Could You Run Your Hospital Better Than the CEO?

— There are clear benefits to physician-run hospitals

A photo of a mature male hospital CEO standing in the doorway of a room or patients beds.
Rafid Rahman, MD, is a resident physician.

Physicians often lead medical teams. Their roles are key in making assessments of a patient's health situation and then making the most efficient, effective plan to optimize the individual's health. This is analogous to what CEOs do for hospital systems. CEOs act as leaders, and ensure that the hospital system aligns with current healthcare regulations and policies. They work to optimize the hospital's financial resources and staffing to deliver quality patient care.

Given the similarities between the two roles, it may seem natural that physicians might eventually come to run hospital systems as CEOs. Yet, only a small percentage of hospitals are run by physicians. For the health of our patients, this needs to change.

When physicians do run hospitals, patients benefit: a cross-sectional study published in 2011 found a strong positive association between higher ranked quality of hospitals with physician CEOs. While this encouraging study helps demonstrate the importance of medical training in understanding and leading patient care organizations, correlation does not imply causation. Straight out of medical school or residency, most physicians are likely not qualified for executive business roles. Why is this? Medical school curriculums don't fully educate students on the business of healthcare.

It wasn't until I began residency that I've started to see how patient volumes and the business side of healthcare impacts resource utilization and patient care. After getting an introduction to this, I'm now looking to learn more about healthcare administration so I can best communicate with my future business colleagues and advocate for my patients. I love clinical medicine and while I may eventually incorporate the business of medicine into my career, I believe that, in general, it is of the utmost importance for all clinicians to become more familiar with the system that manages their patient care.

So, how do you come to understand the business of healthcare? Formal education is a starting point. While medical schools should adjust their curriculums to provide more teaching and training in this area, it will take time to make this shift. So, other forms of continuing education can help. Given the busy schedule of physicians, beginning with a minimal-commitment introduction may be a good idea to learn a bit and see whether you'd truly enjoy being a healthcare administrator. Attending short courses to become certified or gain more experience in medical management, healthcare information and management systems, and healthcare risk management is a good idea. This will help you better understand practice management, personnel management, financial management, compliance requirements, and managed care delivery systems so you can communicate effectively with your healthcare business counterparts. Furthermore, many universities offer healthcare leadership certifications to jump-start your knowledge. As you gain more practical experience and involve yourself in leadership roles, a Master's in Business Administration or Master's in Healthcare Administration may be helpful to achieve the competence needed for executive roles in the hospital.

However, unlike medicine, you do not need to complete years of rigorous education prior to starting your desired role. In the business world, experience and practical application of your knowledge in operations management is what will help you advance your career the fastest. Therefore, it is important for the developing physician executive to start gaining practical business experience while concurrently adding educational business certifications to their repertoire. Moreover, it is unlikely that a hospital executive will immediately give an unskilled (hopeful) physician executive large operations duties from day one, but it is important to build a relationship with executives at your hospital and see which duties you can help with. This will enable you to gain their trust and become more familiar with the system. Whenever you are given a duty, think of how you can quantify (statistics, volume, time) your accomplishment before you even begin, so you will know how to communicate your success as you take on larger and larger roles. Like the stock market, past performance does not indicate future results, but your personal stock value and reputation increases as you are able to effectively communicate your capability and experience in business roles.

Physician executive hopefuls will have years of medical experience gained through medical school, residency, and attending physician roles. During or after this training, a common route into the business side of medicine is through MD/DO-required business roles such as chief medical officer, vice president of medical affairs, or medical director. These can help bridge the pathway between clinical and nonclinical roles, and help build connections with the operations suite executives. Through these medical executive roles and taking on additional hospital executive responsibilities, you'll be well on your way to transition to chief executive roles.

Given the correlation between physician-run hospitals and improved patient outcomes and satisfaction, it's clear we need more health systems run by doctors. Even if your medical school didn't provide you with much business education, consider whether you have the right personality and interests to delve deeper into this side of healthcare. You may one day be the best fit for CEO of your hospital.

Rafid Rahman, MD, is a physical medicine and rehabilitation resident at the University of Missouri School of Medicine. He is a member of MedPage Today's The Lab.