CMOs: Health Systems Investing in Physician Leadership

Health systems are devoting resources to develop physicians as administrative leaders.

Health systems must be committed to developing physicians to serve in administrative leadership roles, the chief medical officers of AdventHealth and RWJBarnabas Health say.

Physicians bring a clinical perspective to administrative roles at health systems and hospitals. Once physicians take on administrative roles, they can help other administrators balance factors that drive clinical care with business priorities such as finance and operations.

"We have a strong belief that physician leadership matters, and we have a strong commitment to physician leadership all the way up to the senior roles at the health system," says Brent Box, MD, senior vice president and CMO of AdventHealth.

Physicians play leadership roles at all levels of the Altamonte Springs, Florida-based health system, he says. "It starts at the top with the chief clinical officer of the health system, who is a physician, Dr. David Moorhead," Box says. In addition, the health system's chief quality and safety officer is a physician, as is the leader of AdventHealth's hospital medicine and clinical documentation program. Several hospital CEOs are physicians, and physicians lead medical groups, service lines, and institutes, he says.

AdventHealth's market leaders make selections of physician leaders such as chief medical officers and work collaboratively with the medical staff and medical executive committees to select physician leaders at the service line level and department levels of the health system's acute care facilities, Box says.

AdventHealth looks for physician leaders who have credibility, he says. Physician leaders should possess clinical excellence, they should be respected by their peers, and they should demonstrate leadership potential at medical staff committees, the market level, or the regional level, Box says. "In addition to credibility, healthcare is team based, so we look for physicians who are oriented toward team leadership," he says.

Physician leaders are pivotal players at RWJBarnabas Health, says Andy Anderson, MD, MBA, CMO and chief quality officer of the West Orange, New Jersey-based health system. "It is important for physicians at the front lines to know there is physician leadership at the table making key decisions for hospitals, service lines, and the health system," he says.

Physicians are involved at almost every level of management at RWJBarnabas, Anderson says. They are involved at the unit level in partnership with nursing leaders. They are involved in hospital administration, including CMOs working with hospital administrators. They are involved at the health system level such as physician leaders who manage medical affairs initiatives and service line leaders.

At RWJBarnabas, physicians are generally selected for administrative roles in a process that takes time, he says. "Typically, a physician would get involved at their local level in areas including committee work or health system quality initiatives. Over time, they take on more administrative responsibilities. Ultimately, physicians become available to serve in leadership roles such as chief of a service line or CMO of a hospital."

Encouraging physician leaders

It can be a challenge to attract physicians to serve in administrative leadership roles, Box says. "We recognize the importance of physician leadership and cultivate it through several programs at the system level and the market level to generate interest in the administrative side of the health system."

Physician leaders are attracted to administrative leadership roles by having the opportunity to change healthcare in a positive way, Anderson says. "Part of that is having role models—having other physician leaders as mentors and people who have been on an administrative leadership trajectory. That helps spark interest and helps nurture physician leaders so they can take on leadership roles at the site level, the hospital level, or the health system level."

Devoting resources to physician leadership

The AdventHealth Leadership Institute, which was established several years ago, is engaged in physician leadership training, Box says. "The leaders of the AdventHealth Leadership Institute are constantly thinking about what it means to be a learning organization. The clinical team partners with our leadership institute to sponsor physician leadership training."

The health system has two other physician leadership programs, he says. In the Physician Team Leadership program, the health system sponsors a six- to seven-month leadership program specifically for physicians. The physicians are nominated for the program by their market leaders. There are 50 clinician leaders in each training cohort. In early 2024, the health will graduate its fifth cohort out of the program. The health system also has the AdventHealth Hospital Medicine Leadership Fellowship. In this program, hospital medicine leaders are trained in a partnership between the clinical team and the leadership institute. About 125 physicians have gone through this program.

RWJBarnabas has dedicated sessions with outside speakers to get physicians motivated and excited about playing leadership roles, Anderson says. The health system has also sent physicians to formal training and national meetings, where they can network and have curriculum around leadership. In addition, the health system encourages mentorship for physician leaders, he says.

RWJBarnabas has developed a manual as a resource for physician leaders, Anderson says.

Effective leadership is a fundamental driver of change and reinforces culture, the manual says. "An effective physician leader should be a role model, teacher, and coach for physician colleagues and for all members of the healthcare team. Leaders should not work in a vacuum, but rather must seek out the input of stakeholders to develop and implement the strategies, goals, and tactics to achieve exceptional outcomes for patients," the manual says.

Physician leadership training has a return on investment, Box says. "At the corporate level, we have invested the money and resources required to pay for our leadership programs because of the recognition of the value of leadership."

Related: Scripps CMO: 'Physicians in Leadership at Health Systems Can Be Incredibly Instrumental'