current or previous [system],” he said.
That preference for sitting CEOs is most pronounced at smaller health systems and individual hospitals, where boards tend to favor the lowered risk. Mr. Young said that appetite has been easing.
“Ten years ago when I started with WittKieffer, I think I would have seen more reliance on systems and hospitals looking for sitting CEOs, but there’s been more of an openness,” he said. “I think a lot of that’s been through the aging of our leadership in the industry and retirements.”
One role that has been evolving and could become a growing pipeline to CEO is chief administrative officer, which serves different purposes for different organizations but tends to bring experience across different support services, and operational and functional areas.
Physician leaders have drawn particular attention from boards in recent years.
“Health systems that I primarily work with are really infatuated with that notion of a physician leader who can really bring a different perspective to the table as well,” Mr. Young said.
What boards are seeking from any candidate has also shifted, he said. The emphasis that once centered on operational prowess and business acumen has moved toward a different set of qualities.
“It used to be about operational prowess, it used to be about business savvy, and now it’s more about connectivity,” Mr. Young said, describing a leader’s ability to bring disparate stakeholders and ideas into alignment. Boards increasingly tell him they want leaders with humility, adaptability and the emotional intelligence to manage through complexity, paired with a demonstrated commitment to developing the next generation of leaders internally rather than perpetually recruiting from outside.
Three CEOs with nontraditional routes to the corner office shared with Becker’s how their paths took shape — as well as advice for aspiring CEOs who do not see a clear path.
Matthew Hanley, MD, president and CEO of Gainesville-based Northeast Georgia Health System.
Dr. Hanley became CEO of Northeast Georgia Health System in March 2025. The journey moved through emergency medicine practice in Lynchburg, Va., a chief medical officer role at Charlotte, N.C.-based Atrium Health, a chief clinical officer role and regional market presidency at St. Louis-based SSM Health and three years in the private sector focused on value-based care. None of it followed a scripted plan.
That stint in the private sector gave him business rigor and a national perspective he said were difficult to build inside a not-for-profit system. Looking inside large organizations across the country also helped him see more clearly what matters most — a clarity, he said, that he brought directly into his leadership at Northeast Georgia.
Dr. Hanley described his career philosophy as making the next best choice at each inflection point, a posture shaped in part by an internationally mobile upbringing across Saudi Arabia, the U.K. and the U.S. When advising leaders who aspire to the CEO level, he steers them toward the same question.
“My question is not ‘what’s the title,’ because there’s a lot of titles that mean nothing in healthcare,” he said. “It’s ‘what are you going to learn, who are you going to be working with, what’s the story you think you’re going to be able to tell when this is done? What’s the level of accountability and responsibility that you’re going to have, and are you passionate about that?'”
He also pushes aspiring leaders to treat leadership as a discipline worthy of deliberate study, the way a physician approaches a subspecialty, and to build a small group of mentors who can offer honest guidance at each stage of the career.
Humility, he said, is the quality he returns to most.
“This is a service job, and if you’re not service-oriented, go find something else to do,” Dr. Hanley said. “We exist through and for our communities and for our patients.”
Marlon Levy, MD, CEO of Richmond, Va.-based VCU Health.
Dr. Levy spent most of his career as a transplant surgeon at VCU Health, leading the system’s transplant surgery division before serving as CMO of VCU Medical Center. He was named CEO in 2024.
The move into formal leadership was gradual, built around a conviction that growth matters more than destination. While serving as division chair, Dr. Levy pursued a master’s in business administration to develop the business fluency he needed to advocate for resources and investment in his transplant program. He carried that orientation forward.
Dr. Levy is skeptical of career plans drawn in straight lines.
“If your goal is to be the CEO, I think you have to be prepared to have lots of twists and turns in your journey, and potentially be prepared to never get there,” he said. “Rather than set your destination on a specific seat, set your destination on continuing to grow, continuing to contribute, continuing to add value to an organization.”
People advance when they are perceived to bring value, specific skills and relevant experience to an organization’s needs, he said, not because tenure entitles them to a promotion.
“The idea that it’s somebody’s turn to be promoted is flat out wrong,” he said.
The leadership traits he places highest are less about credentials than character.
“What’s important is humility and empathy,” he said. “Those are the key characteristics. Being able to put yourself in others’ shoes and understand others’ perspectives is really essential to being successful, regardless of your position, but including that of a chief executive.”
Mandy Eaton, PhD, president and CEO of Springfield, Ill.-based Memorial Health.
Dr. Eaton arrived at the CEO role through human resources, a starting point that rarely appears in the conventional pipeline. She said a deeply personal loss opened the door to a pivot she might not otherwise have made.
“In my case, a deeply personal loss — the death of my daughter — helped fuel my desire to step out of my comfort zone,” Dr. Eaton said. “Dealing with my grief gave me the courage to pivot in my career and to step into new places and new roles. And once I moved into that role, I discovered I enjoyed it, and I was good at it.”
She said her HR experience makes her acutely aware of the challenges of workforce dynamics, and it has given her an understanding of organizational behavior and human performance, plus a data-informed approach to tackling these issues, which she uses every day in her role as CEO.
That background and a doctorate in leadership inform her approach to strategy and culture.
“My leadership style is rooted in big-picture thinking, as well as the understanding of the importance of relationships and getting things done,” she said. “I believe that culture precedes strategy. And trust is really at the foundation of exceptional care delivery, as well as execution.”
For functional leaders who do not see a clear path forward, she points to deliberate growth over a safe career track.
“Look for opportunities to stretch and get involved in other projects that will expand your perspective and insights,” Dr. Eaton said. “Having a mentor also is critical — someone who can help you identify where you need to grow and how to get there. The real work of a CEO is about staying brave enough to keep learning and growing. You have to keep stretching yourself into the version of the leader that your organization needs.”
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