Forum Focus – Physician leadership: The implications for a transformed delivery system

This article first appeared in the February 2014 edition of H&HN magazine.

By John R. Combes, MD

As health care delivery enters a generation of transformation, effective collaboration between physicians and hospitals is more essential than ever.

Strong environmental forces are pushing the separate clinical and operational management models of today’s hospitals to find new ways to collaborate and create a clinical management structure that addresses the efficient use of scarce resources while maintaining strong clinical quality and patient focus. Increasingly, physicians are being called upon to bring their expertise to bear on the management of the clinical enterprise.

Today, approximately 5 percent of hospital leaders are physicians, and that number is expected to increase. Arguably, clinically trained leaders can offer significant insight into patient care, quality and safety issues based on their experience and training. In addition, when physician leaders partner with health care organizations, together they can drive better care coordination. However, until recently, a pathway for physicians to gain the competencies to lead a transformed delivery system was not clear.

As physicians continue to assume leadership roles and serve as drivers of the future health care enterprise, they will need to think long term, understand and be able to see the larger issues, promote collaboration, cultivate a team-based environment, and possess excellent communication and listening skills. On the journey from medical training to practice and leadership, physician leaders often receive little formal training in these skills. As the field continues to embrace leadership development of physicians, education on nonclinical areas such as visioning, managing people and finances, and population health management must and are being implemented at all levels of learning.

In July 2013, the AHA’s Physician Leadership Forum held a session in conjunction with the American College of Physician Executives on physician leadership and the implications for a transformed delivery system. The program included an overview of the changing landscape and the leadership competencies physicians will need to be effective partners with health care organizations to move toward a more accountable and efficient health delivery system. In addition, a panel of experienced physician executives shared insights on different leadership education modes and methods that have proven successful. The PLF published these proceedings, along with a literature review highlighting the need for physician leadership development and characteristics to consider for education programs. To access the full report, please visit

As the complexities of health care reform take shape, more physicians will be called upon to lead the change. Who better to address challenges faced by health care organizations today than those with experience on the front lines? It is imperative, however, that leaders have a common language and the necessary skills and training. Competencies in change management, a strong understanding of the economics of health care, team building and communication skills will be in high demand for all leaders and will comprise many physician leadership educational programs. Navigating the rapidly changing health care landscape requires engaged physician leaders who can take charge of initiatives such as medical home development, care coordination, chronic disease management, practice management, information systems implementation and strategic planning. Physicians who possess the right mix of leadership competencies will serve as effective partners with hospitals and health systems to move toward a more accountable and efficient health delivery system.

John R. Combes, MD,
is AHA senior vice president and president and chief operating officer of the AHA’s Center for Healthcare Governance.

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