Scripps CMO: 'Physicians in Leadership at Health Systems can be Incredibly Instrumental'

Scripps Health has physicians in the C-Suite and leading the medical staff.

Physicians are playing key administrative leadership roles at Scripps Health.

Physicians are well-suited to succeed in administrative leadership roles. With health systems, hospitals, and physician practices nationwide facing tight finances, physicians can be pivotal in helping organizations maintain high standards of patient care with limited resources.

Ghazala Sharieff, MD, MBA, corporate senior vice president as well as chief medical and operations officer for acute care at Scripps Health, says the San Diego-based health system has a strong physician leadership infrastructure that has been strengthened over the past three years.

"Scripps President and CEO Chris Van Gorder divided the CMO role into two sides—I am the acute care CMO and Dr. Anil Keswani is the CMO on the ambulatory side. As of this year, Van Gorder has assigned me and Dr. Keswani operations responsibilities as well. We are driving to both clinical and operational excellence. What that means on my side of the house is the hospitals report up to me, including pharmacy, supply chain, and support services. So, starting with patient experience and quality, we are driving change all the way through the organization by aligning administration and physician leadership," she says.

Ghazala Sharieff, MD, MBA, corporate senior vice president as well as chief medical and operations officer for acute care at Scripps Health. Photo courtesy of Scripps Health.

Physicians play crucial leadership roles at the health system's five hospitals, Sharieff says. "We have a physician operating executive at each hospital—they are a dyad partner to our chief operating executives, so they help run the hospitals on a day-to-day basis. They report up to me. We have about 80 medical directors who report up to the physician operating executives. We truly have alignment up and down the organization. The medical directors help us with our patient experience, quality metrics, and cost control. We also have strong chiefs of staff. I meet with them at least twice a month. They are now becoming more involved in operational leadership decisions. The chiefs of staff are in charge of our medical staff. They align bylaws across all five hospitals. So, they are in charge of the physicians on the medical staff. The chiefs of staff also govern peer review if cases do not go as expected."

Physicians also have a voice in capital expenditures, she says. "One of the things we started this year is a brand new medical equipment and imaging capital process. We have our service lines, which have a dyad partner with physicians, and they prioritize the list of things we are going to need for next year because we can't have everything. They prioritize, then we have our chief operating executives, regional directors, and physician operating executives look at the list and prioritize what they think we really need for the next fiscal year. In the end, we will have one list by site that is transparent to the entire organization. We can't do this process without physician leadership."

Selecting physician leaders

The most important qualities of physician leaders are being open to change and being situational leaders, Sharieff says. "As we saw through COVID, there were times when we all had to be directive but there were also times to be collaborative. So, being fluid in your leadership style is critical as well as being able to pivot quickly. You must avoid always standing firm—just because one decision is made, that may not be the way it always has to be."

For physician leaders, having years of experience in clinical care is more important than a particular background, she says. "Physicians are not going to follow somebody who is one year out of residency. What I advise my junior physicians who want to be in leadership is to get clinical credibility first, then they can advance their leadership journey. People are not going to respect you as much if you have not been working on the frontline."

Physician leadership is often not about compensation, Sharieff says. "There are so many committees and so many ways to get involved. At Scripps, we started what we call Sprint Teams, which address issues that arise. We ask for volunteers to be on those committees, which is a great way to get known as a leader. We will pull you up if we see leadership skills. The way we grow leaders is to give them an opportunity to be involved. It's awesome when we launch a Sprint Team and there are many physician volunteers who want to be involved in the committee. Physicians want to be involved because they realize funds are tight, but they want to make sure that we make the best decisions for patient care."

Physician leaders and the healthcare system

Physician leaders at health systems can have a positive impact on the broader healthcare system, she says.

"Physicians in leadership at health systems can be incredibly instrumental—if the state and federal agencies are willing to listen to those of us truly on the frontlines. The practical experiences that physicians bring to the table are invaluable in guiding smart policy and planning decisions. In San Diego, we formed a regional chief medical officer group, which worked closely with county health officials during COVID to help coordinate COVID practices and have regional alignment. That being said, often decisions are made at levels by people who really have no insight as to what happens at the frontlines of patient care, so I hope for more collaboration, especially in the face of unfunded mandates."